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Pikwer A, Yang B, Granström M, Mattsson N, Sadr-Azodi O. General anesthesia in early childhood and possible association with autism: a population-based matched cohort study. Minerva Anestesiol 2023; 89:22-31. [PMID: 36282219 DOI: 10.23736/s0375-9393.22.16543-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND In experimental animal studies, exposure to general anesthesia in early childhood may results in changes in infant brain morphology and behavior, potentially leading to the development of autistic behaviors in the long-term. However, in clinical studies the role of exposure to general anesthesia in early childhood and the risk of autism is unknown. METHODS This is a population-based cohort study including all children aged 0-5 years of age exposed to general anesthesia between 2001 and 2014 and a corresponding matched population without such an exposure. Propensity score calculation was based on 49 variables (including age of parents, malformations, APGAR Score, and family income, among others). Quasi-Poisson regression was used to estimate risk ratios (RRs) with 95% confidence intervals (CIs) for the association between exposure to general anesthesia and autism or autism spectrum disorder. RESULTS In total, 401,750 children exposed to general anesthesia were compared with 1,187,796 unexposed individuals. Autism or autism spectrum disorder were more common in the children exposed to general anesthesia as compared to unexposed children (1.65% and 0.98%, respectively, P<0.01). There was a statistically significant higher risk of autism or autism spectrum disorder in children exposed to general anesthesia as compared to unexposed children also after propensity score adjustment (RR 1.62, 95% CI: 1.57-1.67). CONCLUSIONS Exposure to general anesthesia in early childhood was associated with an increased risk of autism or autism spectrum disorder. Future studies are needed to asses if general anesthesia may cause autism or if the association is due to other factors.
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Affiliation(s)
- Andreas Pikwer
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden - .,Department of Anesthesia, Eskilstuna County Hospital, Eskilstuna, Sweden -
| | - Bei Yang
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Malin Granström
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.,Department of Anesthesia, Eskilstuna County Hospital, Eskilstuna, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Omid Sadr-Azodi
- Center for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden.,Unit of Surgery, Department of Clinical Sciences, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.,Department of Surgery, Saint Goran Hospital, Stockholm, Sweden
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2
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Jansen WJ, Janssen O, Tijms BM, Vos SJB, Ossenkoppele R, Visser PJ, Aarsland D, Alcolea D, Altomare D, von Arnim C, Baiardi S, Baldeiras I, Barthel H, Bateman RJ, Van Berckel B, Binette AP, Blennow K, Boada M, Boecker H, Bottlaender M, den Braber A, Brooks DJ, Van Buchem MA, Camus V, Carill JM, Cerman J, Chen K, Chételat G, Chipi E, Cohen AD, Daniels A, Delarue M, Didic M, Drzezga A, Dubois B, Eckerström M, Ekblad LL, Engelborghs S, Epelbaum S, Fagan AM, Fan Y, Fladby T, Fleisher AS, Van der Flier WM, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Frings L, Frisoni GB, Fröhlich L, Gabryelewicz T, Gertz HJ, Gill KD, Gkatzima O, Gómez-Tortosa E, Grimmer T, Guedj E, Habeck CG, Hampel H, Handels R, Hansson O, Hausner L, Hellwig S, Heneka MT, Herukka SK, Hildebrandt H, Hodges J, Hort J, Huang CC, Iriondo AJ, Itoh Y, Ivanoiu A, Jagust WJ, Jessen F, Johannsen P, Johnson KA, Kandimalla R, Kapaki EN, Kern S, Kilander L, Klimkowicz-Mrowiec A, Klunk WE, Koglin N, Kornhuber J, Kramberger MG, Kuo HC, Van Laere K, Landau SM, Landeau B, Lee DY, de Leon M, Leyton CE, Lin KJ, Lleó A, Löwenmark M, Madsen K, Maier W, Marcusson J, Marquié M, Martinez-Lage P, Maserejian N, Mattsson N, de Mendonça A, Meyer PT, Miller BL, Minatani S, Mintun MA, Mok VCT, Molinuevo JL, Morbelli SD, Morris JC, Mroczko B, Na DL, Newberg A, Nobili F, Nordberg A, Olde Rikkert MGM, de Oliveira CR, Olivieri P, Orellana A, Paraskevas G, Parchi P, Pardini M, Parnetti L, Peters O, Poirier J, Popp J, Prabhakar S, Rabinovici GD, Ramakers IH, Rami L, Reiman EM, Rinne JO, Rodrigue KM, Rodríguez-Rodriguez E, Roe CM, Rosa-Neto P, Rosen HJ, Rot U, Rowe CC, Rüther E, Ruiz A, Sabri O, Sakhardande J, Sánchez-Juan P, Sando SB, Santana I, Sarazin M, Scheltens P, Schröder J, Selnes P, Seo SW, Silva D, Skoog I, Snyder PJ, Soininen H, Sollberger M, Sperling RA, Spiru L, Stern Y, Stomrud E, Takeda A, Teichmann M, Teunissen CE, Thompson LI, Tomassen J, Tsolaki M, Vandenberghe R, Verbeek MM, Verhey FRJ, Villemagne V, Villeneuve S, Vogelgsang J, Waldemar G, Wallin A, Wallin ÅK, Wiltfang J, Wolk DA, Yen TC, Zboch M, Zetterberg H. Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum. JAMA Neurol 2022; 79:228-243. [PMID: 35099509 DOI: 10.1001/jamaneurol.2021.5216] [Citation(s) in RCA: 83] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design. OBJECTIVE To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria. EXPOSURES Alzheimer disease biomarkers detected on PET or in CSF. MAIN OUTCOMES AND MEASURES Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations. RESULTS Among the 19 097 participants (mean [SD] age, 69.1 [9.8] years; 10 148 women [53.1%]) included, 10 139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P = .04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P = .004), subjective cognitive decline (9%; 95% CI, 3%-15%; P = .005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P = .004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P = .18). CONCLUSIONS AND RELEVANCE This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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Affiliation(s)
- Willemijn J Jansen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Banner Alzheimer's Institute, Phoenix, Arizona
| | - Olin Janssen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands
| | - Stephanie J B Vos
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Pieter Jelle Visser
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniele Altomare
- Laboratory Alzheimer's Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Christine von Arnim
- Division of Geriatrics, University of Goettingen Medical School, Goettingen, Germany.,Clinic for Neurogeriatrics and Neurological Rehabilitation, University and Rehabilitation Hospital Ulm, Ulm, Germany
| | - Simone Baiardi
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Spain
| | - Ines Baldeiras
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Randall J Bateman
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Bart Van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Neuroscience and Physiology, Sahlgren's University Hospital, Mölndal, Sweden
| | - Merce Boada
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Henning Boecker
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany
| | - Michel Bottlaender
- Université Paris-Saclay, Service Hospitalier Frédéric Joliot (CEA), French National Centre for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), BioMaps, Service Hospitalier Frederic Joliot, Orsay, France
| | - Anouk den Braber
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David J Brooks
- Translational and Clinical Research Institute, University of Newcastle upon Tyne, United Kingdom.,Department of Nuclear Medicine, Positron Emission Tomography Centre, Aarhus University, Aarhus, Denmark.,Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Mark A Van Buchem
- Department of Neurology, University Hospital Leiden, Leiden, the Netherlands
| | - Vincent Camus
- Unite Mixte de Recherche, INSERM U930, French National Centre for Scientific Research (CNRS) ERL, Tours, France
| | - Jose Manuel Carill
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), University of Cantabria, Santander, Spain
| | - Jiri Cerman
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Gaël Chételat
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Elena Chipi
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alisha Daniels
- Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Marion Delarue
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Mira Didic
- Assistance Publique Hôpitaux de Marseille (AP-HM), Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France.,Aix Marseille Univ, INSERM, Institut de Neurosciences des Systèmes (INS), Marseille, France
| | - Alexander Drzezga
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany.,Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bruno Dubois
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.,Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stéphane Epelbaum
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Anne M Fagan
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | | | - Wiesje M Van der Flier
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Department of Nuclear Medicine, Klinikum Bayreuth, Bayreuth, Germany
