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Baril AA, Picard C, Labonté A, Sanchez E, Duclos C, Mohammediyan B, Breitner JCS, Villeneuve S, Poirier J. Longer sleep duration and neuroinflammation in at-risk elderly with a parental history of Alzheimer's disease. Sleep 2024:zsae081. [PMID: 38526098 DOI: 10.1093/sleep/zsae081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Indexed: 03/26/2024] Open
Abstract
STUDY OBJECTIVES While short sleep could promote neurodegeneration, long sleep may be a marker of ongoing neurodegeneration, potentially as a result of neuroinflammation. The objective was to evaluate sleep patterns with age of expected Alzheimer's disease (AD) onset and neuroinflammation. METHODS We tested 203 dementia-free participants (68.5±5.4y/o, 78M). The PREVENT-AD cohort includes older persons with a parental history of AD whose age was nearing their expected AD onset. We estimated expected years to AD onset by subtracting the participant's age from their parent's at AD dementia onset. We extracted actigraphy sleep variables of interest (times of sleep onset and morning awakening, time in bed, sleep efficiency, sleep duration) and general profiles (sleep fragmentation, phase delay, hypersomnia). CSF inflammatory biomarkers were assessed with OLINK multiplex technology. RESULTS Proximity to, or exceeding, expected age of onset was associated with a sleep profile suggestive of hypersomnia (longer sleep, later morning awakening time). This hypersomnia sleep profile was associated with higher CSF neuroinflammatory biomarkers (IL-6, MCP-1, global score). Interactions analyses revealed that some of these sleep-neuroinflammation associations were present mostly in those closer/exceeding the age of expected AD onset, APOE4 carriers, and those with better memory performance. CONCLUSIONS Proximity to, or exceeding, parental AD dementia onset was associated with a longer sleep pattern, which was related to elevated proinflammatory CSF biomarkers. We speculate that longer sleep may serve a compensatory purpose potentially triggered by neuroinflammation as individuals are approaching AD onset. Further studies should investigate whether neuroinflammatory-triggered long sleep duration could mitigate cognitive deficits.
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Affiliation(s)
- Andrée-Ann Baril
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Canada
- Department of Medicine, Université de Montréal, Montréal, Canada
| | - Cynthia Picard
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Anne Labonté
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Erlan Sanchez
- Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Catherine Duclos
- Hôpital du Sacré-Coeur de Montréal, CIUSSS-NIM, Montréal, Canada
- Department of Anesthesiology & Pain Medicine, Université de Montréal, Montréal, Canada
| | - Béry Mohammediyan
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
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St-Onge F, Chapleau M, Breitner JCS, Villeneuve S, Pichet Binette A. Tau accumulation and its spatial progression across the Alzheimer's disease spectrum. Brain Commun 2024; 6:fcae031. [PMID: 38410618 PMCID: PMC10896475 DOI: 10.1093/braincomms/fcae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/30/2023] [Accepted: 02/05/2024] [Indexed: 02/28/2024] Open
Abstract
The accumulation of tau abnormality in sporadic Alzheimer's disease is believed typically to follow neuropathologically defined Braak staging. Recent in-vivo PET evidence challenges this belief, however, as accumulation patterns for tau appear heterogeneous among individuals with varying clinical expressions of Alzheimer's disease. We, therefore, sought a better understanding of the spatial distribution of tau in the preclinical and clinical phases of sporadic Alzheimer's disease and its association with cognitive decline. Longitudinal tau-PET data (1370 scans) from 832 participants (463 cognitively unimpaired, 277 with mild cognitive impairment and 92 with Alzheimer's disease dementia) were obtained from the Alzheimer's Disease Neuroimaging Initiative. Among these, we defined thresholds of abnormal tau deposition in 70 brain regions from the Desikan atlas, and for each group of regions characteristic of Braak staging. We summed each scan's number of regions with abnormal tau deposition to form a spatial extent index. We then examined patterns of tau pathology cross-sectionally and longitudinally and assessed their heterogeneity. Finally, we compared our spatial extent index of tau uptake with a temporal meta-region of interest-a commonly used proxy of tau burden-assessing their association with cognitive scores and clinical progression. More than 80% of amyloid-beta positive participants across diagnostic groups followed typical Braak staging, both cross-sectionally and longitudinally. Within each Braak stage, however, the pattern of abnormality demonstrated significant heterogeneity such that the overlap of abnormal regions across participants averaged less than 50%, particularly in persons with mild cognitive impairment. Accumulation of tau progressed more rapidly among cognitively unimpaired and participants with mild cognitive impairment (1.2 newly abnormal regions per year) compared to participants with Alzheimer's disease dementia (less than 1 newly abnormal region per year). Comparing the association of tau pathology and cognitive performance our spatial extent index was superior to the temporal meta-region of interest for identifying associations with memory in cognitively unimpaired individuals and explained more variance for measures of executive function in patients with mild cognitive impairments and Alzheimer's disease dementia. Thus, while participants broadly followed Braak stages, significant individual regional heterogeneity of tau binding was observed at each clinical stage. Progression of the spatial extent of tau pathology appears to be fastest in cognitively unimpaired and persons with mild cognitive impairment. Exploring the spatial distribution of tau deposits throughout the entire brain may uncover further pathological variations and their correlation with cognitive impairments.
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Affiliation(s)
- Frédéric St-Onge
- Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, QC H3A 2B4, Canada
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
| | - Marianne Chapleau
- Faculty of Medicine, University of California San Francisco, San Francisco, CA 94143, USA
| | - John C S Breitner
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC H3A 1Y2, Canada
| | - Sylvia Villeneuve
- Research Center of the Douglas Mental Health University Institute, Montreal, QC H4H 1R3, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC H3A 1Y2, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, QC H3A 2B4, Canada
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Malmö 205 02, Sweden
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Baril A, Picard C, Labonté A, Sanchez E, Duclos C, Mohammediyan B, Ashton NJ, Zetterberg H, Blennow K, Breitner JCS, Villeneuve S, Poirier J. Day-to-day sleep variability with Alzheimer's biomarkers in at-risk elderly. Alzheimers Dement (Amst) 2024; 16:e12521. [PMID: 38371359 PMCID: PMC10870017 DOI: 10.1002/dad2.12521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Measuring day-to-day sleep variability might reveal unstable sleep-wake cycles reflecting neurodegenerative processes. We evaluated the association between Alzheimer's disease (AD) fluid biomarkers with day-to-day sleep variability. METHODS In the PREVENT-AD cohort, 203 dementia-free participants (age: 68.3 ± 5.4; 78 males) with a parental history of sporadic AD were tested with actigraphy and fluid biomarkers. Day-to-day variability (standard deviations over a week) was assessed for sleep midpoint, duration, efficiency, and nighttime activity count. RESULTS Lower cerebrospinal fluid (CSF) ApoE, higher CSF p-tau181/amyloid-β (Aβ)42, and higher plasma p-tau231/Aβ42 were associated with higher variability of sleep midpoint, sleep duration, and/or activity count. The associations between fluid biomarkers with greater sleep duration variability were especially observed in those that carried the APOE4 allele, mild cognitive impairment converters, or those with gray matter atrophy. DISCUSSION Day-to-day sleep variability were associated with biomarkers of AD in at-risk individuals, suggesting that unstable sleep promotes neurodegeneration or, conversely, that AD neuropathology disrupts sleep-wake cycles.
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Affiliation(s)
- Andrée‐Ann Baril
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Cynthia Picard
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Anne Labonté
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Erlan Sanchez
- Sunnybrook Research InstituteUniversity of TorontoTorontoOntarioCanada
| | - Catherine Duclos
- Hôpital du Sacré‐Coeur de MontréalCIUSSS‐NIMMontréalQuébecCanada
- Department of Anesthesiology and Pain MedicineUniversité de MontréalMontréalQuébecCanada
| | - Béry Mohammediyan
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- King's College LondonInstitute of PsychiatryPsychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience InstituteLondonUK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS FoundationLondonUK
- Centre for Age‐Related MedicineStavanger University HospitalStavangerNorway
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK
- UK Dementia Research Institute at UCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesClear Water BayHong KongChina
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience & Physiologythe Sahlgrenska Academy at the University of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - John C. S. Breitner
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Sylvia Villeneuve
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
| | - Judes Poirier
- Douglas Mental Health University InstituteMcGill UniversityMontrealQuébecCanada
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Yakoub Y, Ashton NJ, Strikwerda-Brown C, Montoliu-Gaya L, Karikari TK, Kac PR, Gonzalez-Ortiz F, Gallego-Rudolf J, Meyer PF, St-Onge F, Schöll M, Soucy JP, Breitner JCS, Zetterberg H, Blennow K, Poirier J, Villeneuve S. Longitudinal blood biomarker trajectories in preclinical Alzheimer's disease. Alzheimers Dement 2023; 19:5620-5631. [PMID: 37294682 DOI: 10.1002/alz.13318] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 04/03/2023] [Accepted: 05/11/2023] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Plasma biomarkers are altered years prior to Alzheimer's disease (AD) clinical onset. METHODS We measured longitudinal changes in plasma amyloid-beta (Aβ)42/40 ratio, pTau181, pTau231, neurofilament light chain (NfL), and glial fibrillary acidic protein (GFAP) in a cohort of older adults at risk of AD (n = 373 total, n = 229 with Aβ and tau positron emission tomography [PET] scans) considering genetic and demographic factors as possible modifiers of these markers' progression. RESULTS Aβ42/40 ratio concentrations decreased, while NfL and GFAP values increased over the 4-year follow-up. Apolipoprotein E (APOE) ε4 carriers showed faster increase in plasma pTau181 than non-carriers. Older individuals showed a faster increase in plasma NfL, and females showed a faster increase in plasma GFAP values. In the PET subsample, individuals both Aβ-PET and tau-PET positive showed faster plasma pTau181 and GFAP increase compared to PET-negative individuals. DISCUSSION Plasma markers can track biological change over time, with plasma pTau181 and GFAP markers showing longitudinal change in individuals with preclinical AD. HIGHLIGHTS Longitudinal increase of plasma pTau181 and glial fibrillary acidic protein (GFAP) can be measured in the preclinical phase of AD. Apolipoprotein E ε4 carriers experience faster increase in plasma pTau181 over time than non-carriers. Female sex showed accelerated increase in plasma GFAP over time compared to males. Aβ42/40 and pTau231 values are already abnormal at baseline in individuals with both amyloid and tau PET burden.
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Affiliation(s)
- Yara Yakoub
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Cherie Strikwerda-Brown
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Przemysław R Kac
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Fernando Gonzalez-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jonathan Gallego-Rudolf
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Pierre-François Meyer
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Frédéric St-Onge
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Jean-Paul Soucy
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- UW Department of Medicine, School of Medicine and Public Health, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Judes Poirier
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, Centre for Studies on the Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Strikwerda-Brown C, Hobbs DA, Gonneaud J, St-Onge F, Binette AP, Ozlen H, Provost K, Soucy JP, Buckley RF, Benzinger TLS, Morris JC, Villemagne VL, Doré V, Sperling RA, Johnson KA, Rowe CC, Gordon BA, Poirier J, Breitner JCS, Villeneuve S. Association of Elevated Amyloid and Tau Positron Emission Tomography Signal With Near-Term Development of Alzheimer Disease Symptoms in Older Adults Without Cognitive Impairment. JAMA Neurol 2022; 79:975-985. [PMID: 35907254 PMCID: PMC9339146 DOI: 10.1001/jamaneurol.2022.2379] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/24/2022] [Indexed: 12/12/2022]
Abstract
Importance National Institute on Aging-Alzheimer's Association (NIA-AA) workgroups have proposed biological research criteria intended to identify individuals with preclinical Alzheimer disease (AD). Objective To assess the clinical value of these biological criteria to identify older individuals without cognitive impairment who are at near-term risk of developing symptomatic AD. Design, Setting, and Participants This longitudinal cohort study used data from 4 independent population-based cohorts (PREVENT-AD, HABS, AIBL, and Knight ADRC) collected between 2003 and 2021. Participants were older adults without cognitive impairment with 1 year or more of clinical observation after amyloid β and tau positron emission tomography (PET). Median clinical follow-up after PET ranged from 1.94 to 3.66 years. Exposures Based on binary assessment of global amyloid burden (A) and a composite temporal region of tau PET uptake (T), participants were stratified into 4 groups (A+T+, A+T-, A-T+, A-T-). Presence (+) or absence (-) of neurodegeneration (N) was assessed using temporal cortical thickness. Main Outcomes and Measures Each cohort was analyzed separately. Primary outcome was clinical progression to mild cognitive impairment (MCI), identified by a Clinical Dementia Rating score of 0.5 or greater in Knight ADRC and by consensus committee review in the other cohorts. Clinical raters were blind to imaging, genetic, and fluid biomarker data. A secondary outcome was cognitive decline, based on a slope greater than 1.5 SD below the mean of an independent subsample of individuals without cognitive impairment. Outcomes were compared across the biomarker groups. Results Among 580 participants (PREVENT-AD, 128; HABS, 153; AIBL, 48; Knight ADRC, 251), mean (SD) age ranged from 67 (5) to 76 (6) years across cohorts, with between 55% (137/251) and 74% (95/128) female participants. Across cohorts, 33% to 83% of A+T+ participants progressed to MCI during follow-up (mean progression time, 2-2.72 years), compared with less than 20% of participants in other biomarker groups. Progression further increased to 43% to 100% when restricted to A+T+(N+) individuals. Cox proportional hazard ratios for progression to MCI in the A+T+ group vs other biomarker groups were all 5 or greater. Many A+T+ nonprogressors also showed longitudinal cognitive decline, while cognitive trajectories in other groups remained predominantly stable. Conclusions and Relevance The clinical prognostic value of NIA-AA research criteria was confirmed in 4 independent cohorts, with most A+T+(N+) older individuals without cognitive impairment developing AD symptoms within 2 to 3 years.
