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Xiong C, McCue LM, Buckles V, Grant E, Agboola F, Coble D, Bateman RJ, Fagan AM, Benzinger TL, Hassenstab J, Schindler SE, McDade E, Moulder K, Gordon BA, Cruchaga C, Day GS, Ikeuchi T, Suzuki K, Allegri RF, Vöglein J, Levin J, Morris JC. Cross-sectional and longitudinal comparisons of biomarkers and cognition among asymptomatic middle-aged individuals with a parental history of either autosomal dominant or late-onset Alzheimer's disease. Alzheimers Dement 2023; 19:2923-2932. [PMID: 36640138 PMCID: PMC10345163 DOI: 10.1002/alz.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Comparisons of late-onset Alzheimer's disease (LOAD) and autosomal dominant AD (ADAD) are confounded by age. METHODS We compared biomarkers from cerebrospinal fluid (CSF), magnetic resonance imaging, and amyloid imaging with Pittsburgh Compound-B (PiB) across four groups of 387 cognitively normal participants, 42 to 65 years of age, in the Dominantly Inherited Alzheimer Network (DIAN) and the Adult Children Study (ACS) of LOAD: DIAN mutation carriers (MCs) and non-carriers (NON-MCs), and ACS participants with a positive (FH+) and negative (FH-) family history of LOAD. RESULTS At baseline, MCs had the lowest age-adjusted level of CSF Aβ42 and the highest levels of total and phosphorylated tau-181, and PiB uptake. Longitudinally, MC had similar increase in PiB uptake to FH+, but drastically faster decline in hippocampal volume than others, and was the only group showing cognitive decline. DISCUSSION Preclinical ADAD and LOAD share many biomarker signatures, but cross-sectional and longitudinal differences may exist.
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Affiliation(s)
- Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Lena M. McCue
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Virginia Buckles
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Elizabeth Grant
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Folasade Agboola
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Dean Coble
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Randall J. Bateman
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Anne M Fagan
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Tammie L.S. Benzinger
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Radiology, Washington University, St. Louis, Missouri, USA
- Department of Neurological Surgery, Washington University, St. Louis, Missouri, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Department of Psychology, Washington University, St. Louis, Missouri, USA
| | - Suzanne E. Schindler
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Eric McDade
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Krista Moulder
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Brian A. Gordon
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Psychology, Washington University, St. Louis, Missouri, USA
- Department of Radiology, Washington University, St. Louis, Missouri, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- Department of Psychiatry, Washington University, St. Louis, Missouri, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic in Florida, Jacksonville, FL, USA
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, JAPAN
| | | | | | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri, USA
- Department of Physical Therapy, Washington University, St. Louis, Missouri, USA
- Department of Occupational Therapy, Washington University, St. Louis, Missouri, USA
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Koenig LN, McCue LM, Grant E, Massoumzadeh P, Roe CM, Xiong C, Moulder KL, Wang L, Zazulia AR, Kelly P, Dincer A, Zaza A, Shimony JS, Benzinger TLS, Morris JC. Lack of association between acute stroke, post-stroke dementia, race, and β-amyloid status. Neuroimage Clin 2021; 29:102553. [PMID: 33524806 PMCID: PMC7848631 DOI: 10.1016/j.nicl.2020.102553] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 08/24/2020] [Revised: 12/18/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Stroke and Alzheimer disease share risk factors and often co-occur, and both have been reported to have a higher prevalence in African Americans as compared to non-Hispanic whites. However, their interaction has not been established. The objective of this study was to determine if preclinical Alzheimer disease is a risk factor for stroke and post-stroke dementia and whether racial differences moderate this relationship. METHODS This case-control study was analyzed in 2019 using retrospective data from 2007 to 2013. Participants were adults age 65 and older with and without acute ischemic stroke. Recruitment included word of mouth and referrals in Saint Louis, MO, with stroke participants recruited from acutely hospitalized patients and non-stroke participants from community living older adults who were research volunteers. Our assessment included radiologic reads of infarcts, microbleeds, and white matter hyperintensitites (WMH); a Pittsburgh Compound B PET measure of cortical β-amyloid binding; quantitative measures of hippocampal and WMH volume; longitudinal Mini Mental State Examination (MMSE) scores; and Clinical Dementia Rating (CDR) 1 year post-stroke. RESULTS A total of 243 participants were enrolled, 81 of which had a recent ischemic stroke. Participants had a mean age of 75, 57% were women, and 52% were African American. Cortical amyloid did not differ significantly by race, stroke status, or CDR post-stroke. There were racial differences in MMSE scores at baseline (mean 26.8 for African Americans, 27.9 for non-Hispanic whites, p = 0.03), but not longitudinally. African Americans were more likely to have microbleeds (32.8% vs 22.6%, p = 0.04), and within the acute stroke group, African Americans were more likely to have small infarcts (75.6% vs 56.8%, p = 0.049). CONCLUSION Preclinical Alzheimer disease did not show evidence of being a risk factor for stroke nor predictive of post-stroke dementia. We did not observe racial differences in β-amyloid levels. However, even after controlling for several vascular risk factors, African Americans with clinical stroke presentations had greater levels of vascular pathology on MRI.