| | - Juan Fortea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Kristian Steen Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Giovanni B Frisoni
- Memory Clinic, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Lutz Fröhlich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Hermann-Josef Gertz
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Kiran Dip Gill
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Olymbia Gkatzima
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Eric Guedj
- Aix Marseille University, AP-HM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Centre Européen de Recherche en Imagerie Médicale (CERIMED), Nuclear Medicine Department, Marseille, France
| | - Christian G Habeck
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York
| | - Harald Hampel
- Sorbonne University, Clinical Research Group no. 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Ron Handels
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Lucrezia Hausner
- Universität Heidelberg, Abteilung Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit Mannheim, Mannheim, Germany
| | - Sabine Hellwig
- Department of Psychiatry and Psychotherapy Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital of Bonn, Bonn, Germany.,Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Helmut Hildebrandt
- Klinikum Bremen-Ost, University of Oldenburg, Institute of Psychology, Oldenburg, Germany
| | - John Hodges
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jakub Hort
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Ane Juaristi Iriondo
- Center for Research and Advanced Therapies, Centro de Investigación y Ciencias Avanzadas-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Yoshiaki Itoh
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Adrian Ivanoiu
- Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley.,Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
| | - Frank Jessen
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,DZNE, Bonn, Germany
| | - Peter Johannsen
- Memory Disorder Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Boston
| | - Ramesh Kandimalla
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Department of Radiation Oncology, Emory University, Atlanta, Georgia.,Applied Biology, Council of Scientific and Industrial Research (CSIR)-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, Telangana State, India.,Department of Biochemistry, Kakatiya Medical College/Mahatma Gandhi Memorial Hospital, Warangal, Telangana State, India
| | - Elisabeth N Kapaki
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Silke Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Aleksandra Klimkowicz-Mrowiec
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - William E Klunk
- Department of Psychiatry, Massachusetts General Hospital, Boston.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Milica G Kramberger
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Hung-Chou Kuo
- Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Koen Van Laere
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley
| | - Brigitte Landeau
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Mony de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Cristian E Leyton
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Kun-Ju Lin
- Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Alberto Lleó
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Malin Löwenmark
- Memory Clinic, Department of Geriatrics, Uppsala University Hospital, Uppsala, Sweden
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Jan Marcusson
- Acute Internal Medicine and Geriatrics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marta Marquié
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Pablo Martinez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | | | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | | | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Shinobu Minatani
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,BrainNow Research Institute, Guangdong Province, Shenzhen, China
| | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinic University Hospital, Barcelona, Spain
| | - Silvia Daniela Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - John C Morris
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland.,Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Flavio Nobili
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | | | | | - Pauline Olivieri
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Adela Orellana
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - George Paraskevas
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Piero Parchi
- Istituto delle Scienze Neurologiche di Bologna, IRCCS, Bologna, Italy.,DIMES, University of Bologna, Bologna, Italy
| | | | - Lucilla Parnetti
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Oliver Peters
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin-CBF, Berlin, Deutschland
| | - Judes Poirier
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Julius Popp
- Department of Geriatric Psychiatry, University Hospital of Psychiatry Zürich and University of Zürich, Zürich, Switzerland.,Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sudesh Prabhakar
- Department of Neurology, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Inez H Ramakers
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas
| | | | - Catherine M Roe
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Pedro Rosa-Neto
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Uros Rot
- Department of Neurology, Medical Center, Zaloska 7, Ljubljana, Slovenia
| | - Christopher C Rowe
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience, University of Melbourne, Melbourne, Victoria, Australia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Agustín Ruiz
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Jayant Sakhardande
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Pascual Sánchez-Juan
- Service of Neurology, University Hospital Marqués de Valdecilla-IDIVAL, CIBERNED, Santander, Spain
| | - Sigrid Botne Sando
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | - Isabel Santana
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Marie Sarazin
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Philip Scheltens
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes Schröder
- Section for Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Sang Won Seo
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisboa, Portugal
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Peter J Snyder
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, The University of Rhode Island, Kingston
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Marc Sollberger
- Memory Clinic, University Department of Geriatric Medicine, Felix Platter-Hospital, Basel, Switzerland.,Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard Aging Brain Study, Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Luisa Spiru
- Geriatrics, Gerontology and Old Age Psychiatry Clinical Department, Carol Davila University of Medicine and Pharmacy-Elias, Emergency Clinical Hospital, Bucharest, Romania.,Memory Clinic and Longevity Medicine, Ana Aslan International Foundation, Bucharest, Romania
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Akitoshi Takeda
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Marc Teichmann
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Centre de Référence Démences Rares, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Charlotte E Teunissen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Louisa I Thompson
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jori Tomassen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, George Papanicolau General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, University of Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Nijmegen, the Netherlands
| | - Frans R J Verhey
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Victor Villemagne
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Molecular Biomarkers in Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Jonathan Vogelgsang
- Translational Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Wallin
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Åsa K Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan.,Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Marzena Zboch
- Research-Scientific-Didactic Centre of Dementia-Related Diseases in Scinawa, Medical University of Wroclaw, Wroclaw, Poland
| | - Henrik Zetterberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London (UCL) Queen Square Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute, London, United Kingdom.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
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3
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Ossenkoppele R, Mattsson N, Smith R, Groot C, Cho H, La Joie R, Baker SL, Borroni E, Klein G, Pontecorvo MJ, Devous MD, Jagust WJ, Lyoo CH, Rabinovici GD, Hansson O. Tau PET as a prognostic marker in preclinical and prodromal Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.055932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Colin Groot