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Affiliation(s)
- Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Diana A. Hobbs
- Washington University School of Medicine, St Louis, Missouri
| | - Julie Gonneaud
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Caen, France
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Hazal Ozlen
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Karine Provost
- Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| | - Jean-Paul Soucy
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | | | - John C. Morris
- Washington University School of Medicine, St Louis, Missouri
| | | | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital, Boston
- Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Christopher C. Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, Victoria, Australia
| | - Brian A. Gordon
- Washington University School of Medicine, St Louis, Missouri
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John C. S. Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
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Meyer PF, Ashton NJ, Karikari TK, Strikwerda-Brown C, Köbe T, Gonneaud J, Pichet Binette A, Ozlen H, Yakoub Y, Simrén J, Pannee J, Lantero-Rodriguez J, Labonté A, Baker SL, Schöll M, Vanmechelen E, Breitner JCS, Zetterberg H, Blennow K, Poirier J, Villeneuve S. Plasma p-tau231, p-tau181, PET biomarkers and cognitive change in older adults. Ann Neurol 2022; 91:548-560. [PMID: 35084051 DOI: 10.1002/ana.26308] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate novel plasma p-tau231, p-tau181 as well as Aβ40 and Aβ42 assays as indicators of tau and Aβ pathologies measured with positron emission tomography (PET), and their association with cognitive change, in cognitively unimpaired older adults. METHODS In a cohort of 244 older adults at risk of AD owing to a family history of AD dementia, we measured single molecule array (Simoa)-based plasma tau biomarkers (p-tau231, p-tau181), Aβ40 and Aβ42 with immunoprecipitation mass spectrometry, and Simoa NfL. A subset of 129 participants underwent amyloid-β (18 F-NAV4694) and tau (18 F-flortaucipir) PET assessments. We investigated plasma biomarker associations with Aβ and tau PET at the global and voxel level and tested plasma biomarker combinations for improved detection of Aβ-PET positivity. We also investigated associations with 8-year cognitive change. RESULTS Plasma p-tau biomarkers correlated with flortaucipir binding in medial temporal, parietal and inferior temporal regions. P-tau231 showed further associations in lateral parietal and occipital cortices. Plasma Aβ42/40 explained more variance in global Aβ-PET binding than Aβ42 alone. P-tau231 also showed strong and widespread associations with cortical Aβ-PET binding. Combining Aβ42/40 with p-tau231 or p-tau181 allowed for good distinction between Aβ-negative and -positive participants (AUC range 0.81-0.86). Individuals with low plasma Aβ42/40 and high p-tau experienced faster cognitive decline. INTERPRETATION Plasma p-tau231 showed more robust associations with PET biomarkers than p-tau181 in pre-symptomatic individuals. The combination of p-tau and Aβ42/40 biomarkers detected early AD pathology and cognitive decline. Such markers could be used as pre-screening tools to reduce the cost of prevention trials. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Pierre-François Meyer
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Cherie Strikwerda-Brown
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Theresa Köbe
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Julie Gonneaud
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Hazal Ozlen
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Yara Yakoub
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Joel Simrén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Josef Pannee
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anne Labonté
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, United States
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - John C S Breitner
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Judes Poirier
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, Centre for Studies on Prevention of Alzheimer's Disease (StoP-AD), Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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7
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Gonneaud J, Baria AT, Pichet Binette A, Gordon BA, Chhatwal JP, Cruchaga C, Jucker M, Levin J, Salloway S, Farlow M, Gauthier S, Benzinger TLS, Morris JC, Bateman RJ, Breitner JCS, Poirier J, Vachon-Presseau E, Villeneuve S. Accelerated functional brain aging in pre-clinical familial Alzheimer's disease. Nat Commun 2021; 12:5346. [PMID: 34504080 PMCID: PMC8429427 DOI: 10.1038/s41467-021-25492-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2021] [Indexed: 01/02/2023] Open
Abstract
Resting state functional connectivity (rs-fMRI) is impaired early in persons who subsequently develop Alzheimer's disease (AD) dementia. This impairment may be leveraged to aid investigation of the pre-clinical phase of AD. We developed a model that predicts brain age from resting state (rs)-fMRI data, and assessed whether genetic determinants of AD, as well as beta-amyloid (Aβ) pathology, can accelerate brain aging. Using data from 1340 cognitively unimpaired participants between 18-94 years of age from multiple sites, we showed that topological properties of graphs constructed from rs-fMRI can predict chronological age across the lifespan. Application of our predictive model to the context of pre-clinical AD revealed that the pre-symptomatic phase of autosomal dominant AD includes acceleration of functional brain aging. This association was stronger in individuals having significant Aβ pathology.
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Affiliation(s)
- Julie Gonneaud
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Alex T Baria
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Brian A Gordon
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jasmeer P Chhatwal
- Brigham and Women's Hospital-Massachusetts General Hospital, Boston, MA, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Mathias Jucker
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes Levin
- Ludwig-Maximilians-Universität München, German Center for Neurodegenerative Diseases and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Serge Gauthier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C S Breitner
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Etienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
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8
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Tremblay-Mercier J, Madjar C, Das S, Pichet Binette A, Dyke SOM, Étienne P, Lafaille-Magnan ME, Remz J, Bellec P, Louis Collins D, Natasha Rajah M, Bohbot V, Leoutsakos JM, Iturria-Medina Y, Kat J, Hoge RD, Gauthier S, Tardif CL, Mallar Chakravarty M, Poline JB, Rosa-Neto P, Evans AC, Villeneuve S, Poirier J, Breitner JCS. Open science datasets from PREVENT-AD, a longitudinal cohort of pre-symptomatic Alzheimer's disease. Neuroimage Clin 2021; 31:102733. [PMID: 34192666 PMCID: PMC8254111 DOI: 10.1016/j.nicl.2021.102733] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 02/07/2023]
Abstract
To move Alzheimer Disease (AD) research forward it is essential to collect data from large cohorts, but also make such data available to the global research community. We describe the creation of an open science dataset from the PREVENT-AD (PResymptomatic EValuation of Experimental or Novel Treatments for AD) cohort, composed of cognitively unimpaired older individuals with a parental or multiple-sibling history of AD. From 2011 to 2017, 386 participants were enrolled (mean age 63 years old ± 5) for sustained investigation among whom 349 have retrospectively agreed to share their data openly. Repositories are findable through the unified interface of the Canadian Open Neuroscience Platform and contain up to five years of longitudinal imaging data, cerebral fluid biochemistry, neurosensory capacities, cognitive, genetic, and medical information. Imaging data can be accessed openly at https://openpreventad.loris.ca while most of the other information, sensitive by nature, is accessible by qualified researchers at https://registeredpreventad.loris.ca. In addition to being a living resource for continued data acquisition, PREVENT-AD offers opportunities to facilitate understanding of AD pathogenesis.
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Affiliation(s)
| | - Cécile Madjar
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Samir Das
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Alexa Pichet Binette
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Stephanie O M Dyke
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Pierre Étienne
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Marie-Elyse Lafaille-Magnan
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; Centre for Child Development and Mental Health, Jewish General Hospital. Montréal, QC, Canada.
| | - Jordana Remz
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada.
| | - Pierre Bellec
- CRIUGM - Université de Montréal, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada.
| | - D Louis Collins
- McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - M Natasha Rajah
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Veronique Bohbot
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | | | - Yasser Iturria-Medina
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Justin Kat
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Richard D Hoge
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada.
| | - Serge Gauthier
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McGill University Research Centre for Studies in Aging, McGill University, Montréal, QC, Canada.
| | - Christine L Tardif
- McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - M Mallar Chakravarty
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - Jean-Baptiste Poline
- McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Pedro Rosa-Neto
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University Research Centre for Studies in Aging, McGill University, Montréal, QC, Canada.
| | - Alan C Evans
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Sylvia Villeneuve
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montréal, QC, Canada; McGill University, Montréal, QC, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montréal, QC, Canada.
| | - Judes Poirier
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
| | - John C S Breitner
- StoP-AD Centre, Douglas Mental Health Institute Research Centre, Montréal, QC, Canada; McGill University, Montréal, QC, Canada.
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9
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Pichet Binette A, Vachon-Presseau É, Morris J, Bateman R, Benzinger T, Collins DL, Poirier J, Breitner JCS, Villeneuve S. Amyloid and Tau Pathology Associations With Personality Traits, Neuropsychiatric Symptoms, and Cognitive Lifestyle in the Preclinical Phases of Sporadic and Autosomal Dominant Alzheimer's Disease. Biol Psychiatry 2021; 89:776-785. [PMID: 32228870 PMCID: PMC7415608 DOI: 10.1016/j.biopsych.2020.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Major prevention trials for Alzheimer's disease (AD) are now focusing on multidomain lifestyle interventions. However, the exact combination of behavioral factors related to AD pathology remains unclear. In 2 cohorts of cognitively unimpaired individuals at risk of AD, we examined which combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle (years of education or lifetime cognitive activity) related to the pathological hallmarks of AD, amyloid-β, and tau deposits. METHODS A total of 115 older adults with a parental or multiple-sibling family history of sporadic AD (PREVENT-AD [PRe-symptomatic EValuation of Experimental or Novel Treatments for AD] cohort) underwent amyloid and tau positron emission tomography and answered several questionnaires related to behavioral attributes. Separately, we studied 117 mutation carriers from the DIAN (Dominant Inherited Alzheimer Network) study group cohort with amyloid positron emission tomography and behavioral data. Using partial least squares analysis, we identified latent variables relating amyloid or tau pathology with combinations of personality traits, neuropsychiatric symptoms, and cognitive lifestyle. RESULTS In PREVENT-AD, lower neuroticism, neuropsychiatric burden, and higher education were associated with less amyloid deposition (p = .014). Lower neuroticism and neuropsychiatric features, along with higher measures of openness and extraversion, were related to less tau deposition (p = .006). In DIAN, lower neuropsychiatric burden and higher education were also associated with less amyloid (p = .005). The combination of these factors accounted for up to 14% of AD pathology. CONCLUSIONS In the preclinical phase of both sporadic and autosomal dominant AD, multiple behavioral features were associated with AD pathology. These results may suggest potential pathways by which multidomain interventions might help delay AD onset or progression.
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Affiliation(s)
- Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Étienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Faculty of Dentistry, McGill University, Montreal, Quebec, Canada; Alan Edwards Centre for Research on Pain, McGill University, Montreal, Quebec, Canada
| | - John Morris
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Randall Bateman
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Neurology, Washington University School of Medicine, St. Louis, Missouri
| | - Tammie Benzinger
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri; Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
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10
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Köbe T, Binette AP, Vogel JW, Meyer PF, Breitner JCS, Poirier J, Villeneuve S. Vascular risk factors are associated with a decline in resting-state functional connectivity in cognitively unimpaired individuals at risk for Alzheimer's disease: Vascular risk factors and functional connectivity changes. Neuroimage 2021; 231:117832. [PMID: 33549747 DOI: 10.1016/j.neuroimage.2021.117832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 01/25/2021] [Accepted: 01/27/2021] [Indexed: 12/12/2022] Open
Abstract
Resting-state functional connectivity is suggested to be cross-sectionally associated with both vascular burden and Alzheimer's disease (AD) pathology. However, evidence is lacking regarding longitudinal changes in functional connectivity. This study includes 247 cognitively unimpaired individuals with a family history of sporadic AD (185 women/ 62 men; mean [SD] age of 63 [5.3] years). Plasma total-, HDL-, and LDL-cholesterol and systolic and diastolic blood pressure were measured at baseline. Global (whole-brain) brain functional connectivity and connectivity from canonical functional networks were computed from resting-state functional MRI obtained at baseline and ~3.5 years of annual follow-ups, using a predefined functional parcellation. A subsample underwent Aβ- and tau-PET (n=91). Linear mixed-effects models demonstrated that global functional connectivity increased over time across the entire sample. In contrast, higher total-cholesterol and LDL-cholesterol levels were associated with greater reduction of functional connectivity in the default-mode network over time. In addition, higher diastolic blood pressure was associated with global functional connectivity reduction. The associations were similar when the analyses were repeated using two other functional brain parcellations. Aβ and tau deposition in the brain were not associated with changes in functional connectivity over time in the subsample. These findings provide evidence that vascular burden is associated with a decrease in functional connectivity over time in older adults with elevated risk for AD. Future studies are needed to determine if the impact of vascular risk factors on functional brain changes precede the impact of AD pathology on functional brain changes.