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Affiliation(s)
- Lauren N Koenig
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Lena M McCue
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO USA
| | - Elizabeth Grant
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO USA
| | - Parinaz Massoumzadeh
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Catherine M Roe
- Department of Neurology, Washington University School of Medicine, St. Louis, MO USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO USA
| | - Krista L Moulder
- Department of Neurology, Washington University School of Medicine, St. Louis, MO USA
| | - Liang Wang
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Allyson R Zazulia
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA; Department of Neurology, Washington University School of Medicine, St. Louis, MO USA
| | - Peggy Kelly
- Department of Neurology, Washington University School of Medicine, St. Louis, MO USA
| | - Aylin Dincer
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Aiad Zaza
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Joshua S Shimony
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO USA.
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Morris JC, Schindler SE, McCue LM, Moulder KL, Benzinger TLS, Cruchaga C, Fagan AM, Grant E, Gordon BA, Holtzman DM, Xiong C. Assessment of Racial Disparities in Biomarkers for Alzheimer Disease. JAMA Neurol 2020; 76:264-273. [PMID: 30615028 DOI: 10.1001/jamaneurol.2018.4249] [Citation(s) in RCA: 197] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Racial differences in molecular biomarkers for Alzheimer disease may suggest race-dependent biological mechanisms. Objective To ascertain whether there are racial disparities in molecular biomarkers for Alzheimer disease. Design, Setting, and Participants A total of 1255 participants (173 African Americans) were enrolled from January 1, 2004, through December 31, 2015, in longitudinal studies at the Knight Alzheimer Disease Research Center at Washington University and completed a magnetic resonance imaging study of the brain and/or positron emission tomography of the brain with Pittsburgh compound B (radioligand for aggregated amyloid-β) and/or cerebrospinal fluid (CSF) assays for the concentrations of amyloid-β42, total tau, and phosphorylated tau181. Independent cross-sectional analyses were conducted from April 22, 2016, to August 27, 2018, for each biomarker modality with an analysis of variance or analysis of covariance including age, sex, educational level, race, apolipoprotein E (APOE) ε4 allele status, and clinical status (normal cognition or dementia). All biomarker assessments were conducted without knowledge of the clinical status of the participants. Main Outcomes and Measures The primary outcomes were hippocampal volumes adjusted for differences in intracranial volumes, global cerebral amyloid burden as transformed into standardized uptake value ratios (partial volume corrected), and CSF concentrations of amyloid-β42, total tau, and phosphorylated tau181. Results Of the 1255 participants (707 women and 548 men; mean [SD] age, 70.8 [9.9] years), 116 of 173 African American participants (67.1%) and 724 of 1082 non-Hispanic white participants (66.9%) had normal cognition. There were no racial differences in the frequency of cerebral ischemic lesions noted on results of brain magnetic resonance imaging, mean cortical standardized uptake value ratios for Pittsburgh compound B, or for amyloid-β42 concentrations in CSF. However, in individuals with a reported family history of dementia, mean (SE) total hippocampal volumes were lower for African American participants than for white participants (6418.26 [138.97] vs 6990.50 [44.10] mm3). Mean (SE) CSF concentrations of total tau were lower in African American participants than in white participants (293.65 [34.61] vs 443.28 [18.20] pg/mL; P < .001), as were mean (SE) concentrations of phosphorylated tau181 (53.18 [4.91] vs 70.73 [2.46] pg/mL; P < .001). There was a significant race by APOE ε4 interaction for both CSF total tau and phosphorylated tau181 such that only APOE ε4-positive participants showed the racial differences. Conclusions and Relevance The results of this study suggest that analyses of molecular biomarkers of Alzheimer disease should adjust for race. The lower CSF concentrations of total tau and phosphorylated tau181 in African American individuals appear to reflect a significant race by APOE ε4 interaction, suggesting a differential effect of this Alzheimer risk variant in African American individuals compared with white individuals.