- Alzheimer Center and Department of Neurology Amsterdam Neuroscience VU University Medical Center Amsterdam Netherlands
| | - Hanna Cho
- Gangnam Severance Hospital Yonsei University College of Medicine Seoul South Korea
| | - Renaud La Joie
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California San Francisco CA USA
| | | | | | | | | | | | | | - Chul Hyoung Lyoo
- Gangnam Severance Hospital Yonsei University College of Medicine Seoul South Korea
| | - Gil D. Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California San Francisco CA USA
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Malmö Sweden
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4
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Tideman P, Stomrud E, Mattsson N, Palmqvist S, Hansson O. Amyloid‐β accumulation is independently related to executive function in cognitively unimpaired adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.052016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University Malmö Sweden
- Memory Clinic, Skåne University Hospital Malmö Sweden
| | - Erik Stomrud
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Lund University Lund Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University Malmö Sweden
- Neurology Clinic, Skåne University Hospital Lund Sweden
- Wallenberg Centre for Molecular Medicine, Lund University Lund Sweden
| | - Sebastian Palmqvist
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Lund University Lund Sweden
| | - Oskar Hansson
- Memory Clinic, Skåne University Hospital Malmö Sweden
- Lund University Lund Sweden
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5
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Johansson M, Smith R, Stomrud E, Johansson P, Janelidze S, van Westen D, Mattsson N, Hansson O. Mild behavioral impairment is predictive of tau deposition in the earliest stages of Alzheimer's disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.042595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maurits Johansson
- Division of Clinical Sciences, Helsingborg, Department of Clinical Sciences Lund Lund University Helsingborg Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Mälmo Lund University Lund Sweden
- Psychiatry Clinic, Helsingborg Hospital Helsingborg Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö Lund University Malmö Sweden
- Memory Clinic Skåne University Hospital Malmö Sweden
- Emmaboda Health Centre, Region Kalmar County Emmaboda Sweden
| | - Per Johansson
- Division of Clinical Sciences, Helsingborg, Department of Clinical Sciences Lund Lund University Helsingborg Sweden
- Department of Internal Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | | | - Danielle van Westen
- Imaging and Function Skåne University Health Care Lund Sweden
- Diagnostic Radiology, Department of Clinical Sciences Lund Lund University Lund Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
- Wallenberg Centre for Molecular Medicine Lund University Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Mälmo Lund University Malmö Sweden
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6
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Pereira JB, Janelidze S, Ossenkoppele R, Brinkmalm A, Mattsson N, Stomrud E, Smith R, Zetterberg H, Blennow K, Hansson O. Untangling the roles of amyloid and tau in synaptic and axonal loss in the course of Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.043169] [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: 11/10/2022]
Affiliation(s)
- Joana B. Pereira
- Lund University Lund Sweden
- Karolinska Institutet Stockholm Sweden
| | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands Amsterdam Netherlands
| | | | | | - Erik Stomrud
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology the Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Kaj Blennow
- Sahlgrenska University Hospital Mölndal Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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7
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Kumar A, Shoai M, Malarstig A, Stomrud E, Palmqvist S, Hardy J, Mattsson N, Hansson O. Genome‐wide polygenic risk scores for identification of gene therapeutic target. Alzheimers Dement 2020. [DOI: 10.1002/alz.040903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Maryam Shoai
- Institute of Neurology University College London London United Kingdom
| | | | | | | | - John Hardy
- Institute of Neurology University College London London United Kingdom
| | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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8
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Janelidze S, Palmqvist S, Quiroz YT, Lopera F, Stomrud E, Su Y, Chen Y, Serrano GE, Leuzy A, Mattsson N, Strandberg O, Smith R, Villegas A, Sepulveda D, Chai X, Proctor N, Zetterberg H, Beach TG, Blennow K, Reiman EM, Dage JL, Hansson O. Phospho‐tau217 and phospho‐tau181 in plasma and CSF as biomarkers for Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.037520] [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: 11/07/2022]
Affiliation(s)
| | | | | | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Erik Stomrud
- Memory Clinic Skåne University Hospital Malmö Sweden
| | - Yi Su
- Banner Alzheimer's Institute Phoenix AZ USA
| | | | | | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Olof Strandberg
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | - Ruben Smith
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Andres Villegas
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Diego Sepulveda
- Grupo de Neurociencias de Antioquia, Universidad de Antioquia Medellin Colombia
| | - Xiyun Chai
- Eli Lilly and Company Indianapolis IN USA
| | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology the Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | | | - Kaj Blennow
- Sahlgrenska University Hospital Mölndal Sweden
| | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Clinical Memory Research Unit Department of Clinical Sciences Lund University Malmö Sweden
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9
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Ashton NJ, Leuzy A, Karikari TK, Dodich A, Boccardi M, Barthel H, Bischof GN, Carrillo MC, Chiotis K, Corre J, Démonet J, Drzezga A, Gietl AF, Johnson KC, Lorenzi M, Nordberg AK, Ossenkoppele R, Rabinovici GD, Ratib O, Sabri O, Treyer V, Unschuld PG, Villemagne VLL, Winblad B, Wolters EE, Frisoni GB, Garibotto V, Mattsson N, Zetterberg H, Blennow K, Hansson O. Alzheimer’s disease biomarker roadmap 2020: Fluid biomarkers. Alzheimers Dement 2020. [DOI: 10.1002/alz.039557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation London United Kingdom
- Institute of Psychiatry Psychology & Neuroscience King's College London London United Kingdom
- Department of Psychiatry and Neurochemistry Institute of Neuroscience & Physiology the Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Henryk Barthel
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Gerard N Bischof
- Medical Faculty and University Hospital of Cologne Cologne Germany
| | | | | | - Julie Corre
- Centre National de la Recherche Scientifique Montpellier France
| | - Jean‐François Démonet
- Department of Clinical Neurosciences Leenaards Memory Centre Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne Switzerland
| | | | - Anton F. Gietl
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Karen C Johnson
- University of Tennessee Health Science Center Memphis TN USA
| | | | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Gil D Rabinovici
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
| | - Osman Ratib
- Geneva University Hospitals Geneva Switzerland
| | - Osama Sabri
- Department of Nuclear Medicine University of Leipzig Leipzig Germany
| | - Valerie Treyer
- Institute for Regenerative Medicine University of Zurich Schlieren Switzerland
| | - Paul G. Unschuld
- Hospital for Psychogeriatric Medicine University of Zurich Zurich Switzerland
| | | | | | - Emma E Wolters
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Giovanni B Frisoni
- Memory Clinic and LANVIE‐Laboratory of Neuroimaging of Aging University Hospitals and University of Geneva Geneva Switzerland
| | - Valentina Garibotto
- Division of Nuclear Medicine Geneva University Hospitals and University of Geneva Geneva Switzerland
| | | | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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10
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Smith R, Strandberg O, Mattsson N, Leuzy A, Palmqvist S, Pontecorvo MJ, Devous MD, Ossenkoppele R, Hansson O. The accumulation rate of tau aggregates is higher in females and younger individuals. Alzheimers Dement 2020. [DOI: 10.1002/alz.043876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
- Neurology Clinic Skåne University Hospital Lund Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Lund Sweden
| | | | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Rik Ossenkoppele
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Mälmo Lund University Malmö Sweden
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11