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Affiliation(s)
- Theresa Köbe
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; German Center for Neurodegenerative Diseases (DZNE), 01307, Dresden, Germany.
| | - Alexa Pichet Binette
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Jacob W Vogel
- Montreal Neurological Institute, McGill University, H3A 2B4, Montreal, QC, Canada
| | - Pierre-François Meyer
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, McGill University, H3A 1A1, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StoP-AD) Centre, H4H 1R3, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University, H3A 2B4, Montreal, Quebec, Canada.
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11
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Gonneaud J, Bedetti C, Pichet Binette A, Benzinger TLS, Morris JC, Bateman RJ, Poirier J, Breitner JCS, Villeneuve S. Association of education with Aβ burden in preclinical familial and sporadic Alzheimer disease. Neurology 2020; 95:e1554-e1564. [PMID: 32759192 PMCID: PMC7713743 DOI: 10.1212/wnl.0000000000010314] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 03/23/2020] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE To determine whether years of education and the ε4 risk allele at APOE influence β-amyloid (Aβ) pathology similarly in asymptomatic individuals with a family history of sporadic Alzheimer disease (AD) and presymptomatic autosomal dominant AD mutation carriers. METHODS We analyzed cross-sectional data from 106 asymptomatic individuals with a parental history of sporadic AD (PREVENT-AD cohort; age 67.28 ± 4.72 years) and 117 presymptomatic autosomal dominant AD mutation carriers (DIAN cohort; age 35.04 ± 9.43 years). All participants underwent structural MRI and Aβ-PET imaging. In each cohort we investigated the influence of years of education, APOE ε4 status, and their interaction on Aβ-PET. RESULTS Asymptomatic individuals with a parental history of sporadic AD showed increased Aβ burden associated with APOE ε4 carriage and lower level of education, but no interaction between these. Presymptomatic mutation carriers of autosomal dominant AD showed no relation between APOE ε4 and Aβ burden, but increasing level of education was associated with reduced Aβ burden. The association between educational attainment and Aβ burden was similar in the 2 cohorts. CONCLUSIONS While the APOE ε4 allele confers increased tendency toward Aβ accumulation in sporadic AD only, protective environmental factors, like increased education, may promote brain resistance against Aβ pathology in both sporadic and autosomal dominant AD.
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Affiliation(s)
- Julie Gonneaud
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO.
| | - Christophe Bedetti
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - Alexa Pichet Binette
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - Tammie L S Benzinger
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - John C Morris
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - Randall J Bateman
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - Judes Poirier
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - John C S Breitner
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO
| | - Sylvia Villeneuve
- From the Department of Psychiatry (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), McGill University; Douglas Mental Health University Institute (J.G., C.B., A.P.B., J.P., J.C.S.B., S.V.), StoP-AD Centre, Montreal, Canada; Knight Alzheimer's Disease Research Center (T.L.S.B., J.C.M., R.J.B.); and Washington University School of Medicine (T.L.S.B., J.C.M., R.J.B.), St. Louis, MO.
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12
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Meyer PF, Pichet Binette A, Gonneaud J, Breitner JCS, Villeneuve S. Characterization of Alzheimer Disease Biomarker Discrepancies Using Cerebrospinal Fluid Phosphorylated Tau and AV1451 Positron Emission Tomography. JAMA Neurol 2020; 77:508-516. [PMID: 31961372 DOI: 10.1001/jamaneurol.2019.4749] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Fluid and imaging biomarkers of Alzheimer disease (AD) are often used interchangeably, but some biomarkers may reveal earlier stages of disease. Objective To characterize individuals with tau abnormality indicated by cerebrospinal fluid (CSF) assay or positron emission tomography (PET). Design, Setting, and Participants Between 2010 and 2019, 322 participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI) underwent CSF and PET assessments of tau pathology. Data-driven, clinically relevant thresholds for CSF phosphorylated tau (P-tau) (≥26.64 pg/mL) and flortaucipir-PET meta-regions of interest (ROI) (standard uptake value ratio ≥1.37) indicated participants' tau status as CSF-/PET-, CSF+/PET-, CSF-/PET+, and CSF+/PET+. Of 1659 ADNI participants with a CSF or flortaucipir assessment, 588 had both measures (1071 were excluded). Among these, 266 were further excluded because they did not have flortaucipir and CSF testing within less than 25 months, leaving 322 for analysis. Of these, 213 were cognitively unimpaired (CU); 98 had mild cognitive impairment (MCI); and 11 had AD dementia. Main Outcomes and Measures We compared tau-positive vs tau-negative groups as indicated by either modality or demographic and clinical variables, amyloid β-PET burden, and flortaucipir-PET binding across Braak stage-related ROIs. We also compared 5-year rates of CSF P-tau accumulation and cognitive decline prior to flortaucipir-PET scanning. Results Among the 322 study participants, 180 were women (56%), and the mean (SD) age was 73.08 (7.37) years. Two hundred ten participants were CSF-/PET- (65%); 63 were CSF+/PET- (19.5%); 15 were CSF-/PET+ (4.6%); and 34 were CSF+/PET+ (10.5%). Most CSF-/PET+ participants had measures near CSF or PET tau thresholds. The CSF+/PET- participants showed faster 5-year accrual of P-tau and increased flortaucipir-PET binding in early Braak ROIs but similar memory decline compared with CSF-/PET- participants. Tau-positive individuals by either measure showed increased amyloid β-PET burden. All CSF+/PET+ individuals were amyloid-positive, and 26 had MCI or AD dementia (76%). Compared with the CSF-/PET- group, CSF+/PET+ individuals had experienced faster 5-year accrual of CSF P-tau and decline in memory and executive function, resulting in reduced cognitive abilities at the time of flortaucipir-PET assessment. Conclusions and Relevance Suprathreshold CSF P-tau without flortaucipir-PET abnormality may indicate a stage of AD development characterized by early tau abnormality without measurable loss in cognitive performance. Persons with both tau CSF and PET abnormality appear to have reduced cognitive capacities resulting from faster antecedent cognitive decline. Elevation of CSF P-tau appears to precede flortaucipir-PET positivity in the progression of AD pathogenesis and related cognitive decline.
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Affiliation(s)
- Pierre-François Meyer
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Julie Gonneaud
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
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Köbe T, Gonneaud J, Pichet Binette A, Meyer PF, McSweeney M, Rosa-Neto P, Breitner JCS, Poirier J, Villeneuve S. Association of Vascular Risk Factors With β-Amyloid Peptide and Tau Burdens in Cognitively Unimpaired Individuals and Its Interaction With Vascular Medication Use. JAMA Netw Open 2020; 3:e1920780. [PMID: 32031648 DOI: 10.1001/jamanetworkopen.2019.20780] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Vascular risk factors are associated with increased risk of Alzheimer disease (AD), but it is unclear whether there is a direct association of these risk factors with AD pathogenesis. OBJECTIVES To assess the associations of vascular risk factors with AD pathogenesis in asymptomatic individuals, and to test whether this association is moderated among individuals who use vascular medications. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from the Presymptomatic Evaluation of Experimental or Novel Treatments for Alzheimer Disease (PREVENT-AD) cohort of cognitively unimpaired individuals aged 55 to 82 years with a parental or multiple-sibling history of sporadic AD, who were recruited via advertisement from the greater Montreal, Quebec, Canada, metropolitan area. Participants were enrolled between September 9, 2011, to May, 3, 2017, and stratified by use vs no use of vascular medications. Data were analyzed July 1, 2018, to April 5, 2019. MAIN OUTCOMES AND MEASURES Principal analyses investigated associations of total, high-density lipoprotein, and low-density lipoprotein cholesterol levels, systolic and diastolic blood pressure, pulse pressure, and a combined vascular risk score (measured using the Framingham Coronary Risk Profile) with global β-amyloid peptide (Aβ) and entorhinal tau burden as measured by positron emission tomography (PET). Potential moderating associations of use of vascular medications with these associations were examined. Secondary similar analyses considered cerebrospinal fluid (CSF) Aβ1-42 and phosphorylated tau levels. RESULTS Among 215 participants (mean [SD] age, 62.3 [5.0] years; 161 [74.8%] women), 120 participants underwent PET, including 75 participants (62.5%) who were not using vascular medications, and 162 participants underwent CSF assessment, including 113 participants (69.8%) who were not using vascular medications. There was an overlap of 67 participants who underwent PET and CSF assessment. Interaction analyses showed that among participants not using vascular medications, higher Aβ deposition as measured by PET was associated with higher total cholesterol level (β = -0.002 [SE, 0.001]; P = .02), low-density lipoprotein cholesterol level (β = -0.002 [SE, 0.001]; P = .006), systolic blood pressure (β = -0.006 [SE, 0.002]; P = .02), pulse pressure (β = -0.007 [SE, 0.002]; P = .004), and Framingham Coronary Risk Profile score (β = -0.038 [SE, 0.011]; P = .001), but such associations were absent in participants who used vascular medications. Interactions were also found between vascular medication use and high-density lipoprotein cholesterol (β = -3.302 [SE, 1.540]; P = .03), low-density lipoprotein cholesterol (β = 1.546 [SE, 0.754]; P = .04), and Framingham Coronary Risk Profile score (β = 23.102 [SE, 10.993]; P = .04) on Aβ1-42 burden as measured in CSF. Higher Framingham Coronary Risk Profile scores were associated with reduced tau burden among participants using vascular medications but not among participants not using vascular medications (interaction, β = -0.010 [SE, 0.005]; P = .046). CONCLUSIONS AND RELEVANCE These findings corroborate previously reported associations of vascular risk factors with Aβ burden but not tau burden. However, these associations were found only among individuals who were not using vascular medications. These results suggest that medication use or other control of vascular risk factors should be considered in Alzheimer disease prevention trials.
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Affiliation(s)
- Theresa Köbe
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Julie Gonneaud
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Pierre-François Meyer
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Melissa McSweeney
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
| | - John C S Breitner
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- Studies on Prevention of Alzheimer's Disease Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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14
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Pichet Binette A, Gonneaud J, Vogel JW, La Joie R, Rosa-Neto P, Collins DL, Poirier J, Breitner JCS, Villeneuve S, Vachon-Presseau E. Morphometric network differences in ageing versus Alzheimer's disease dementia. Brain 2020; 143:635-649. [PMID: 32040564 PMCID: PMC7009528 DOI: 10.1093/brain/awz414] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 07/04/2019] [Revised: 10/21/2019] [Accepted: 11/15/2019] [Indexed: 12/21/2022] Open
Abstract
Age being the main risk factor for Alzheimer's disease, it is particularly challenging to disentangle structural changes related to normal brain ageing from those specific to Alzheimer's disease. Most studies aiming to make this distinction focused on older adults only and on a priori anatomical regions. Drawing on a large, multi-cohort dataset ranging from young adults (n = 468; age range 18-35 years), to older adults with intact cognition (n = 431; age range 55-90 years) and with Alzheimer's disease (n = 50 with late mild cognitive impairment and 71 with Alzheimer's dementia, age range 56-88 years), we investigated grey matter organization and volume differences in ageing and Alzheimer's disease. Using independent component analysis on all participants' structural MRI, we first derived morphometric networks and extracted grey matter volume in each network. We also derived a measure of whole-brain grey matter pattern organization by correlating grey matter volume in all networks across all participants from the same cohort. We used logistic regressions and receiver operating characteristic analyses to evaluate how well grey matter volume in each network and whole-brain pattern could discriminate between ageing and Alzheimer's disease. Because increased heterogeneity is often reported as one of the main features characterizing brain ageing, we also evaluated interindividual heterogeneity within morphometric networks and across the whole-brain organization in ageing and Alzheimer's disease. Finally, to investigate the clinical validity of the different grey matter features, we evaluated whether grey matter volume or whole-brain pattern was related to clinical progression in cognitively normal older adults. Ageing and Alzheimer's disease contributed additive effects on grey matter volume in nearly all networks, except frontal lobe networks, where differences in grey matter were more specific to ageing. While no networks specifically discriminated Alzheimer's disease from ageing, heterogeneity in grey matter volumes across morphometric networks and in the whole-brain grey matter pattern characterized individuals with cognitive impairments. Preservation of the whole-brain grey matter pattern was also related to lower risk of developing cognitive impairment, more so than grey matter volume. These results suggest both ageing and Alzheimer's disease involve widespread atrophy, but that the clinical expression of Alzheimer's disease is uniquely associated with disruption of morphometric organization.