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Affiliation(s)
- John C Morris
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Lena M McCue
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Krista L Moulder
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Psychiatry, Washington University School of Medicine, St Louis, Missouri
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Elizabeth Grant
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
| | - Brian A Gordon
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri.,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri.,Division of Biostatistics, Washington University School of Medicine, St Louis, Missouri
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Madigan MJ, Racette SB, Coggan AR, Stein RI, McCue LM, Gropler RJ, Peterson LR. Weight Loss Affects Intramyocardial Glucose Metabolism in Obese Humans. Circ Cardiovasc Imaging 2019; 12:e009241. [PMID: 31352791 DOI: 10.1161/circimaging.119.009241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Michael J Madigan
- Department of Medicine (S.B.R., M.J.M., R.I.S., R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO
| | - Susan B Racette
- Department of Medicine (S.B.R., M.J.M., R.I.S., R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO.,Program in Physical Therapy (S.B.R.), Washington University School of Medicine (WUSM), St. Louis, MO
| | - Andrew R Coggan
- Department of Kinesiology, Indiana University Purdue University, Indianapolis (A.R.C.)
| | - Richard I Stein
- Department of Medicine (S.B.R., M.J.M., R.I.S., R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO
| | - Lena M McCue
- Division of Biostatistics (L.M.M.), Washington University School of Medicine (WUSM), St. Louis, MO
| | - Robert J Gropler
- Department of Medicine (S.B.R., M.J.M., R.I.S., R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO.,Department of Radiology (R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO
| | - Linda R Peterson
- Department of Medicine (S.B.R., M.J.M., R.I.S., R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO.,Department of Radiology (R.J.G., L.R.P.), Washington University School of Medicine (WUSM), St. Louis, MO
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Schindler SE, Sutphen CL, Teunissen C, McCue LM, Morris JC, Holtzman DM, Mulder SD, Scheltens P, Xiong C, Fagan AM. Upward drift in cerebrospinal fluid amyloid β 42 assay values for more than 10 years. Alzheimers Dement 2018; 14:62-70. [PMID: 28710906 PMCID: PMC5750131 DOI: 10.1016/j.jalz.2017.06.2264] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 05/31/2017] [Accepted: 06/02/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION The best-established cerebrospinal fluid (CSF) biomarkers for Alzheimer's disease are levels of amyloid β 42 (Aβ42), total tau (tau), and phosphorylated tau 181 (ptau). We examined whether a widely used commercial immunoassay for CSF Aβ42, tau, and ptau provided stable measurements for more than ∼10 years. METHODS INNOTEST assay values for CSF Aβ42, tau, and ptau from Washington University in St. Louis and VU Medical Center, Amsterdam, were evaluated. RESULTS Aβ42 values as measured by the INNOTEST assay drifted upward by approximately 3% per year over the past decade. Tau values remained relatively stable, whereas results for ptau were mixed. DISCUSSION Assay drift may reduce statistical power or even confound analyses. The drift in INNOTEST Aβ42 values may reduce diagnostic accuracy for Alzheimer's disease in the clinic. We recommend methods to account for assay drift in existing data sets and to reduce assay drift in future studies.
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Affiliation(s)
- Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Courtney L Sutphen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Charlotte Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, VU Medical Center, Amsterdam, The Netherlands
| | - Lena M McCue
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Sandra D Mulder
- Neurochemistry Laboratory, Department of Clinical Chemistry, VU Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, VU Medical Center, Amsterdam, The Netherlands
| | - Chengjie Xiong
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.
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Schindler SE, Jasielec MS, Weng H, Hassenstab JJ, Grober E, McCue LM, Morris JC, Holtzman DM, Xiong C, Fagan AM. Neuropsychological measures that detect early impairment and decline in preclinical Alzheimer disease. Neurobiol Aging 2017; 56:25-32. [PMID: 28482211 DOI: 10.1016/j.neurobiolaging.2017.04.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [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: 10/21/2016] [Revised: 04/03/2017] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
Abstract
Identifying which neuropsychological measures detect early cognitive changes associated with Alzheimer disease (AD), brain pathology would be helpful clinically for the diagnosis of early AD and for the design of clinical trials. We evaluated which neuropsychological measures in our cognitive battery are most strongly associated with cerebrospinal fluid (CSF) biomarkers of AD brain pathology. We studied a large cohort (n = 233) of middle-to older-aged community-dwelling individuals (mean age 61 years) who had no clinical symptoms of dementia and underwent baseline CSF collection at baseline. Participants completed a battery of 9 neuropsychological measures at baseline and then every 1 to 3 years. CSF tau/Aβ42 was associated with baseline performance on 5/9 neuropsychological measures, especially measures of episodic memory, and longitudinal performance on 7/9 neuropsychological measures, especially measures of global cognition. The free recall portion of the Free and Cued Selective Reminding Task (FCSRT-free) detected declining cognition in the high CSF tau/Aβ42 group the earliest, followed by another measure of episodic memory and a sequencing task.