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Leuzy A, Ashton NJ, Karikari TK, Simrén J, Mårtensson G, Benedet AL, Hye A, Schöll M, Mecocci P, Vellas B, Tsolaki M, Kłoszewska I, Lovestone S, Aarsland D, Mattsson N, Hansson O, Westman E, Blennow K, Zetterberg H. Plasma‐based biomarkers for Aβ and tau predict longitudinal brain atrophy in cognitively healthy elderly and in patients with Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.046490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | - Joel Simrén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry The Sahlgrenska Academy at the University of Gothenburg Molndal Sweden
| | | | | | - Abdul Hye
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | | | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine University of Perugia Perugia Italy
| | | | - Magda Tsolaki
- Aristotle University of Thessaloniki Thessaloniki Greece
| | | | | | - Dag Aarsland
- Centre for Age‐Related Medicine Stavanger University Hospital Stavanger Norway
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Eric Westman
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience King´s College London London United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology University of Gothenburg Mölndal Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry The Sahlgrenska Academy at University of Gothenburg Mölndal Sweden
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12
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Gertje EC, Janelidze S, van Westen D, Palmqvist S, Hansson O, Mattsson N. White matter lesions are associated with CSF biomarkers of neuroinflammation in prodromal Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.041795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit Lund University Malmö Sweden
- Wallenberg Centre for Molecular Medicine Lund University Lund Sweden
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13
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Provost K, Iaccarino L, Soleimani‐Meigooni DN, Lesman‐Segev OH, Joie R, Mattsson N, Hansson O, Eichenlaub U, Edwards L, Strom A, Pham JQ, Mellinger TJ, Janabi M, Baker SL, Jagust WJ, Rabinovici GD. Comparison of
18
F‐Flortaucipir visual assessment, SUVR quantification and CSF pTau for defining T‐status in the AT(N) framework. Alzheimers Dement 2020. [DOI: 10.1002/alz.037276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Karine Provost
- University of California, San Francisco San Francisco CA USA
| | | | | | | | - Renaud Joie
- University of California, San Francisco San Francisco CA USA
| | - Niklas Mattsson
- Wallenberg Centre for Molecular Medicine Lund University Lund Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Lauren Edwards
- University of California, San Francisco San Francisco CA USA
| | - Amelia Strom
- University of California, San Francisco San Francisco CA USA
| | - Julie Q. Pham
- University of California, San Francisco San Francisco CA USA
| | | | | | | | - William J. Jagust
- Lawrence Berkeley National Laboratory Berkeley CA USA
- University of California, Berkeley Berkeley CA USA
| | - Gil D. Rabinovici
- University of California, Berkeley Berkeley CA USA
- Memory and Aging Center UCSF Weill Institute for Neurosciences University of California, San Francisco San Francisco CA USA
- Molecular Biophysics and Integrated Bioimaging Division Lawrence Berkeley National Laboratory Berkeley CA USA
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14
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Simrén J, Leuzy A, Karikari TK, Hye A, Mattsson N, Hansson O, Schöll M, Mecocci P, Vellas B, Tsolaki M, Kloszewska I, Soininen H, Lovestone S, Aarsland D, Westman E, Blennow K, Zetterberg H, Ashton NJ. Ultrasensitive blood biomarkers to predict cognitive decline and diagnose Alzheimer’s disease in the absence of AT(N) classification as the reference standard. Alzheimers Dement 2020. [DOI: 10.1002/alz.041808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Joel Simrén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry The Sahlgrenska Academy at the University of Gothenburg Molndal Sweden
| | - Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Abdul Hye
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
| | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine University of Perugia Perugia Italy
| | | | - Magda Tsolaki
- Aristotle University of Thessaloniki Thessaloniki Greece
| | | | - Hilkka Soininen
- Institute of Clinical Medicine University of Eastern Finland Kuopio Finland
| | | | - Dag Aarsland
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- Centre for Age‐Related Medicine Stavanger University Hospital Stavanger Norway
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet Stockholm Sweden
| | | | - Henrik Zetterberg
- University of Gothenburg Gothenburg Sweden
- Department of Neurodegenerative Disease UCL Queen Square Institute of Neurology London United Kingdom
| | - Nicholas J Ashton
- Institute of Psychiatry, Psychology & Neuroscience King's College London London United Kingdom
- University of Gothenburg Gothenburg Sweden
- Wallenberg Centre for Molecular and Translational Medicine University of Gothenburg Gothenburg Sweden
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15
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Leuzy A, Klein G, Ossenkoppele R, Mattsson N, Janelidze S, Palmqvist S, Strandberg O, Coloma PM, Borroni E, Stomrud E, Smith R, Hansson O. Longitudinal [
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F]RO948 PET SUVR is associated with Aβ accumulation and baseline tau pathology. Alzheimers Dement 2020. [DOI: 10.1002/alz.046474] [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: 11/10/2022]
Affiliation(s)
- Antoine Leuzy
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Gregory Klein
- Roche Pharma Research and Early Development Roche Innovation Center Basel Switzerland
| | | | | | | | | | | | - Preciosa M Coloma
- Real World Data Science (RWD‐S) Neuroscience and Established Products F. Hoffmann‐La Roche Ltd. Pharmaceuticals Division Basel Switzerland
| | | | - Erik Stomrud
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit Department of Clinical Sciences Malmö Lund University Malmö Sweden
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16
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Janelidze S, Mattsson N, Smith R, Stomrud E, Palmqvist S, Dage JL, Hansson O. Plasma phospho‐tau217 is a potential early diagnostic and prognostic biomarker of Alzheimer’s disease. Alzheimers Dement 2020. [DOI: 10.1002/alz.042489] [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: 11/10/2022]
Affiliation(s)
| | | | - Ruben Smith
- Clinical Memory Research Unit Lund University Malmö Sweden
| | | | | | | | - Oskar Hansson
- Clinical Memory Research Unit Lund University Malmö Sweden
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Hadad R, Larsen B, Fenger A, Stavnem D, Mattsson N, Kristiansen O, Nielsen O, Sajadieh A. Night heart rate variability identifies cardiovascular risk in community dwelling people with uncomplicated type 2 diabetes mellitus. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Low Heart rate variability (HRV) reflects cardiac autonomic neuropathy, associated with increased cardiovascular mortality in type 2 diabetes (T2DM) patients. Measuring HRV is challenged by environmental noise, mental stress and physical activity during the day-time. Thus, measuring night-time HRV during sleep may be a better tool to predict cardiovascular (CV) events in low risk T2DM patients without previous cardiovascular disease.
Methods
Copenhagen Holter Study included 678 community dwelling subjects aged 55–75 years free of previous cardiovascular disease. Day- and night-time HRV were available for 653. The population included 133 well-controlled T2DM patients (mean HbA1c 7.2%). Median follow- up was 14.4 years. HRV is defined as standard deviation for the mean value of normal-to-normal complexes (SDNN). Night-time HRV measurements were pre-defined from 2:00 to 2:15 AM. CV events were defined as CV death, myocardial infarction, stroke, or coronary revascularization.
Results
The rate of CV events was 17 and 31 per 1000 patient-year in patients without and with T2DM, respectively (p=0.015). Night-time SDNN was inversely associated with CV events in T2DM patients with a HR of 0.74 (0.61–0.89), P=0.001, for each 10 ms increment in SDNN, after adjustment for sex, age, LDL, smoking, systolic BP, glucose, CRP and NT pro-BNP (table 1). Twenty-four-hours HRV was not associated with cardiovascular events (table 1). Conventional risk factors had an AUC of 0.704 (95% CI 0.602–0.806) to predict CV events in T2DM. Prediction was improved by the addition of night-time SDNN; AUC 0.765 (95% CI 0.669–0.862), P=0.037, but not by CRP or NT-proBNP (Figure 1). In subjects with well-controlled T2DM and night-time SDNN ≤30 ms, the 10-year risk of CV death and CV even-rate were 12% and 45%, respectively. This allocates these T2DM patients in a “very high-risk” group, and more aggressive targets for blood-pressure and lipids according to the current guidelines.
Conclusion
Reduced night-time HRV associates with increased risk of CV events in persons with well-controlled T2DM. We observed improved risk prediction of cardiovascular events in T2DM by night-time HRV, which may have therapeutic consequences.