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Affiliation(s)
- Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1Y2, Canada
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - Julie Gonneaud
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - Jacob W Vogel
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Qc, H3A 2B4, Canada
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Pedro Rosa-Neto
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1Y2, Canada
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - D Louis Collins
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Qc, H3A 2B4, Canada
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1Y2, Canada
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - John C S Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1Y2, Canada
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1Y2, Canada
- Douglas Mental Health University Institute, Montreal, Qc, H4H 1R3, Canada
- McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Qc, H3A 2B4, Canada
| | - Etienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, Qc, H3A 1G1, Canada
- Faculty of Dentistry, McGill University, Montreal, Qc, H3A 1G1, Canada
- Alan Edwards Centre for Research on Pain (AECRP), McGill University, Montreal, Qc, H3A 1G1, Canada
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15
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Villeneuve S, Vogel JW, Gonneaud J, Pichet Binette A, Rosa-Neto P, Gauthier S, Bateman RJ, Fagan AM, Morris JC, Benzinger TLS, Johnson SC, Breitner JCS, Poirier J. Proximity to Parental Symptom Onset and Amyloid-β Burden in Sporadic Alzheimer Disease. JAMA Neurol 2019; 75:608-619. [PMID: 29482212 DOI: 10.1001/jamaneurol.2017.5135] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Alzheimer disease (AD) develops during several decades. Presymptomatic individuals might be the best candidates for clinical trials, but their identification is challenging because they have no symptoms. Objective To assess whether a sporadic parental estimated years to symptom onset calculation could be used to identify information about amyloid-β (Aβ) levels in asymptomatic individuals with a parental history of AD dementia. Design, Setting, and Participants This cohort study analyzed Aβ1-42 in cerebrospinal fluid (CSF) specimens from 101 cognitively normal individuals who had a lumbar puncture as part of the Presymptomatic Evaluation of Novel or Experimental Treatments for Alzheimer Disease (PREVENT-AD) cohort from September 1, 2011, through November 30, 2016 (374 participants were enrolled in the cohort during this period). The study estimated each participant's proximity to his/her parent's symptom onset by subtracting the index relative's onset age from his/her current age. The association between proximity to parental symptom onset and Aβ levels was then assessed using apolipoprotein E ε4 (APOE4) status and sex as interactive terms. These analyses were performed again in 2 independent cohorts using CSF and Pittsburgh compound B carbon 11-labeled positron emission tomography (PIB-PET) Aβ biomarkers: the Adult Children Study (ACS) and the Wisconsin Registry for Alzheimer Prevention (WRAP) cohorts. Main Outcomes and Measures The association between proximity to parental symptom onset and Aβ burden in asymptomatic individuals with a parental history of sporadic AD. Results The present analysis included a subset of 101 PREVENT-AD individuals (mean [SD] age, 61.8 [5.1] years; 30 [29.7%] male), 128 ACS participants (112 participants underwent CSF measurement: mean [SD] age, 63.4 [5.1] years; 31 [27.7%] male; and 107 underwent PIB-PET: mean [SD] age, 64.6 [5.3] years; 27 [25.2%] male), and 135 WRAP participants (85 participants underwent CSF measurement: mean [SD] age, 59.9 [6.0] years; 27 [31.8%] male; and 135 underwent PIB-PET: mean [SD] age, 59.6 [6.1] years; 43 [31.9%] male). In the PREVENT-AD cohort, individuals approaching their parent's onset age had lower CSF Aβ1-42 levels (range, 402-1597; B = -9.09, P = .04). This association was stronger in APOE4 carriers (B = -17.9, P = .03) and women (B = -19.8, P = .02). In the ACS cohort, the main association was replicated using PIB-PET data, and the sex interaction was replicated using CSF and PIB-PET data. In the WRAP cohort, the results were not replicated using cross-sectional data, but the main association and the APOE interaction were replicated using PIB-PET longitudinal data. Conclusions and Relevance These results suggest that proximity to parental symptom onset may help estimate Aβ biomarker changes in women or APOE4 carrier asymptomatic individuals with a parental history of sporadic AD.
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Affiliation(s)
- Sylvia Villeneuve
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Jacob W Vogel
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Julie Gonneaud
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Serge Gauthier
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison.,Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - John C S Breitner
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada.,McGill Centre for Integrative Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
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16
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Tullo S, Patel R, Devenyi GA, Salaciak A, Bedford SA, Farzin S, Wlodarski N, Tardif CL, Breitner JCS, Chakravarty MM. MR-based age-related effects on the striatum, globus pallidus, and thalamus in healthy individuals across the adult lifespan. Hum Brain Mapp 2019; 40:5269-5288. [PMID: 31452289 PMCID: PMC6864890 DOI: 10.1002/hbm.24771] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 07/17/2019] [Accepted: 08/05/2019] [Indexed: 01/18/2023] Open
Abstract
While numerous studies have used magnetic resonance imaging (MRI) to elucidate normative age‐related trajectories in subcortical structures across the human lifespan, there exists substantial heterogeneity among different studies. Here, we investigated the normative relationships between age and morphology (i.e., volume and shape), and microstructure (using the T1‐weighted/T2‐weighted [T1w/T2w] signal ratio as a putative index of myelin and microstructure) of the striatum, globus pallidus, and thalamus across the adult lifespan using a dataset carefully quality controlled, yielding a final sample of 178 for the morphological analyses, and 162 for the T1w/T2w analyses from an initial dataset of 253 healthy subjects, aged 18–83. In accordance with previous cross‐sectional studies of adults, we observed age‐related volume decrease that followed a quadratic relationship between age and bilateral striatal and thalamic volumes, and a linear relationship in the globus pallidus. Our shape indices consistently demonstrated age‐related posterior and medial areal contraction bilaterally across all three structures. Beyond morphology, we observed a quadratic inverted U‐shaped relationship between T1w/T2w signal ratio and age, with a peak value occurring in middle age (at around 50 years old). After permutation testing, the Akaike information criterion determined age relationships remained significant for the bilateral globus pallidus and thalamus, for both the volumetric and T1w/T2w analyses. Our findings serve to strengthen and expand upon previous volumetric analyses by providing a normative baseline of morphology and microstructure of these structures to which future studies investigating patients with various disorders can be compared.
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Affiliation(s)
- Stephanie Tullo
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada.,Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Raihaan Patel
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada.,Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada
| | - Gabriel A Devenyi
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Alyssa Salaciak
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Saashi A Bedford
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada.,Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Sarah Farzin
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Nancy Wlodarski
- Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - Christine L Tardif
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
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- Centre for the Studies on the Prevention of AD, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - John C S Breitner
- Centre for the Studies on the Prevention of AD, Douglas Mental Health University Institute, Verdun, Quebec, Canada
| | - M Mallar Chakravarty
- Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada.,Computational Brain Anatomy Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada.,Department of Biological and Biomedical Engineering, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Meyer PF, Labonté A, Rosa-Neto P, Poirier J, Breitner JCS. No apparent effect of naproxen on CSF markers of innate immune activation. Ann Clin Transl Neurol 2019; 6:1127-1133. [PMID: 31211178 PMCID: PMC6562029 DOI: 10.1002/acn3.788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 02/14/2019] [Revised: 04/10/2019] [Accepted: 04/21/2019] [Indexed: 01/05/2023] Open
Abstract
We studied 78 participants having a parental or multiple‐sibling history of Alzheimer’s disease (AD) in a two‐year randomized placebo‐controlled trial of naproxen 220 mg b.i.d. for mitigation of early AD pathogenesis. Naproxen was detected in cerebrospinal fluid at concentrations ~100 times lower than in plasma, but produced negligible change in immune markers. The repeated lack of benefit in AD prevention trials using naproxen and related drugs may reflect limited CNS permeability, lack of expected drug effects, or both. These findings suggest reconsideration of implications from results of AD prevention trials using anti‐inflammatory drugs.
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Affiliation(s)
- Pierre-François Meyer
- Faculty of Medicine McGill University Montréal Québec Canada.,Center for Studies on the Prevention of Alzheimer's Disease (StoP-AD) Douglas Mental Health University Institute Montréal Québec Canada
| | - Anne Labonté
- Center for Studies on the Prevention of Alzheimer's Disease (StoP-AD) Douglas Mental Health University Institute Montréal Québec Canada.,Douglas Mental Health University Institute Research Centre Montréal Québec Canada
| | - Pedro Rosa-Neto
- Faculty of Medicine McGill University Montréal Québec Canada.,Center for Studies on the Prevention of Alzheimer's Disease (StoP-AD) Douglas Mental Health University Institute Montréal Québec Canada.,Douglas Mental Health University Institute Research Centre Montréal Québec Canada.,McGill Centre for Studies in Aging Douglas Mental Health University Institute Montréal Québec Canada
| | - Judes Poirier
- Faculty of Medicine McGill University Montréal Québec Canada.,Center for Studies on the Prevention of Alzheimer's Disease (StoP-AD) Douglas Mental Health University Institute Montréal Québec Canada.,Douglas Mental Health University Institute Research Centre Montréal Québec Canada
| | - John C S Breitner
- Faculty of Medicine McGill University Montréal Québec Canada.,Center for Studies on the Prevention of Alzheimer's Disease (StoP-AD) Douglas Mental Health University Institute Montréal Québec Canada.,Douglas Mental Health University Institute Research Centre Montréal Québec Canada
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Tuwaig M, Savard M, Jutras B, Poirier J, Collins DL, Rosa-Neto P, Fontaine D, Breitner JCS. Deficit in Central Auditory Processing as a Biomarker of Pre-Clinical Alzheimer's Disease. J Alzheimers Dis 2018; 60:1589-1600. [PMID: 28984583 PMCID: PMC5757649 DOI: 10.3233/jad-170545] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prevention of dementia due to Alzheimer's disease (d/AD) requires interventions that slow the disease process prior to symptom onset. To develop such interventions, one needs metrics that assess pre-symptomatic disease progression. Familiar measures of progression include cerebrospinal fluid (CSF) biochemical and imaging analyses, as well as cognitive testing. Changes in the latter can sometimes be difficult to distinguish from effects of "normal" aging. A different approach involves testing of "central auditory processing" (CAP), which enables comprehension of auditory stimuli amidst a distracting background (e.g., conversation in a noisy bar or restaurant). Such comprehension is often impaired in d/AD. Similarly, effortful or diminished auditory comprehension is sometimes reported by cognitively healthy elders, raising the possibility that CAP deficit may be a marker of pre-symptomatic AD. In 187 cognitively and physically healthy members of the aging, AD family history-positive PREVENT-AD cohort, we therefore evaluated whether CAP deficits were associated with known markers of AD neurodegeneration. Such markers included CSF tau concentrations and magnetic resonance imaging volumetric and cortical thickness measures in key AD-related regions. Adjusting for age, sex, education, pure-tone hearing, and APOEɛ4 status, we observed a persistent relationship between CAP scores and CSF tau levels, entorhinal and hippocampal cortex volumes, cortical thickness, and deficits in cognition (Repeatable Battery for Assessment of Neuropsychological Status total score, and several of its index scales). These cross-sectional observations suggest that CAP may serve as a novel metric for pre-symptomatic AD pathogenesis. They are therefore being followed up longitudinally with larger samples.