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Affiliation(s)
- Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Mateusz S Jasielec
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Hua Weng
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason J Hassenstab
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Ellen Grober
- Department of Neurology, Albert Einstein College of Medicine, New York, NY, USA
| | - Lena M McCue
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David M Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA.
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McCue LM, Flick LH, Twyman KA, Xian H. Gastrointestinal dysfunctions as a risk factor for sleep disorders in children with idiopathic autism spectrum disorder: A retrospective cohort study. Autism 2017; 21:1010-1020. [PMID: 28954536 DOI: 10.1177/1362361316667061] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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
Sleep disorders often co-occur with autism spectrum disorder. They further exacerbate autism spectrum disorder symptoms and interfere with children's and parental quality of life. This study examines whether gastrointestinal dysfunctions increase the odds of having sleep disorders in 610 children with idiopathic autism spectrum disorder, aged 2-18 years, from the Autism Genetic Resource Exchange research program. The adjusted odds ratio for sleep disorder among those with gastrointestinal dysfunctions compared to those without was 1.74 (95% confidence interval: 1.22-2.48). In addition, the odds of having multiple sleep disorder symptoms among children with gastrointestinal dysfunctions, adjusted for age, gender, behavioral problems, bed wetting, current and past supplements, and current and past medications for autism spectrum disorder symptoms were 1.75 (95% confidence interval: 1.10-2.79) compared to children without gastrointestinal dysfunctions. Early detection and treatment of gastrointestinal dysfunctions in autism spectrum disorder may be means to reduce prevalence and severity of sleep problems and improve quality of life and developmental outcomes in this population.
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McCue LM, Flick LH, Twyman KA, Xian H, Conturo TE. Prevalence of non-febrile seizures in children with idiopathic autism spectrum disorder and their unaffected siblings: a retrospective cohort study. BMC Neurol 2016; 16:245. [PMID: 27894273 PMCID: PMC5126876 DOI: 10.1186/s12883-016-0764-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 11/15/2016] [Indexed: 01/27/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is a heterogeneous disorder characterized not only by deficits in communication and social interactions but also a high rate of co-occurring disorders, including metabolic abnormalities, gastrointestinal and sleep disorders, and seizures. Seizures, when present, interfere with cognitive development and are associated with a higher mortality rate in the ASD population. Methods To determine the relative prevalence of non-febrile seizures in children with idiopathic ASD from multiplex and simplex families compared with the unaffected siblings in a cohort of 610 children with idiopathic ASD and their 160 unaffected siblings, participating in the Autism Genetic Resource Exchange project, the secondary analysis was performed comparing the life-time prevalence of non-febrile seizures. Statistical models to account for non-independence of observations, inherent with the data from multiplex families, were used in assessing potential confounding effects of age, gender, and history of febrile seizures on odds of having non-febrile seizures. Results The life-time prevalence of non-febrile seizures was 8.2% among children with ASD and 2.5% among their unaffected siblings. In a logistic regression analysis that adjusted for familial clustering, children with ASD had 5.27 (95%CI: 1.51–18.35) times higher odds of having non-febrile seizures compared to their unaffected siblings. In this comparison, age, presence of gastrointestinal dysfunction, and history of febrile seizures were significantly associated with the prevalence of non-febrile seizures. Conclusion Children with idiopathic ASD are significantly more likely to have non-febrile seizures than their unaffected siblings, suggesting that non-febrile seizures may be ASD-specific. Further studies are needed to determine modifiable risk factors for non-febrile seizures in ASD.
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Affiliation(s)
- Lena M McCue
- Division of Biostatistics, Washington University in St. Louis, School of Medicine, 660 Euclid Ave., St. Louis, MO, 63110, USA.
| | - Louise H Flick
- Epidemiology Department, Saint Louis University, College for Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO, 63104, USA
| | - Kimberly A Twyman
- Department of Pediatrics, Saint Louis University School of Medicine, 1465 S Grand Blvd., St Louis, MO, 63104, USA
| | - Hong Xian
- Department of Biostatistics, Saint Louis University, College for Public Health and Social Justice, 3545 Lafayette Ave., St. Louis, MO, 63104, USA
| | - Thomas E Conturo
- Department of Radiology, Washington University School of Medicine, 4525 Scott Ave., St Louis, MO, 63110, USA
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