Figure 1. ROC Curve
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Danish Heart Foundation
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Affiliation(s)
- R Hadad
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - B.S Larsen
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - A.S Fenger
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - D Stavnem
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - N Mattsson
- Bispebjerg University Hospital, Copenhagen, Denmark
| | | | - O.W Nielsen
- Bispebjerg University Hospital, Copenhagen, Denmark
| | - A Sajadieh
- Bispebjerg University Hospital, Copenhagen, Denmark
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18
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Karikari TK, Pascoal TA, Ashton NJ, Janelidze S, Benedet AL, Rodriguez JL, Chamoun M, Savard M, Kang MS, Therriault J, Schöll M, Massarweh G, Soucy JP, Höglund K, Brinkmalm G, Mattsson N, Palmqvist S, Gauthier S, Stomrud E, Zetterberg H, Hansson O, Rosa-Neto P, Blennow K. Blood phosphorylated tau 181 as a biomarker for Alzheimer's disease: a diagnostic performance and prediction modelling study using data from four prospective cohorts. Lancet Neurol 2020; 19:422-433. [PMID: 32333900 DOI: 10.1016/s1474-4422(20)30071-5] [Citation(s) in RCA: 572] [Impact Index Per Article: 143.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/23/2020] [Accepted: 02/24/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND CSF and PET biomarkers of amyloid β and tau accurately detect Alzheimer's disease pathology, but the invasiveness, high cost, and poor availability of these detection methods restrict their widespread use as clinical diagnostic tools. CSF tau phosphorylated at threonine 181 (p-tau181) is a highly specific biomarker for Alzheimer's disease pathology. We aimed to assess whether blood p-tau181 could be used as a biomarker for Alzheimer's disease and for prediction of cognitive decline and hippocampal atrophy. METHODS We developed and validated an ultrasensitive blood immunoassay for p-tau181. Assay performance was evaluated in four clinic-based prospective cohorts. The discovery cohort comprised patients with Alzheimer's disease and age-matched controls. Two validation cohorts (TRIAD and BioFINDER-2) included cognitively unimpaired older adults (mean age 63-69 years), participants with mild cognitive impairment (MCI), Alzheimer's disease, and frontotemporal dementia. In addition, TRIAD included healthy young adults (mean age 23 years) and BioFINDER-2 included patients with other neurodegenerative disorders. The primary care cohort, which recruited participants in Montreal, Canada, comprised control participants from the community without a diagnosis of a neurological condition and patients referred from primary care physicians of the Canadian National Health Service for specialist care. Concentrations of plasma p-tau181 were compared with established CSF and PET biomarkers and longitudinal measurements using Spearman correlation, area under the curve (AUC), and linear regression analyses. FINDINGS We studied 37 individuals in the discovery cohort, 226 in the first validation cohort (TRIAD), 763 in the second validation cohort (BioFINDER-2), and 105 in the primary care cohort (n=1131 individuals). In all cohorts, plasma p-tau181 showed gradual increases along the Alzheimer's disease continuum, from the lowest concentrations in amyloid β-negative young adults and cognitively unimpaired older adults, through higher concentrations in the amyloid β-positive cognitively unimpaired older adults and MCI groups, to the highest concentrations in the amyloid β-positive MCI and Alzheimer's disease groups (p<0·001, Alzheimer's disease vs all other groups). Plasma p-tau181 distinguished Alzheimer's disease dementia from amyloid β-negative young adults (AUC=99·40%) and cognitively unimpaired older adults (AUC=90·21-98·24% across cohorts), as well as other neurodegenerative disorders, including frontotemporal dementia (AUC=82·76-100% across cohorts), vascular dementia (AUC=92·13%), progressive supranuclear palsy or corticobasal syndrome (AUC=88·47%), and Parkinson's disease or multiple systems atrophy (AUC=81·90%). Plasma p-tau181 was associated with PET-measured cerebral tau (AUC=83·08-93·11% across cohorts) and amyloid β (AUC=76·14-88·09% across cohorts) pathologies, and 1-year cognitive decline (p=0·0015) and hippocampal atrophy (p=0·015). In the primary care cohort, plasma p-tau181 discriminated Alzheimer's disease from young adults (AUC=100%) and cognitively unimpaired older adults (AUC=84·44%), but not from MCI (AUC=55·00%). INTERPRETATION Blood p-tau181 can predict tau and amyloid β pathologies, differentiate Alzheimer's disease from other neurodegenerative disorders, and identify Alzheimer's disease across the clinical continuum. Blood p-tau181 could be used as a simple, accessible, and scalable test for screening and diagnosis of Alzheimer's disease. FUNDING Alzheimer Drug Discovery Foundation, European Research Council, Swedish Research Council, Swedish Alzheimer Foundation, Swedish Dementia Foundation, Alzheimer Society Research Program.
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Affiliation(s)
- Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tharick A Pascoal
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada; Montreal Neurological Institute, Montreal, QC, Canada
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden; Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia, South London and Maudsley NHS Foundation Trust, London, UK
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Andréa Lessa Benedet
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Juan Lantero Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mira Chamoun
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Melissa Savard
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Min Su Kang
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada; Montreal Neurological Institute, Montreal, QC, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Kina Höglund
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Gunnar Brinkmalm
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden; Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Serge Gauthier
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Neurodegenerative Disease, Institute of Neurology and UK Dementia Research Institute, University College London, London, UK
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Montreal, QC, Canada; Montreal Neurological Institute, Montreal, QC, Canada
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
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Mattsson N, Cullen NC, Andreasson U, Zetterberg H, Blennow K. Association Between Longitudinal Plasma Neurofilament Light and Neurodegeneration in Patients With Alzheimer Disease. JAMA Neurol 2020; 76:791-799. [PMID: 31009028 DOI: 10.1001/jamaneurol.2019.0765] [Citation(s) in RCA: 369] [Impact Index Per Article: 92.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Importance Plasma neurofilament light (NfL) has been suggested as a noninvasive biomarker to monitor neurodegeneration in Alzheimer disease (AD), but studies are lacking. Objective To examine whether longitudinal plasma NfL levels are associated with other hallmarks of AD. Design, Setting, and Participants This North American cohort study used data from 1583 individuals in the multicenter Alzheimer's Disease Neuroimaging Initiative study from September 7, 2005, through June 16, 2016. Patients were eligible for inclusion if they had NfL measurements. Annual plasma NfL samples were collected for up to 11 years and were analyzed in 2018. Exposures Clinical diagnosis, Aβ and tau cerebrospinal fluid (CSF) biomarkers, imaging measures (magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography), and tests on cognitive scores. Main Outcomes and Measures The primary outcome was the association between baseline exposures (diagnosis, CSF biomarkers, imaging measures, and cognition) and longitudinal plasma NfL levels, analyzed by an ultrasensitive assay. The secondary outcomes were the associations between a multimodal classification scheme with Aβ, tau, and neurodegeneration (ie, the ATN system) and plasma NfL levels and between longitudinal changes in plasma NfL levels and changes in the other measures. Results Of the included 1583 participants, 716 (45.2%) were women, and the mean (SD) age was 72.9 (7.1) years; 401 had no cognitive impairment, 855 had mild cognitive impairment, and 327 had AD dementia. The NfL level was increased at baseline in patients with mild cognitive impairment and AD dementia (mean levels: cognitive unimpairment, 32.1 ng/L; mild cognitive impairment, 37.9 ng/L; and AD dementia, 45.9 ng/L; P < .001) and increased in all diagnostic groups, with the greatest increase in patients with AD dementia. A longitudinal increase in NfL level correlated with baseline CSF biomarkers (low Aβ42 [P = .001], high total tau [P = .02], and high phosphorylated tau levels [P = .02]), magnetic resonance imaging measures (small hippocampal volumes [P < .001], thin regional cortices [P = .009], and large ventricular volumes [P = .002]), low fluorodeoxyglucose-positron emission tomography uptake (P = .01), and poor cognitive performance (P < .001) for a global cognitive score. With use of the ATN system, increased baseline NfL levels were seen in A-T+N+ (P < .001), A+T-N+ (P < .001), and A+T+N+ (P < .001), and increased rates of NfL levels were seen in A-T+N- (P = .009), A-T+N+ (P = .02), A+T-N+ (P = .04), and A+T+N+ (P = .002). Faster increase in NfL levels correlated with faster increase in CSF biomarkers of neuronal injury, faster rates of atrophy and hypometabolism, and faster worsening in global cognition (all P < .05 in patients with mild cognitive impairment; associations differed slightly in cognitively unimpaired controls and patients with AD dementia). Conclusions and Relevance The findings suggest that plasma NfL can be used as a noninvasive biomarker associated with neurodegeneration in patients with AD and may be useful to monitor effects in trials of disease-modifying drugs.