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Affiliation(s)
- Miranda Tuwaig
- Douglas Mental Health University Institute, Montreal, QC, Canada.,McGill University, Montreal, QC, Canada
| | - Mélissa Savard
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Benoît Jutras
- Sainte-Justine Hospital Pediatric Research Centre, Montreal, QC, Canada.,Université de Montréal, Montreal, QC, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, Montreal, QC, Canada.,McGill University, Montreal, QC, Canada
| | - D Louis Collins
- Douglas Mental Health University Institute, Montreal, QC, Canada.,McGill University, Montreal, QC, Canada
| | - Pedro Rosa-Neto
- Douglas Mental Health University Institute, Montreal, QC, Canada.,McGill University, Montreal, QC, Canada
| | - David Fontaine
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, Montreal, QC, Canada.,McGill University, Montreal, QC, Canada
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Vogel JW, Vachon-Presseau E, Pichet Binette A, Tam A, Orban P, La Joie R, Savard M, Picard C, Poirier J, Bellec P, Breitner JCS, Villeneuve S. Brain properties predict proximity to symptom onset in sporadic Alzheimer's disease. Brain 2018; 141:1871-1883. [PMID: 29688388 PMCID: PMC5972641 DOI: 10.1093/brain/awy093] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Revised: 02/20/2018] [Accepted: 02/25/2018] [Indexed: 11/16/2022] Open
Abstract
See Tijms and Visser (doi:10.1093/brain/awy113) for a scientific commentary on this article.Alzheimer's disease is preceded by a lengthy 'preclinical' stage spanning many years, during which subtle brain changes occur in the absence of overt cognitive symptoms. Predicting when the onset of disease symptoms will occur is an unsolved challenge in individuals with sporadic Alzheimer's disease. In individuals with autosomal dominant genetic Alzheimer's disease, the age of symptom onset is similar across generations, allowing the prediction of individual onset times with some accuracy. We extend this concept to persons with a parental history of sporadic Alzheimer's disease to test whether an individual's symptom onset age can be informed by the onset age of their affected parent, and whether this estimated onset age can be predicted using only MRI. Structural and functional MRIs were acquired from 255 ageing cognitively healthy subjects with a parental history of sporadic Alzheimer's disease from the PREVENT-AD cohort. Years to estimated symptom onset was calculated as participant age minus age of parental symptom onset. Grey matter volume was extracted from T1-weighted images and whole-brain resting state functional connectivity was evaluated using degree count. Both modalities were summarized using a 444-region cortical-subcortical atlas. The entire sample was divided into training (n = 138) and testing (n = 68) sets. Within the training set, individuals closer to or beyond their parent's symptom onset demonstrated reduced grey matter volume and altered functional connectivity, specifically in regions known to be vulnerable in Alzheimer's disease. Machine learning was used to identify a weighted set of imaging features trained to predict years to estimated symptom onset. This feature set alone significantly predicted years to estimated symptom onset in the unseen testing data. This model, using only neuroimaging features, significantly outperformed a similar model instead trained with cognitive, genetic, imaging and demographic features used in a traditional clinical setting. We next tested if these brain properties could be generalized to predict time to clinical progression in a subgroup of 26 individuals from the Alzheimer's Disease Neuroimaging Initiative, who eventually converted either to mild cognitive impairment or to Alzheimer's dementia. The feature set trained on years to estimated symptom onset in the PREVENT-AD predicted variance in time to clinical conversion in this separate longitudinal dataset. Adjusting for participant age did not impact any of the results. These findings demonstrate that years to estimated symptom onset or similar measures can be predicted from brain features and may help estimate presymptomatic disease progression in at-risk individuals.
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Affiliation(s)
- Jacob W Vogel
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
| | | | - Alexa Pichet Binette
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
| | - Angela Tam
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
| | - Pierre Orban
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Renaud La Joie
- Memory and Aging Center, University of California, San Francisco, California, USA
| | - Mélissa Savard
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
| | - Cynthia Picard
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
- McGill University and Genome Quebec Innovation Centre, Quebec, Canada
| | - Pierre Bellec
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada
- Department of Computer Science and Operations Research, University of Montreal, Montreal, QC, Canada
| | - John C S Breitner
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Centre for the Studies on Prevention of Alzheimer’s Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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20
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Lafaille-Magnan ME, Breitner JCS. Author response: Odor identification as a biomarker of preclinical AD in older adults at risk. Neurology 2018; 90:343. [PMID: 29440548 DOI: 10.1212/wnl.0000000000004959] [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: 11/15/2022] Open
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21
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Picard C, Julien C, Frappier J, Miron J, Théroux L, Dea D, Breitner JCS, Poirier J. Alterations in cholesterol metabolism-related genes in sporadic Alzheimer's disease. Neurobiol Aging 2018; 66:180.e1-180.e9. [PMID: 29503034 DOI: 10.1016/j.neurobiolaging.2018.01.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 01/26/2018] [Accepted: 01/28/2018] [Indexed: 11/27/2022]
Abstract
Genome-wide association studies have identified several cholesterol metabolism-related genes as top risk factors for late-onset Alzheimer's disease (LOAD). We hypothesized that specific genetic variants could act as disease-modifying factors by altering the expression of those genes. Targeted association studies were conducted with available genomic, transcriptomic, proteomic, and histopathological data from 3 independent cohorts: the Alzheimer's Disease Neuroimaging Initiative (ADNI), the Quebec Founder Population (QFP), and the United Kingdom Brain Expression Consortium (UKBEC). First, a total of 273 polymorphisms located in 17 cholesterol metabolism-related loci were screened for associations with cerebrospinal fluid LOAD biomarkers beta amyloid, phosphorylated tau, and tau (from the ADNI) and with amyloid plaque and tangle densities (from the QFP). Top polymorphisms were then contrasted with gene expression levels measured in 134 autopsied healthy brains (from the UKBEC). In the end, only SREBF2 polymorphism rs2269657 showed significant dual associations with LOAD pathological biomarkers and gene expression levels. Furthermore, SREBF2 expression levels measured in LOAD frontal cortices inversely correlated with age at death; suggesting a possible influence on survival rate.
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Affiliation(s)
- Cynthia Picard
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cédric Julien
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Josée Frappier
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Justin Miron
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Louise Théroux
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Doris Dea
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | | | - John C S Breitner
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montreal, Quebec, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.
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22
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Verfaillie SCJ, Pichet Binette A, Vachon-Presseau E, Tabrizi S, Savard M, Bellec P, Ossenkoppele R, Scheltens P, van der Flier WM, Breitner JCS, Villeneuve S. Subjective Cognitive Decline Is Associated With Altered Default Mode Network Connectivity in Individuals With a Family History of Alzheimer's Disease. Biol Psychiatry Cogn Neurosci Neuroimaging 2017; 3:463-472. [PMID: 29735156 DOI: 10.1016/j.bpsc.2017.11.012] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/20/2017] [Accepted: 11/22/2017] [Indexed: 01/03/2023]
Abstract
BACKGROUND Both subjective cognitive decline (SCD) and a family history of Alzheimer's disease (AD) portend risk of brain abnormalities and progression to dementia. Posterior default mode network (pDMN) connectivity is altered early in the course of AD. It is unclear whether SCD predicts similar outcomes in cognitively normal individuals with a family history of AD. METHODS We studied 124 asymptomatic individuals with a family history of AD (age 64 ± 5 years). Participants were categorized as having SCD if they reported that their memory was becoming worse (SCD+). We used extensive neuropsychological assessment to investigate five different cognitive domain performances at baseline (n = 124) and 1 year later (n = 59). We assessed interconnectivity among three a priori defined ROIs: pDMN, anterior ventral DMN, medial temporal memory system (MTMS), and the connectivity of each with the rest of brain. RESULTS Sixty-eight (55%) participants reported SCD. Baseline cognitive performance was comparable between groups (all false discovery rate-adjusted p values > .05). At follow-up, immediate and delayed memory improved across groups, but the improvement in immediate memory was reduced in SCD+ compared with SCD- (all false discovery rate-adjusted p values < .05). When compared with SCD-, SCD+ subjects showed increased pDMN-MTMS connectivity (false discovery rate-adjusted p < .05). Higher connectivity between the MTMS and the rest of the brain was associated with better baseline immediate memory, attention, and global cognition, whereas higher MTMS and pDMN-MTMS connectivity were associated with lower immediate memory over time (all false discovery rate-adjusted p values < .05). CONCLUSIONS SCD in cognitively normal individuals is associated with diminished immediate memory practice effects and a brain connectivity pattern that mirrors early AD-related connectivity failure.
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Affiliation(s)
- Sander C J Verfaillie
- Montreal Neurological Institute, Montreal, Quebec, Canada; Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Alzheimer Center and Department of Neurology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Alexa Pichet Binette
- Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | | | - Shirin Tabrizi
- Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
| | - Mélissa Savard
- Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada
| | - Pierre Bellec
- Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Quebec, Canada; Department of Computer Science and Operations Research, University of Montreal, Montreal, Quebec, Canada
| | - Rik Ossenkoppele
- Alzheimer Center and Department of Neurology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands; Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - John C S Breitner
- Montreal Neurological Institute, Montreal, Quebec, Canada; Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Montreal Neurological Institute, Montreal, Quebec, Canada; Centre for the Studies on Prevention of Alzheimer's Disease, Douglas Mental Health University Institute Research Centre, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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23
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Lafaille-Magnan ME, Poirier J, Etienne P, Tremblay-Mercier J, Frenette J, Rosa-Neto P, Breitner JCS. Odor identification as a biomarker of preclinical AD in older adults at risk. Neurology 2017; 89:327-335. [PMID: 28659431 PMCID: PMC5574678 DOI: 10.1212/wnl.0000000000004159] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/28/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess odor identification (OI) as an indicator of presymptomatic Alzheimer disease (AD) pathogenesis in cognitively normal aging individuals at increased risk of AD dementia. METHODS In 274 members of the PREVENT-AD cohort of healthy aging persons with a parental or multiple-sibling history of AD dementia, we assessed the cross-sectional association of OI with potential indicators of presymptomatic AD. Some 101 participants donated CSF, thus enabling assessment of AD pathology with the biomarkers total tau (t-tau), phospho-tau (P181-tau), and their ratios with β-amyloid (Aβ1-42). Adjusted analyses considered age, cognition, APOE ε4 status, education, and sex as covariates. We measured OI using the University of Pennsylvania Smell Identification Test and cognitive performance using the Repeatable Battery for Assessment of Neuropsychological Status. Standard kits provided assays of the AD biomarkers. Analyses used robust-fit linear regression models. RESULTS Reduced OI was associated with lower cognitive score and older age, as well as increased ratios of CSF t-tau and P181-tau to Aβ1-42 (all p < 0.02). However, the observed associations of OI with age and cognition were unapparent in adjusted models that restricted observations to CSF donors and included AD biomarkers. OI showed little association with CSF Aβ1-42 alone except in APOE ε4 carriers having lowest-quartile Aβ1-42 levels. CONCLUSIONS These findings from healthy high-risk older individuals suggest that OI reflects degree of preclinical AD pathology, while its relationships with age and cognition result from the association of these latter variables with such pathology. Diminished OI may be a practical and affordable biomarker of AD pathology.
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Affiliation(s)
- Marie-Elyse Lafaille-Magnan
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada.
| | - Judes Poirier
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | - Pierre Etienne
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | - Jennifer Tremblay-Mercier
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | - Joanne Frenette
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
| | - John C S Breitner
- From the Centre for Studies on Prevention of AD (M.-E.L.-M., J.P., P.E., J.T.-M., J.F., P.R.-N., J.C.S.B.) and McGill Centre for Studies in Aging (P.R.-N.), Douglas Mental Health University Institute, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
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Breitner JCS. Comment: MCI trials-Categorical "square pegs" in dimensional "round holes"? Neurology 2017; 88:1757. [PMID: 28381505 DOI: 10.1212/wnl.0000000000003893] [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: 11/15/2022] Open
Affiliation(s)
- John C S Breitner
- From the Centre for Studies on Prevention of AD, Douglas Mental Health University Institute Research Centre, and the Department of Psychiatry and Behavioral Sciences, McGill University Faculty of Medicine, Montreal, Canada
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25
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Cavanagh C, Tse YC, Nguyen HB, Krantic S, Breitner JCS, Quirion R, Wong TP. Inhibiting tumor necrosis factor-α before amyloidosis prevents synaptic deficits in an Alzheimer's disease model. Neurobiol Aging 2016; 47:41-49. [PMID: 27552480 DOI: 10.1016/j.neurobiolaging.2016.07.009] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 07/11/2016] [Accepted: 07/15/2016] [Indexed: 12/12/2022]
Abstract
Deficits in synaptic structure and function are likely to underlie cognitive impairments in Alzheimer's disease. While synaptic deficits are commonly found in animal models of amyloidosis, it is unclear how amyloid pathology may impair synaptic functions. In some amyloid mouse models of Alzheimer's disease, however, synaptic deficits are preceded by hyperexcitability of glutamate synapses. In the amyloid transgenic mouse model TgCRND8, we therefore investigated whether early enhancement of glutamatergic transmission was responsible for development of later synaptic deficits. Hippocampi from 1-month-old TgCRND8 mice revealed increased basal transmission and plasticity of glutamate synapses that was related to increased levels of tumor necrosis factor α (TNFα). Treating these 1-month-old mice for 4 weeks with the TNFα inhibitor XPro1595 prevented synaptic deficits otherwise apparent at the age of 6 months. In this mouse model at least, reversing the hyperexcitability of glutamate synapses via TNFα blockade before the onset of amyloid plaque formation prevented later synaptic deficits.