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Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Nicholas C Cullen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute at University College London, London, United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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Bjurström MF, Mattsson N, Harsten A, Dietz N, Bodelsson M. Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent. Minerva Anestesiol 2020; 86:636-644. [DOI: 10.23736/s0375-9393.20.14138-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Janelidze S, Stomrud E, Smith R, Palmqvist S, Mattsson N, Airey DC, Proctor NK, Chai X, Shcherbinin S, Sims JR, Triana-Baltzer G, Theunis C, Slemmon R, Mercken M, Kolb H, Dage JL, Hansson O. Cerebrospinal fluid p-tau217 performs better than p-tau181 as a biomarker of Alzheimer's disease. Nat Commun 2020; 11:1683. [PMID: 32246036 PMCID: PMC7125218 DOI: 10.1038/s41467-020-15436-0] [Citation(s) in RCA: 214] [Impact Index Per Article: 53.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 03/06/2020] [Indexed: 01/01/2023] Open
Abstract
Cerebrospinal fluid (CSF) p-tau181 (tau phosphorylated at threonine 181) is an established biomarker of Alzheimer's disease (AD), reflecting abnormal tau metabolism in the brain. Here we investigate the performance of CSF p-tau217 as a biomarker of AD in comparison to p-tau181. In the Swedish BioFINDER cohort (n = 194), p-tau217 shows stronger correlations with the tau positron emission tomography (PET) tracer [18F]flortaucipir, and more accurately identifies individuals with abnormally increased [18F]flortaucipir retention. Furthermore, longitudinal increases in p-tau217 are higher compared to p-tau181 and better correlate with [18F]flortaucipir uptake. P-tau217 correlates better than p-tau181 with CSF and PET measures of neocortical amyloid-β burden and more accurately distinguishes AD dementia from non-AD neurodegenerative disorders. Higher correlations between p-tau217 and [18F]flortaucipir are corroborated in an independent EXPEDITION3 trial cohort (n = 32). The main results are validated using a different p-tau217 immunoassay. These findings suggest that p-tau217 might be more useful than p-tau181 in the diagnostic work up of AD.
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Affiliation(s)
- Shorena Janelidze
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden.
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Entrégatan 7, 222 42, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Entrégatan 7, 222 42, Lund, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Entrégatan 7, 222 42, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Klinikgatan 32, 221 84, Lund, Sweden
| | | | | | - Xiyun Chai
- Eli Lilly and Company, Indianapolis, IN, 46285, USA
| | | | - John R Sims
- Eli Lilly and Company, Indianapolis, IN, 46285, USA
| | - Gallen Triana-Baltzer
- Neuroscience Biomarkers, Janssen Research & Development, 3210 Merryfield Row, San Diego, CA, CA 92121, USA
| | - Clara Theunis
- Janssen Pharmaceutical Companies of Johnson & Johnson, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Randy Slemmon
- Neuroscience Biomarkers, Janssen Research & Development, 3210 Merryfield Row, San Diego, CA, CA 92121, USA
| | - Marc Mercken
- Janssen Pharmaceutical Companies of Johnson & Johnson, Turnhoutseweg 30, 2340, Beerse, Belgium
| | - Hartmuth Kolb
- Neuroscience Biomarkers, Janssen Research & Development, 3210 Merryfield Row, San Diego, CA, CA 92121, USA.
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Sölvegatan 18, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Simrisbanvägen 14, 205 02, Malmö, Sweden.
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22
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Janelidze S, Mattsson N, Palmqvist S, Smith R, Beach TG, Serrano GE, Chai X, Proctor NK, Eichenlaub U, Zetterberg H, Blennow K, Reiman EM, Stomrud E, Dage JL, Hansson O. Plasma P-tau181 in Alzheimer's disease: relationship to other biomarkers, differential diagnosis, neuropathology and longitudinal progression to Alzheimer's dementia. Nat Med 2020; 26:379-386. [PMID: 32123385 DOI: 10.1038/s41591-020-0755-1] [Citation(s) in RCA: 537] [Impact Index Per Article: 134.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Accepted: 01/07/2020] [Indexed: 12/17/2022]
Abstract
Plasma phosphorylated tau181 (P-tau181) might be increased in Alzheimer's disease (AD), but its usefulness for differential diagnosis and prognosis is unclear. We studied plasma P-tau181 in three cohorts, with a total of 589 individuals, including cognitively unimpaired participants and patients with mild cognitive impairment (MCI), AD dementia and non-AD neurodegenerative diseases. Plasma P-tau181 was increased in preclinical AD and further increased at the MCI and dementia stages. It correlated with CSF P-tau181 and predicted positive Tau positron emission tomography (PET) scans (area under the curve (AUC) = 0.87-0.91 for different brain regions). Plasma P-tau181 differentiated AD dementia from non-AD neurodegenerative diseases with an accuracy similar to that of Tau PET and CSF P-tau181 (AUC = 0.94-0.98), and detected AD neuropathology in an autopsy-confirmed cohort. High plasma P-tau181 was associated with subsequent development of AD dementia in cognitively unimpaired and MCI subjects. In conclusion, plasma P-tau181 is a noninvasive diagnostic and prognostic biomarker of AD, which may be useful in clinical practice and trials.
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Affiliation(s)
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | | | | | - Xiyun Chai
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Erik Stomrud
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden. .,Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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23
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Obrocki P, Khatun A, Ness D, Senkevich K, Hanrieder J, Capraro F, Mattsson N, Andreasson U, Portelius E, Ashton NJ, Blennow K, Schöll M, Paterson RW, Schott JM, Zetterberg H. Perspectives in fluid biomarkers in neurodegeneration from the 2019 biomarkers in neurodegenerative diseases course-a joint PhD student course at University College London and University of Gothenburg. Alzheimers Res Ther 2020; 12:20. [PMID: 32111242 PMCID: PMC7049194 DOI: 10.1186/s13195-020-00586-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/12/2020] [Indexed: 12/12/2022]
Abstract
Until relatively recently, a diagnosis of probable Alzheimer's disease (AD) and other neurodegenerative disorders was principally based on clinical presentation, with post-mortem examination remaining a gold standard for disease confirmation. This is in sharp contrast to other areas of medicine, where fluid biomarkers, such as troponin levels in myocardial infarction, form an integral part of the diagnostic and treatment criteria. There is a pressing need for such quantifiable and easily accessible tools in neurodegenerative diseases.In this paper, based on lectures given at the 2019 Biomarkers in Neurodegenerative Diseases Course, we provide an overview of a range of cerebrospinal fluid (CSF) and blood biomarkers in neurodegenerative disorders, including the 'core' AD biomarkers amyloid β (Aβ) and tau, as well as other disease-specific and general markers of neuroaxonal injury. We then highlight the main challenges in the field, and how those could be overcome with the aid of new methodological advances, such as assay automation, mass spectrometry and ultrasensitive immunoassays.As we hopefully move towards an era of disease-modifying treatments, reliable biomarkers will be essential to increase diagnostic accuracy, allow for earlier diagnosis, better participant selection and disease activity and treatment effect monitoring.
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Affiliation(s)
- Pawel Obrocki
- Department of Medicine, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
| | - Ayesha Khatun
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK
| | - Deborah Ness
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Konstantin Senkevich
- First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia.,Petersburg Nuclear Physics Institute named by B.P. Konstantinov of National Research Center, Kurchatov Institute, Gatchina, Russia
| | - Jörg Hanrieder
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Federica Capraro
- The Francis Crick Institute, London, UK.,Department of Neuromuscular Diseases, University College London Queen Square Institute of Neurology, London, UK
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Ulf Andreasson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erik Portelius
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK.,NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Michael Schöll
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ross W Paterson
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Department of Neurodegeneration, UCL Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,UK Dementia Research Institute, University College London, London, UK.,Department of Neurodegenerative Disease, University College London Institute of Neurology, London, UK
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24
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Blennow K, Shaw LM, Stomrud E, Mattsson N, Toledo JB, Buck K, Wahl S, Eichenlaub U, Lifke V, Simon M, Trojanowski JQ, Hansson O. Predicting clinical decline and conversion to Alzheimer's disease or dementia using novel Elecsys Aβ(1-42), pTau and tTau CSF immunoassays. Sci Rep 2019; 9:19024. [PMID: 31836810 PMCID: PMC6911086 DOI: 10.1038/s41598-019-54204-z] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [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: 08/29/2019] [Accepted: 10/31/2019] [Indexed: 02/06/2023] Open
Abstract
We evaluated the performance of CSF biomarkers for predicting risk of clinical decline and conversion to dementia in non-demented patients with cognitive symptoms. CSF samples from patients in two multicentre longitudinal studies (ADNI, n = 619; BioFINDER, n = 431) were analysed. Aβ(1-42), tTau and pTau CSF concentrations were measured using Elecsys CSF immunoassays, and tTau/Aβ(1-42) and pTau/Aβ(1-42) ratios calculated. Patients were classified as biomarker (BM)-positive or BM-negative at baseline. Ability of biomarkers to predict risk of clinical decline and conversion to AD/dementia was assessed using pre-established cut-offs for Aβ(1-42) and ratios; tTau and pTau cut-offs were determined. BM-positive patients showed greater clinical decline than BM-negative patients, demonstrated by greater decreases in MMSE scores (all biomarkers: -2.10 to -0.70). Risk of conversion to AD/dementia was higher in BM-positive patients (HR: 1.67 to 11.48). Performance of Tau/Aβ(1-42) ratios was superior to single biomarkers, and consistent even when using cut-offs derived in a different cohort. Optimal pTau and tTau cut-offs were approximately 27 pg/mL and 300 pg/mL in both BioFINDER and ADNI. Elecsys pTau/Aβ(1-42) and tTau/Aβ(1-42) are robust biomarkers for predicting risk of clinical decline and conversion to dementia in non-demented patients, and may support AD diagnosis in clinical practice.
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Affiliation(s)
- Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erik Stomrud
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Jon B Toledo
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Houston Methodist Hospital, Houston, TX, USA
| | | | | | | | | | - Maryline Simon
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Malmö, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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25
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Hall S, Janelidze S, Zetterberg H, Brix B, Mattsson N, Surova Y, Blennow K, Hansson O. Cerebrospinal fluid levels of neurogranin in Parkinsonian disorders. Mov Disord 2019; 35:513-518. [PMID: 31837067 DOI: 10.1002/mds.27950] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND CSF concentration of neurogranin has been suggested as a biomarker for synapse dysfunction. OBJECTIVES To investigate CSF neurogranin in parkinsonian disorders compared to controls and Alzheimer's disease and the possible correlations between neurogranin and cognitive and motor impairment. METHODS We included 157 patients with PD, 29 with PD with dementia, 11 with dementia with Lewy bodies, 26 with MSA, 21 with PSP, 6 with corticobasal syndrome, 47 controls, and 124 with Alzheimer's disease. CSF neurogranin was measured using two enzyme-linked immunosorbent assays; from EUROIMMUN and the University of Gothenburg. RESULTS We found a strong correlation between CSF neurogranin-EI and CSF neurogranin-University of Gothenburg (Rs = 0.890; P < 0.001). Neurogranin was decreased in PD, PD with dementia, MSA, and PSP compared to controls and Alzheimer's disease. Neurogranin did not correlate with motor or cognitive impairment, longitudinal decline, or progression to dementia in PD. CONCLUSIONS CSF neurogranin is decreased in parkinsonian disorders compared to controls, emphasizing the importance of synaptic dysfunction in these disorders. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sara Hall
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Mölndal, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, United Kingdom
| | | | - Niklas Mattsson
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Yulia Surova
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Mölndal, Sweden.,Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Oskar Hansson
- Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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26
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Moseby-Knappe M, Mattsson N, Nielsen N, Zetterberg H, Blennow K, Dankiewicz J, Dragancea I, Friberg H, Lilja G, Insel PS, Rylander C, Westhall E, Kjaergaard J, Wise MP, Hassager C, Kuiper MA, Stammet P, Wanscher MCJ, Wetterslev J, Erlinge D, Horn J, Pellis T, Cronberg T. Serum Neurofilament Light Chain for Prognosis of Outcome After Cardiac Arrest. JAMA Neurol 2019; 76:64-71. [PMID: 30383090 DOI: 10.1001/jamaneurol.2018.3223] [Citation(s) in RCA: 143] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Prognostication of neurologic outcome after cardiac arrest is an important but challenging aspect of patient therapy management in critical care units. Objective To determine whether serum neurofilament light chain (NFL) levels can be used for prognostication of neurologic outcome after cardiac arrest. Design, Setting and Participants Prospective clinical biobank study of data from the randomized Target Temperature Management After Cardiac Arrest trial, an international, multicenter study with 29 participating sites. Patients were included between November 11, 2010, and January 10, 2013. Serum NFL levels were analyzed between August 1 and August 23, 2017, after trial completion. A total of 782 unconscious patients with out-of-hospital cardiac arrest of presumed cardiac origin were eligible. Exposures Serum NFL concentrations analyzed at 24, 48, and 72 hours after cardiac arrest with an ultrasensitive immunoassay. Main Outcomes and Measures Poor neurologic outcome at 6-month follow-up, defined according to the Cerebral Performance Category Scale as cerebral performance category 3 (severe cerebral disability), 4 (coma), or 5 (brain death). Results Of 782 eligible patients, 65 patients (8.3%) were excluded because of issues with aliquoting, missing sampling, missing outcome, or transport problems of samples. Of the 717 patients included (91.7%), 580 were men (80.9%) and median (interquartile range [IQR]) age was 65 (56-73) years. A total of 360 patients (50.2%) had poor neurologic outcome at 6 months. Median (IQR) serum NFL level was significantly increased in the patients with poor outcome vs good outcome at 24 hours (1426 [299-3577] vs 37 [20-70] pg/mL), 48 hours (3240 [623-8271] vs 46 [26-101] pg/mL), and 72 hours (3344 [845-7838] vs 54 [30-122] pg/mL) (P < .001 at all time points), with high overall performance (area under the curve, 0.94-0.95) and high sensitivities at high specificities (eg, 69% sensitivity with 98% specificity at 24 hours). Serum NFL levels had significantly greater performance than the other biochemical serum markers (ie, tau, neuron-specific enolase, and S100). At comparable specificities, serum NFL levels had greater sensitivity for poor outcome compared with routine electroencephalogram, somatosensory-evoked potentials, head computed tomography, and both pupillary and corneal reflexes (ranging from 29.2% to 49.0% greater for serum NFL level). Conclusions and Relevance Findings from this study suggest that the serum NFL level is a highly predictive marker of long-term poor neurologic outcome at 24 hours after cardiac arrest and may be a useful complement to currently available neurologic prognostication methods.