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Affiliation(s)
- Chelsea Cavanagh
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Yiu Chung Tse
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Huy-Binh Nguyen
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - Slavica Krantic
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France; INSERM, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, UMR_S 1138, Centre de Recherche des Cordeliers, Paris, France; Centre National de la Recherche Scientifique (ou CNRS) ERL 8228, Centre de Recherche des Cordeliers, Paris, France
| | - John C S Breitner
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Centre for Studies on Prevention of Alzheimer's Disease, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Remi Quirion
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Tak Pan Wong
- Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada; Department of Psychiatry, McGill University, Montreal, Quebec, Canada.
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26
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Affiliation(s)
- John C S Breitner
- Centre for Studies on Prevention of Alzheimer's Disease, Douglas Hospital Research Centre, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Quebec, Canada
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27
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Orban P, Madjar C, Savard M, Dansereau C, Tam A, Das S, Evans AC, Rosa-Neto P, Breitner JCS, Bellec P. Test-retest resting-state fMRI in healthy elderly persons with a family history of Alzheimer's disease. Sci Data 2015; 2:150043. [PMID: 26504522 PMCID: PMC4603392 DOI: 10.1038/sdata.2015.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/21/2015] [Indexed: 11/21/2022] Open
Abstract
We present a test-retest dataset of resting-state fMRI data obtained in 80 cognitively normal elderly volunteers enrolled in the “Pre-symptomatic Evaluation of Novel or Experimental Treatments for Alzheimer's Disease” (PREVENT-AD) Cohort. Subjects with a family history of Alzheimer's disease in first-degree relatives were recruited as part of an on-going double blind randomized clinical trial of Naproxen or placebo. Two pairs of scans were acquired ~3 months apart, allowing the assessment of both intra- and inter-session reliability, with the possible caveat of treatment effects as a source of inter-session variation. Using the NeuroImaging Analysis Kit (NIAK), we report on the standard quality of co-registration and motion parameters of the data, and assess their validity based on the spatial distribution of seed-based connectivity maps as well as intra- and inter-session reliability metrics in the default-mode network. This resource, released publicly as sample UM1 of the Consortium for Reliability and Reproducibility (CoRR), will benefit future studies focusing on the preclinical period preceding the appearance of dementia in Alzheimer's disease.
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Affiliation(s)
- Pierre Orban
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
| | - Cécile Madjar
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - Mélissa Savard
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - Christian Dansereau
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
| | - Angela Tam
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada
| | - Samir Das
- McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McConnell Brain Imaging Center, Montreal Neurological Institute, 3801 University , Montreal, QC H3A 2B4, Canada
| | - Alan C Evans
- McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McConnell Brain Imaging Center, Montreal Neurological Institute, 3801 University , Montreal, QC H3A 2B4, Canada
| | - Pedro Rosa-Neto
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McGill University Research Centre for Studies in Aging, 6825 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - John C S Breitner
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada
| | - Pierre Bellec
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
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Barucker C, Sommer A, Beckmann G, Eravci M, Harmeier A, Schipke CG, Brockschnieder D, Dyrks T, Althoff V, Fraser PE, Hazrati LN, George-Hyslop PS, Breitner JCS, Peters O, Multhaup G. Alzheimer amyloid peptide aβ42 regulates gene expression of transcription and growth factors. J Alzheimers Dis 2015; 44:613-24. [PMID: 25318543 DOI: 10.3233/jad-141902] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The pathogenesis of Alzheimer's disease (AD) is characterized by the aggregation of amyloid-β (Aβ) peptides leading to deposition of senile plaques and a progressive decline of cognitive functions, which currently remains the main criterion for its diagnosis. Robust biomarkers for AD do not yet exist, although changes in the cerebrospinal fluid levels of tau and Aβ represent promising candidates in addition to brain imaging and genetic risk profiling. Although concentrations of soluble Aβ42 correlate with symptoms of AD, less is known about the biological activities of Aβ peptides which are generated from the amyloid-β protein precursor. An unbiased DNA microarray study showed that Aβ42, at sub-lethal concentrations, specifically increases expression of several genes in neuroblastoma cells, notably the insulin-like growth factor binding proteins 3 and 5 (IGFBP3/5), the transcription regulator inhibitor of DNA binding, and the transcription factor Lim only domain protein 4. Using qRT-PCR, we confirmed that mRNA levels of the identified candidate genes were exclusively increased by the potentially neurotoxic Aβ42 wild-type peptide, as both the less toxic Aβ40 and a non-toxic substitution peptide Aβ42 G33A did not affect mRNA levels. In vivo immunohistochemistry revealed a corresponding increase in both hippocampal and cortical IGFBP5 expression in an AD mouse model. Proteomic analyses of human AD cerebrospinal fluid displayed increased in vivo concentrations of IGFBPs. IGFBPs and transcription factors, as identified here, are modulated by soluble Aβ42 and may represent useful early biomarkers.
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Affiliation(s)
- Christian Barucker
- Institut fuer Chemie und Biochemie, Freie Universitaet Berlin, Berlin, Germany Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
| | - Anette Sommer
- Bayer Pharma AG, Global Drug Discovery, Berlin, Germany
| | | | - Murat Eravci
- Institut fuer Chemie und Biochemie, Freie Universitaet Berlin, Berlin, Germany
| | - Anja Harmeier
- Institut fuer Chemie und Biochemie, Freie Universitaet Berlin, Berlin, Germany
| | - Carola G Schipke
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Thomas Dyrks
- Bayer Pharma AG, Global Drug Discovery, Berlin, Germany
| | - Veit Althoff
- Institut fuer Chemie und Biochemie, Freie Universitaet Berlin, Berlin, Germany
| | - Paul E Fraser
- Tanz Centre for Research in Neurodegenerative Diseases, Departments of Medicine and Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Lili-Naz Hazrati
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Diseases, Departments of Medicine and Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - John C S Breitner
- Douglas Mental Health University Institute, Verdun, QC, Canada Department of Psychiatry, McGill University Faculty of Medicine, Montreal, QC, Canada
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Gerhard Multhaup
- Institut fuer Chemie und Biochemie, Freie Universitaet Berlin, Berlin, Germany Department of Pharmacology & Therapeutics, McGill University, Montreal, QC, Canada
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Colby-Milley J, Cavanagh C, Jego S, Breitner JCS, Quirion R, Adamantidis A. Sleep-Wake Cycle Dysfunction in the TgCRND8 Mouse Model of Alzheimer's Disease: From Early to Advanced Pathological Stages. PLoS One 2015; 10:e0130177. [PMID: 26076358 PMCID: PMC4468206 DOI: 10.1371/journal.pone.0130177] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/18/2015] [Indexed: 12/11/2022] Open
Abstract
In addition to cognitive decline, individuals affected by Alzheimer’s disease (AD) can experience important neuropsychiatric symptoms including sleep disturbances. We characterized the sleep-wake cycle in the TgCRND8 mouse model of AD, which overexpresses a mutant human form of amyloid precursor protein resulting in high levels of β-amyloid and plaque formation by 3 months of age. Polysomnographic recordings in freely-moving mice were conducted to study sleep-wake cycle architecture at 3, 7 and 11 months of age and corresponding levels of β-amyloid in brain regions regulating sleep-wake states were measured. At all ages, TgCRND8 mice showed increased wakefulness and reduced non-rapid eye movement (NREM) sleep during the resting and active phases. Increased wakefulness in TgCRND8 mice was accompanied by a shift in the waking power spectrum towards fast frequency oscillations in the beta (14-20 Hz) and low gamma range (20-50 Hz). Given the phenotype of hyperarousal observed in TgCRND8 mice, the role of noradrenergic transmission in the promotion of arousal, and previous work reporting an early disruption of the noradrenergic system in TgCRND8, we tested the effects of the alpha-1-adrenoreceptor antagonist, prazosin, on sleep-wake patterns in TgCRND8 and non-transgenic (NTg) mice. We found that a lower dose (2 mg/kg) of prazosin increased NREM sleep in NTg but not in TgCRND8 mice, whereas a higher dose (5 mg/kg) increased NREM sleep in both genotypes, suggesting altered sensitivity to noradrenergic blockade in TgCRND8 mice. Collectively our results demonstrate that amyloidosis in TgCRND8 mice is associated with sleep-wake cycle dysfunction, characterized by hyperarousal, validating this model as a tool towards understanding the relationship between β-amyloid overproduction and disrupted sleep-wake patterns in AD.
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Affiliation(s)
- Jessica Colby-Milley
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Chelsea Cavanagh
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Sonia Jego
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - John C. S. Breitner
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Rémi Quirion
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
| | - Antoine Adamantidis
- Douglas Mental Health University Institute, Dept. of Psychiatry, McGill University, Montreal, Quebec, H4H 1R3, Canada
- Inselspital, Bern University Hospital, Bern University, Dept. of Neurology, Freiburgstrasse, 18, 3010 Bern, Switzerland
- * E-mail:
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Breitner JCS, Galasko D. Encouraging trends toward reduced risk of Alzheimer disease: What's good for the heart is good for the brain. Neurol Clin Pract 2015; 5:190-192. [PMID: 29443188 DOI: 10.1212/cpj.0000000000000110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- John C S Breitner
- Centre for Studies on Prevention of Alzheimer's Disease (JCSB), Douglas Hospital Research Centre, and Department of Psychiatry (JCSB), McGill University Faculty of Medicine, Montreal, Quebec, Canada; Alzheimer's Disease Research Center (DG) and Department of Neurosciences (DG), University of California at San Diego
| | - Douglas Galasko
- Centre for Studies on Prevention of Alzheimer's Disease (JCSB), Douglas Hospital Research Centre, and Department of Psychiatry (JCSB), McGill University Faculty of Medicine, Montreal, Quebec, Canada; Alzheimer's Disease Research Center (DG) and Department of Neurosciences (DG), University of California at San Diego
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Affiliation(s)
- J C S Breitner
- Centre for Studies on Prevention of Alzheimer's Disease, Douglas Hospital Research Centre, Montreal, QC, Canada.
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Chuang YF, Breitner JCS, Chiu YL, Khachaturian A, Hayden K, Corcoran C, Tschanz J, Norton M, Munger R, Welsh-Bohmer K, Zandi PP. Use of diuretics is associated with reduced risk of Alzheimer's disease: the Cache County Study. Neurobiol Aging 2014; 35:2429-2435. [PMID: 24910391 DOI: 10.1016/j.neurobiolaging.2014.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 03/27/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
Abstract
Although the use of antihypertensive medications has been associated with reduced risk of Alzheimer's disease (AD), it remains unclear which class provides the most benefit. The Cache County Study of Memory Health and Aging is a prospective longitudinal cohort study of dementing illnesses among the elderly population of Cache County, Utah. Using waves I to IV data of the Cache County Study, 3417 participants had a mean of 7.1 years of follow-up. Time-varying use of antihypertensive medications including different class of diuretics, angiotensin converting enzyme inhibitors, β-blockers, and calcium channel blockers was used to predict the incidence of AD using Cox proportional hazards analyses. During follow-up, 325 AD cases were ascertained with a total of 23,590 person-years. Use of any antihypertensive medication was associated with lower incidence of AD (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.61-0.97). Among different classes of antihypertensive medications, thiazide (aHR, 0.7; 95% CI, 0.53-0.93), and potassium-sparing diuretics (aHR, 0.69; 95% CI, 0.48-0.99) were associated with the greatest reduction of AD risk. Thiazide and potassium-sparing diuretics were associated with decreased risk of AD. The inverse association of potassium-sparing diuretics confirms an earlier finding in this cohort, now with longer follow-up, and merits further investigation.
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Affiliation(s)
- Yi-Fang Chuang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John C S Breitner
- Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Yen-Ling Chiu
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ara Khachaturian
- National Supercomputing Center (NSCEE) for Energy and the Environment, University of Nevada, Las Vegas, NV, USA
| | - Kathleen Hayden
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Chris Corcoran
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA
| | - JoAnn Tschanz
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA
| | - Maria Norton
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA; Department of Family, Consumer, and Human Development, Utah State University, Logan, UT, USA
| | - Ron Munger
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Kathleen Welsh-Bohmer
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Reckess GZ, Brandt J, Luis CA, Zandi P, Martin B, Breitner JCS. Screening by telephone in the Alzheimer's disease anti-inflammatory prevention trial. J Alzheimers Dis 2014; 36:433-43. [PMID: 23645097 DOI: 10.3233/jad-130113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Compared with in-person assessment methods, telephone screening for dementia and other cognitive syndromes may improve efficiency of large population studies or prevention trials. We used data from the Alzheimer's Disease Anti-Inflammatory Prevention Trial to compare performance of a four-test Telephone Assessment Battery (TAB) that included the Telephone Interview for Cognitive Status (TICS) to that of a traditional in-person Cognitive Assessment Battery. Among 1,548 elderly participants with valid telephone and in-person screening results obtained within 90 days of each other, 225 persons were referred for a full cognitive diagnostic evaluation that was completed within six months of screening. Drawing on results from this panel of 225 individuals, we used the Capture-Recapture method to estimate population numbers of cognitively impaired participants. The latter estimates enabled us to compare the performance characteristics of the two screening batteries at specified cut-offs for detection of dementia and milder forms of impairment. Although our results provide relatively imprecise estimates of the performance characteristics of the two batteries, a comparison of their relative performance suggests that, at selected cut-off points, the TAB produces results broadly comparable to in-person screening and may be slightly more sensitive in detecting mild impairment. TAB performance characteristics also appeared slightly better than those of the TICS alone. Given its benefits in time and cost when screening for cognitive disorders, telephone screening should be considered for large samples.
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Affiliation(s)
- Gila Z Reckess
- Department of Psychiatry & Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
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Breitner JCS, Lyketsos CG. Three Cardinal Lessons from ADAPT - 10 Years on. J Prev Alzheimers Dis 2014; 1:176-180. [PMID: 29251745 DOI: 10.14283/jpad.2014.31] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The Alzheimer's Disease Anti-inflammatory Prevention Trial was a placebo-controlled three-arm pharmaco-prevention trial of the non-steroidal anti-inflammatory drugs naproxen sodium and celecoxib for prevention of incident Alzheimer's disease (AD) dementia in older (aged 70 and over) adults. Although subjects were at increased risk of symptoms because of a firstdegree family history, they were meant to be cognitively healthy at enrollment. ADAPT encountered several problems that resulted in the termination of its treatments after only two years on average. Interim results were complex but potentially interesting. In the end, however, the results were null. We describe the complications that prevented ADAPT from achieving conclusive results, and suggest that these could have been avoided if the trial design and execution had been better guided by preliminary data. We believe such data should be available before beginning further ambitious phase III trials of this sort, and we suggest a broad method by which such data can be accumulated with reasonable economy.
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Affiliation(s)
- J C S Breitner
- Dr. Breitner, Centre for Studies on Prevention of Alzheimer's Disease, Douglas Hospital Research Centre; Faculty of Medicine, McGill University,
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Luck T, Riedel-Heller SG, Luppa M, Wiese B, Bachmann C, Jessen F, Bickel H, Weyerer S, Pentzek M, König HH, Prokein J, Eisele M, Wagner M, Mösch E, Werle J, Fuchs A, Brettschneider C, Scherer M, Breitner JCS, Maier W. A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study. Acta Psychiatr Scand 2014; 129:63-72. [PMID: 23521526 DOI: 10.1111/acps.12129] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/19/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Progression from cognitive impairment (CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear. METHOD We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis (RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival. RESULTS Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living (iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years). CONCLUSION Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia.
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Affiliation(s)
- T Luck
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany; Douglas Mental Health University Institute, McGill University, Montreal, Canada
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Peterson D, Munger C, Crowley J, Corcoran C, Cruchaga C, Goate AM, Norton MC, Green RC, Munger RG, Breitner JCS, Welsh-Bohmer KA, Lyketsos C, Tschanz J, Kauwe JSK. Variants in PPP3R1 and MAPT are associated with more rapid functional decline in Alzheimer's disease: the Cache County Dementia Progression Study. Alzheimers Dement 2013; 10:366-71. [PMID: 23727081 DOI: 10.1016/j.jalz.2013.02.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 12/21/2012] [Accepted: 02/06/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Single-nucleotide polymorphisms (SNPs) located in the gene encoding the regulatory subunit of the protein phosphatase 2B (PPP3R1, rs1868402) and the microtubule-associated protein tau (MAPT, rs3785883) gene were recently associated with higher cerebrospinal fluid (CSF) tau levels in samples from the Knight Alzheimer's Disease Research Center at Washington University (WU) and Alzheimer's Disease Neuroimaging Initiative (ADNI). In these same samples, these SNPs were also associated with faster functional decline, or progression of Alzheimer's disease (AD) as measured by the Clinical Dementia Rating sum of boxes scores (CDR-sb). We attempted to validate the latter association in an independent, population-based sample of incident AD cases from the Cache County Dementia Progression Study (DPS). METHODS All 92 AD cases from the DPS with a global CDR-sb ≤1 (mild) at initial clinical assessment who were later assessed on CDR-sb data on at least two other time points were genotyped at the two SNPs of interest (rs1868402 and rs3785883). We used linear mixed models to estimate associations between these SNPs and CDR-sb trajectory. All analyses were performed using Proc Mixed in SAS. RESULTS Although we observed no association between rs3785883 or rs1868402 alone and change in CDR-sb (P > .10), there was a significant association between a combined genotype model and change in CDR-sb: carriers of the high-risk genotypes at both loci progressed >2.9 times faster than noncarriers (P = .015). When data from DPS were combined with previously published data from WU and ADNI, change in CDR-sb was 30% faster for each copy of the high-risk allele at rs3785883 (P = .0082) and carriers of both high-risk genotypes at both loci progressed 6 times faster (P < .0001) than all others combined. CONCLUSIONS We replicate a previous report by Cruchaga et al that specific variations in rs3785883 and rs1868402 are associated with accelerated progression of AD. Further characterization of this association will provide a better understanding of how genetic factors influence the rate of progression of AD and could provide novel insights into preventative and therapeutic strategies.
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Affiliation(s)
- David Peterson
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Caitlin Munger
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Jared Crowley
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Chris Corcoran
- Department of Mathematics and Statistics, Utah State University, Logan, UT, USA; Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Alison M Goate
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Maria C Norton
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Family Consumer and Human Development, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine and Partners Center for Personalized Genetic Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ronald G Munger
- Department of Nutrition Dietetics and Food Sciences, Utah State University, Logan, UT, USA
| | - John C S Breitner
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | | | - Constantine Lyketsos
- Department of Psychiatry, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Joann Tschanz
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA
| | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, UT, USA.
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Shao H, Breitner JCS, Whitmer RA, Wang J, Hayden K, Wengreen H, Corcoran C, Tschanz J, Norton M, Munger R, Welsh-Bohmer K, Zandi PP. Hormone therapy and Alzheimer disease dementia: new findings from the Cache County Study. Neurology 2012; 79:1846-52. [PMID: 23100399 DOI: 10.1212/wnl.0b013e318271f823] [Citation(s) in RCA: 178] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Observational studies suggest reduced risk of Alzheimer disease (AD) in users of hormone therapy (HT), but trials show higher risk. We examined whether the association of HT with AD varies with timing or type of HT use. METHODS Between 1995 and 2006, the population-based Cache County Study followed 1,768 women who had provided a detailed history on age at menopause and use of HT. During this interval, 176 women developed incident AD. Cox proportional hazard models evaluated the association of HT use with AD, overall and in relation to timing, duration of use, and type (opposed vs unopposed) of HT. RESULTS Women who used any type of HT within 5 years of menopause had 30% less risk of AD (95% confidence interval 0.49-0.99), especially if use was for 10 or more years. By contrast, AD risk was not reduced among those who had initiated HT 5 or more years after menopause. Instead, rates were increased among those who began "opposed" estrogen-progestin compounds within the 3 years preceding the Cache County Study baseline (adjusted hazard ratio 1.93; 95% confidence interval 0.94-3.96). This last hazard ratio was similar to the ratio of 2.05 reported in randomized trial participants assigned to opposed HT. CONCLUSIONS Association of HT use and risk of AD may depend on timing of use. Although possibly beneficial if taken during a critical window near menopause, HT (especially opposed compounds) initiated in later life may be associated with increased risk. The relation of AD risk to timing and type of HT deserves further study.
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Affiliation(s)
- Huibo Shao
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Lee CT, Leoutsakos JM, Lyketsos CG, Steffens DC, Breitner JCS, Norton MC. Latent class-derived subgroups of depressive symptoms in a community sample of older adults: the Cache County Study. Int J Geriatr Psychiatry 2012; 27:1061-9. [PMID: 22135008 PMCID: PMC3419796 DOI: 10.1002/gps.2824] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Accepted: 10/21/2011] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We sought to identify possible subgroups of elders that varied in depressive symptomatology and to examine symptom patterns and health status differences between subgroups. METHODS The Cache County memory study is a population-based epidemiological study of dementia with 5092 participants. Depressive symptoms were measured with a modified version of the diagnostic interview schedule-depression. There were 400 nondemented participants who endorsed currently (i.e., in the past 2 weeks) experiencing at least one of the three "gateway" depressive symptoms and then completed a full depression interview. Responses to all nine current depressive symptoms were modeled using the latent class analysis. RESULTS Three depression subgroups were identified: a significantly depressed subgroup (62%), with the remainder split evenly between a subgroup with low probability of all symptoms (21%), and a subgroup with primarily psychomotor changes, sleep symptoms, and fatigue (17%). Latent class analysis derived subgroups of depressive symptoms and Diagnostic and statistical manual of mental disorders, fourth edition depression diagnostic group were nonredundant. Age, gender, education, marital status, early or late onset, number of episodes, current episode duration, and functional status were not significant predictors of depression subgroup. The first subgroup was more likely to be recently bereaved and had less physical health problems, whereas the third subgroup were less likely to be using antidepressants compared with the second subgroup. CONCLUSIONS There are distinct subgroups of depressed elders, which are not redundant with the Diagnostic and statistical manual of mental disorders, fourth edition classification scheme, offering an alternative diagnostic approach to clinicians and researchers. Future work will examine whether these depressive symptom profiles are predictive of incident dementia and earlier mortality.
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Affiliation(s)
- Chien-Ti Lee
- Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
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Norton MC, Dew J, Smith H, Fauth E, Piercy KW, Breitner JCS, Tschanz J, Wengreen H, Welsh-Bohmer K. Lifestyle behavior pattern is associated with different levels of risk for incident dementia and Alzheimer's disease: the Cache County study. J Am Geriatr Soc 2012; 60:405-12. [PMID: 22316091 PMCID: PMC3302927 DOI: 10.1111/j.1532-5415.2011.03860.x] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [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] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To identify distinct behavioral patterns of diet, exercise, social interaction, church attendance, alcohol consumption, and smoking and to examine their association with subsequent dementia risk. DESIGN Longitudinal, population-based dementia study. SETTING Rural county in northern Utah, at-home evaluations. PARTICIPANTS Two thousand four hundred ninety-one participants without dementia (51% male, average age 73.0 ± 5,7; average education 13.7 ± 4.1 years) initially reported no problems in activities of daily living and no stroke or head injury within the past 5 years. MEASUREMENTS Six dichotomized lifestyle behaviors were examined (diet: high ≥ median on the Dietary Approaches to Stop Hypertension scale; exercise: ≥5 h/wk of light activity and at least occasional moderate to vigorous activity; church attendance: attending church services at least weekly; social Interaction: spending time with family and friends at least twice weekly; alcohol: currently drinking alcoholic beverages ≥ 2 times/wk; nonsmoker: no current use or fewer than 100 cigarettes ever). Latent class analysis (LCA) was used to identify patterns among these behaviors. Proportional hazards regression modeled time to dementia onset as a function of behavioral class, age, sex, education, and apolipoprotein E status. Follow-up averaged 6.3 ± 5.3 years, during which 278 cases of incident dementia (200 Alzheimer's disease (AD)) were diagnosed. RESULTS LCA identified four distinct lifestyle classes. Unhealthy-religious (UH-R; 11.5%), unhealthy-nonreligious (UH-NR; 10.5%), healthy-moderately religious (H-MR; 38.5%), and healthy-very religious (H-VR; 39.5%). UH-NR (hazard ratio (HR) = 0.54, P = .028), H-MR (HR = 0.56, P = .003), and H-VR (HR = 0.58, P = .005) had significantly lower dementia risk than UH-R. Results were comparable for AD, except that UH-NR was less definitive. CONCLUSION Functionally independent older adults appear to cluster into subpopulations with distinct patterns of lifestyle behaviors with different levels of risk for subsequent dementia and AD.
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Affiliation(s)
- Maria C Norton
- Department of Family Consumer and Human Development, Utah State University, Logan, Utah 84322, USA.
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Plassman BL, Steffens DC, Burke JR, Welsh-Bohmer KA, Newman TN, Drosdick D, Helms MJ, Potter GG, Breitner JCS. Duke Twins Study of Memory in Aging in the NAS-NRC Twin Registry. Twin Res Hum Genet 2012. [DOI: 10.1375/twin.9.6.950] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe Duke Twins Study of Memory in Aging is an ongoing, longitudinal study of cognitive change and dementia in the population-based National Academy of Sciences-National Research Council (NAS-NRC) Twin Registry of World War II Male Veterans. The primary goal of this study has been to estimate the overall genetic and environmental contributions to dementia with a specific focus on Alzheimer's disease. An additional goal has been to examine specific genetic and environmental antecedents of cognitive decline and dementia. Since 1989, we have completed 4 waves of data collection. Each wave included a 2-phase telephone cognitive screening protocol, followed by an in-home standardized clinical assessment for those with suspected dementia. For many participants, we have obtained postmortem neuro-pathological confirmation of the diagnosis of dementia. In addition to data on cognition, we have also collected information on occupational history, medical history, medications and other lifetime experiences that may influence cognitive function in late life. We provide an overview of the study's methodology and describe the focus of recent research.
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Dublin S, Anderson ML, Haneuse SJ, Heckbert SR, Crane PK, Breitner JCS, McCormick W, Bowen JD, Teri L, McCurry SM, Larson EB. Atrial fibrillation and risk of dementia: a prospective cohort study. J Am Geriatr Soc 2011; 59:1369-75. [PMID: 21806558 PMCID: PMC3289545 DOI: 10.1111/j.1532-5415.2011.03508.x] [Citation(s) in RCA: 113] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To determine whether atrial fibrillation (AF) is associated with risk of incident dementia or Alzheimer's disease (AD), beyond its effect on stroke. DESIGN Prospective cohort study. SETTING An integrated healthcare delivery system. PARTICIPANTS A population-based sample of 3,045 community-dwelling adults aged 65 and older without dementia or clinical stroke followed from 1994 to 2008. MEASUREMENTS AF was identified from health plan electronic data using International Classification of Diseases, Ninth Revision, codes from inpatient and outpatient encounters. Covariates came from self-report, study measures, and health plan data. Participants were screened every 2 years using the Cognitive Abilities Screening Instrument (range 0-100), with detailed neuropsychological and clinical assessment of those scoring less than 86. A multidisciplinary consensus committee determined diagnoses of all-cause dementia and possible or probable AD using standard research criteria. RESULTS AF was present in 132 (4.3%) participants at baseline and was diagnosed in 370 (12.2%) more over a mean of 6.8 years of follow-up; 572 participants (18.8%) developed dementia (449 with AD). The adjusted hazard ratio associated with AF was 1.38 (95% confidence interval (CI)=1.10-1.73) for all-cause dementia and 1.50 (95% CI=1.16-1.94) for possible or probable AD. Results were similar for participants with and without clinically recognized stroke during follow-up and in sensitivity analyses examining only probable AD. CONCLUSION AF is associated with higher risk of developing AD and dementia. Future studies should examine whether specific treatments, including optimal anticoagulation, can decrease this risk.
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Affiliation(s)
- Sascha Dublin
- Group Health Research Institute, Seattle, Washington, USA.
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Breitner JCS. Further evidence for vascular mediation of Alzheimer's dementia pathogenesis? Biol Psychiatry 2011; 70:113-4. [PMID: 21708304 DOI: 10.1016/j.biopsych.2011.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2011] [Accepted: 05/31/2011] [Indexed: 11/29/2022]
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Treiber KA, Carlson MC, Corcoran C, Norton MC, Breitner JCS, Piercy KW, Deberard MS, Stein D, Foley B, Welsh-Bohmer KA, Frye A, Lyketsos CG, Tschanz JT. Cognitive stimulation and cognitive and functional decline in Alzheimer's disease: the cache county dementia progression study. J Gerontol B Psychol Sci Soc Sci 2011; 66:416-25. [PMID: 21441386 PMCID: PMC3132266 DOI: 10.1093/geronb/gbr023] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2010] [Accepted: 02/06/2011] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To examine the association of engagement in cognitively stimulating activities with cognitive and functional decline in a population-based sample of incident Alzheimer's disease (AD). METHOD After diagnosis, 187 participants (65% females) were followed semiannually for a mean 2.7 (SD = 0.4) years. Mean age and education were 84.6 (SD = 5.8) and 13.2 (SD = 2.9) years. Caregivers enumerated cognitively stimulating leisure activities via the Lifestyle Activities Questionnaire. Cognition was assessed using the Mini-Mental State Examination and functional ability via the Clinical Dementia Rating sum of boxes. Linear mixed models tested the association between stimulating activities and change over time in each outcome. Covariates were demographic factors, estimated premorbid IQ, presence/absence of the APOE ε4 allele, duration of dementia, level of physical activity, and general health. RESULTS At initial assessment, 87% of participants were engaged in one or more stimulating activities, with mean (SD) activities = 4.0 (3.0). This number declined to 2.4 (2.0) at the final visit. There was a statistical interaction between dementia duration and number of activities in predicting rate of cognitive decline (p = .02) and overall functional ability (p = .006). DISCUSSION Active involvement in cognitively stimulating pursuits may be beneficial for persons with AD.
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Gray SL, Walker R, Dublin S, Haneuse S, Crane PK, Breitner JCS, Bowen J, McCormick W, Larson EB. Histamine-2 receptor antagonist use and incident dementia in an older cohort. J Am Geriatr Soc 2011; 59:251-7. [PMID: 21314645 DOI: 10.1111/j.1532-5415.2010.03275.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To examine whether histamine-2 receptor antagonist medications (H2RAs) are associated with a lower incidence of all-cause dementia or Alzheimer's disease (AD), as some studies have suggested. DESIGN Prospective population-based cohort SETTING Group Health, an integrated health maintenance organization, Seattle, Washington. PARTICIPANTS Two thousand nine hundred twenty-three participants aged 65 and older without dementia at baseline, with initial recruitment between 1994 and 1996. MEASUREMENTS Follow-up occurred every 2 years to identify incident dementia and AD using standard criteria. Exposure to H2RAs was determined based on automated pharmacy data. Three aspects of exposure (time-varying) were examined based on standard daily dose (SDD): cumulative use, intensity of use (highest SDD in any prior 2-year window), and cumulative use stratified according to recency (1-3 years vs >3 years before). RESULTS Over a mean follow-up of 6.7 years, 585 subjects developed dementia (453 developed AD). Total cumulative exposure was not associated with dementia (P=.35; omnibus test) or AD (P=.23). The adjusted hazard ratios for the highest exposure category (>1,080 SDDs) compared with light or no use were 1.28 (95% confidence interval (CI)=0.95-1.72) for dementia and 1.41 (95% CI=1.00-1.97) for AD. Intensity of use was not associated with dementia (P=.39) or AD (P=.63). Examining exposure according to recent and distant cumulative use also showed no association with dementia (P=.11) or AD (P=.30). CONCLUSION No association was found between H2RA use and risk of all-cause dementia or AD using more-detailed and -extensive information about past H2RA use than any prior study.
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Affiliation(s)
- Shelly L Gray
- School of Pharmacy, University of Washington, Seattle, Washington, USA.
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Mayeux R, Reitz C, Brickman AM, Haan MN, Manly JJ, Glymour MM, Weiss CC, Yaffe K, Middleton L, Hendrie HC, Warren LH, Hayden KM, Welsh-Bohmer KA, Breitner JCS, Morris JC. Operationalizing diagnostic criteria for Alzheimer's disease and other age-related cognitive impairment-Part 1. Alzheimers Dement 2011; 7:15-34. [PMID: 21255741 DOI: 10.1016/j.jalz.2010.11.005] [Citation(s) in RCA: 45] [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] [Indexed: 11/24/2022]
Abstract
In this article, the challenges faced by several noted population studies for Alzheimer dementia in operationalizing current clinical diagnostic criteria for Alzheimer's disease (AD) have been reviewed. Differences in case ascertainment, methodological biases, cultural and educational influences on test performance, inclusion of special populations such as underrepresented minorities and the oldest old, and detection of the earliest symptomatic stages of underlying AD have been considered. Classification of Alzheimer dementia may be improved by the incorporation of biomarkers for AD if the sensitivity, specificity, and predictive value of the biomarkers are established and if they are appropriate for epidemiological studies, as may occur should a plasma biomarker be developed. Biomarkers for AD could also facilitate studies of the interactions of various forms of neurodegenerative disorders with cerebrovascular disease, resulting in "mixed dementia".
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Affiliation(s)
- Richard Mayeux
- Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA.
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Norton MC, Smith KR, Østbye T, Tschanz JT, Corcoran C, Schwartz S, Piercy KW, Rabins PV, Steffens DC, Skoog I, Breitner JCS, Welsh-Bohmer KA. Greater risk of dementia when spouse has dementia? The Cache County study. J Am Geriatr Soc 2010; 58:895-900. [PMID: 20722820 DOI: 10.1111/j.1532-5415.2010.02806.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the effects of caring for a spouse with dementia on the caregiver's risk for incident dementia. DESIGN Population-based study of incident dementia in spouses of persons with dementia. SETTING Rural county in northern Utah. PARTICIPANTS Two thousand four hundred forty-two subjects (1,221 married couples) aged 65 and older. MEASUREMENTS Incident dementia was diagnosed in 255 subjects, with onset defined as age when subject met Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised, criteria for dementia. Cox proportional hazards regression tested the effect of time-dependent exposure to dementia in one's spouse, adjusted for potential confounders. RESULTS A subject whose spouse experienced incident dementia onset had a six times greater risk for incident dementia as subjects whose spouses were dementia free (hazard rate ratio (HRR)=6.0, 95% confidence interval (CI)=2.2-16.2, P<.001). In sex-specific analyses, husbands had higher risks (HRR=11.9, 95% CI=1.7-85.5, P=.01) than wives (HRR=3.7, 95% CI=1.2-11.6, P=.03). CONCLUSION The chronic and often severe stress associated with dementia caregiving may exert substantial risk for the development of dementia in spouse caregivers. Additional (not mutually exclusive) explanations for findings are discussed.
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Affiliation(s)
- Maria C Norton
- Department of Family, Consumer, and Human Development Utah State University, Logan, Utah, USA.
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Sonnen JA, Larson EB, Walker RL, Haneuse S, Crane PK, Gray SL, Breitner JCS, Montine TJ. Nonsteroidal anti-inflammatory drugs are associated with increased neuritic plaques. Neurology 2010; 75:1203-10. [PMID: 20811000 DOI: 10.1212/wnl.0b013e3181f52db1] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Observational and experimental studies suggest that nonsteroidal anti-inflammatory drugs (NSAIDs) may protect against Alzheimer disease (AD); however, clinical trials and other observational studies, including the Adult Changes in Thought (ACT) study, show no protection or promotion of AD. The objective of this study is to determine the relationship between common dementia-associated pathologies and mid- to late-life NSAID exposure. METHODS We examined the association of mid- to late-life NSAID use with neuropathologic findings on 257 autopsies from ACT, a population-based study of brain aging and incident dementia. Cumulative standard daily doses (SDD) of nonselective NSAIDs were determined from ≥10 years of computerized pharmacy dispensing data. Analyses were adjusted for selection bias to broaden generalizability of results to 3,026 eligible participants in the ACT cohort. Seven pathologic indices were evaluated: intermediate or frequent score for neuritic plaques, Braak stages V or VI for neurofibrillary tangles, >2 cerebral microinfarcts, the presence of any neocortical Lewy bodies, any macroscopic infarcts, any amyloid angiopathy, and moderate or severe atherosclerosis. RESULTS Of the neuropathologic indices evaluated, only neuritic plaque score was significantly increased in participants with greater use of nonselective NSAIDs (p = 0.065), specifically in those with high levels of cumulative use: 1,000-2,000 SDD (adjusted relative risk [RR] 2.16, 95% confidence interval [CI] 1.02-4.25, compared to light/nonuse [<60 SDD]) and >2,000 SDD (adjusted RR 2.37, 95% CI 1.24-4.67). CONCLUSIONS Increased neuritic plaque accumulation may explain the association between heavy use of nonselective NSAIDs and increased risk of dementia among ACT participants.
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Affiliation(s)
- J A Sonnen
- Department of Pathology, University of Washington, Seattle, WA 98104, USA.
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Sonnen JA, Montine KS, Quinn JF, Breitner JCS, Montine TJ. Cerebrospinal fluid biomarkers in mild cognitive impairment and dementia. J Alzheimers Dis 2010; 19:301-9. [PMID: 20061646 DOI: 10.3233/jad-2010-1236] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Given the magnitude of the public health problem of dementia in the elderly, there is a pressing need for research, development, and timely application of biomarkers that will identify latent and prodromal illness as well as dementia. Although identification of risk factors and neuroimaging measures will remain key to these efforts, this review focuses on recent progress in the discovery, validation, and standardization of cerebrospinal fluid (CSF) biomarkers, small molecules and macromolecules whose CSF concentration can aid in diagnosis at different stages of disease as well as in assessment of disease progression and response to therapeutics. A multimodal approach that brings independent information from risk factor assessment, neuroimaging, and biomarkers may soon guide physicians in the early diagnosis and management of cognitive impairment in the elderly.
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Affiliation(s)
- Joshua A Sonnen
- Department of Pathology, Division of Neuropathology, University of Washington, Seattle, WA 98104-2420, USA.
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