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Affiliation(s)
- Marion Moseby-Knappe
- Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Niklas Mattsson
- Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden.,Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Niklas Nielsen
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, University College of London Institute of Neurology, London, United Kingdom.,United Kingdom Dementia Research Institute, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Josef Dankiewicz
- Department of Clinical Sciences Lund, Cardiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Irina Dragancea
- Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Skåne University Hospital, Lund, Sweden
| | - Gisela Lilja
- Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Philip S Insel
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Christian Rylander
- Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Erik Westhall
- Department of Clinical Sciences Lund, Clinical Neurophysiology, Skåne University Hospital, Lund, Sweden
| | - Jesper Kjaergaard
- Departments of Cardiology, Rigshospitalet and Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, United Kingdom
| | - Christian Hassager
- Departments of Cardiology, Rigshospitalet and Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael A Kuiper
- Department of Intensive Care, Medical Center Leeuwarden, Leeuwarden, the Netherlands
| | | | - Michael C Jaeger Wanscher
- Department of Cardiothoracic Anaesthesia, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Jørn Wetterslev
- Copenhagen Trial Unit, Centre for Clinical Intervention Research Department, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - David Erlinge
- Department of Clinical Sciences Lund, Cardiology, Lund University, Skåne University Hospital, Lund, Sweden
| | - Janneke Horn
- Department of Intensive Care, Academic Medical Center, Amsterdam, the Netherlands
| | - Tommaso Pellis
- Anesthesia and Intensive Care, Card. G. Panico Hospital Agency, Tricase, Italy
| | - Tobias Cronberg
- Department of Clinical Sciences Lund, Neurology, Lund University, Skåne University Hospital, Lund, Sweden
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27
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Palmqvist S, Insel PS, Stomrud E, Janelidze S, Zetterberg H, Brix B, Eichenlaub U, Dage JL, Chai X, Blennow K, Mattsson N, Hansson O. Cerebrospinal fluid and plasma biomarker trajectories with increasing amyloid deposition in Alzheimer's disease. EMBO Mol Med 2019; 11:e11170. [PMID: 31709776 PMCID: PMC6895602 DOI: 10.15252/emmm.201911170] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 10/09/2019] [Accepted: 10/14/2019] [Indexed: 12/19/2022] Open
Abstract
Failures in Alzheimer's disease (AD) drug trials highlight the need to further explore disease mechanisms and alterations of biomarkers during the development of AD. Using cross‐sectional data from 377 participants in the BioFINDER study, we examined seven cerebrospinal fluid (CSF) and six plasma biomarkers in relation to β‐amyloid (Aβ) PET uptake to understand their evolution during AD. In CSF, Aβ42 changed first, closely followed by Aβ42/Aβ40, phosphorylated‐tau (P‐tau), and total‐tau (T‐tau). CSF neurogranin, YKL‐40, and neurofilament light increased after the point of Aβ PET positivity. The findings were replicated using Aβ42, Aβ40, P‐tau, and T‐tau assays from five different manufacturers. Changes were seen approximately simultaneously for CSF and plasma biomarkers. Overall, plasma biomarkers had smaller dynamic ranges, except for CSF and plasma P‐tau which were similar. In conclusion, using state‐of‐the‐art biomarkers, we identified the first changes in Aβ, closely followed by soluble tau. Only after Aβ PET became abnormal, biomarkers of neuroinflammation, synaptic dysfunction, and neurodegeneration were altered. These findings lend in vivo support of the amyloid cascade hypotheses in humans.
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Affiliation(s)
- Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Philip S Insel
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK.,UK Dementia Research Institute at UCL, London, UK
| | | | | | | | - Xiyun Chai
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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28
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Whelan CD, Mattsson N, Nagle MW, Vijayaraghavan S, Hyde C, Janelidze S, Stomrud E, Lee J, Fitz L, Samad TA, Ramaswamy G, Margolin RA, Malarstig A, Hansson O. Multiplex proteomics identifies novel CSF and plasma biomarkers of early Alzheimer's disease. Acta Neuropathol Commun 2019; 7:169. [PMID: 31694701 PMCID: PMC6836495 DOI: 10.1186/s40478-019-0795-2] [Citation(s) in RCA: 124] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/24/2019] [Indexed: 12/13/2022] Open
Abstract
To date, the development of disease-modifying therapies for Alzheimer’s disease (AD) has largely focused on the removal of amyloid beta Aβ fragments from the CNS. Proteomic profiling of patient fluids may help identify novel therapeutic targets and biomarkers associated with AD pathology. Here, we applied the Olink™ ProSeek immunoassay to measure 270 CSF and plasma proteins across 415 Aβ- negative cognitively normal individuals (Aβ- CN), 142 Aβ-positive CN (Aβ+ CN), 50 Aβ- mild cognitive impairment (MCI) patients, 75 Aβ+ MCI patients, and 161 Aβ+ AD patients from the Swedish BioFINDER study. A validation cohort included 59 Aβ- CN, 23 Aβ- + CN, 44 Aβ- MCI and 53 Aβ+ MCI. To compare protein concentrations in patients versus controls, we applied multiple linear regressions adjusting for age, gender, medications, smoking and mean subject-level protein concentration, and corrected findings for false discovery rate (FDR, q < 0.05). We identified, and replicated, altered levels of ten CSF proteins in Aβ+ individuals, including CHIT1, SMOC2, MMP-10, LDLR, CD200, EIF4EBP1, ALCAM, RGMB, tPA and STAMBP (− 0.14 < d < 1.16; q < 0.05). We also identified and replicated alterations of six plasma proteins in Aβ+ individuals OSM, MMP-9, HAGH, CD200, AXIN1, and uPA (− 0.77 < d < 1.28; q < 0.05). Multiple analytes associated with cognitive performance and cortical thickness (q < 0.05). Plasma biomarkers could distinguish AD dementia (AUC = 0.94, 95% CI = 0.87–0.98) and prodromal AD (AUC = 0.78, 95% CI = 0.68–0.87) from CN. These findings reemphasize the contributions of immune markers, phospholipids, angiogenic proteins and other biomarkers downstream of, and potentially orthogonal to, Aβ- and tau in AD, and identify candidate biomarkers for earlier detection of neurodegeneration.
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29
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Abstract
Importance Different brain regions appear to be involved during β-amyloid (Aβ) accumulation in Alzheimer disease (AD), but a longitudinally valid system to track Aβ stages in vivo using positron emission tomography (PET) is lacking. Objective To construct a longitudinally valid in vivo staging system for AD using amyloid PET. Design, Setting, and Participants Longitudinal multicenter cohort study using data accessed on August 20, 2018, from the Alzheimer's Disease Neuroimaging Initiative database of scans performed from June 9, 2010, to July 12, 2018, from 741 persons: 304 without cognitive impairment, 384 with mild cognitive impairment, and 53 with AD dementia. Cerebrospinal fluid (CSF) Aβ42 and fluorine 18-labeled florbetapir (18F-florbetapir) data were used to determine early, intermediate, and late regions of Aβ accumulation. β-Amyloid stages ranging from 0 to 3 were constructed using these composites. Each subsequent stage required involvement of more advanced regions. Patients were followed up at 2, 4, and 6 years. Replication and validation were conducted using an independent cohort (Swedish BioFINDER) and gene expression information from the Allen Human Brain Atlas database. Analyses were conducted August 21, 2018, to May 24, 2019. Main Outcomes and Measures The main outcome was change in stage. Stages were compared for diagnosis, CSF biomarkers of tau, and longitudinal atrophy, cognitive measures, and regional gene expression. Transitions between stages were tested using longitudinal 18F-florbetapir data. Results Among 641 participants with CSF Aβ42 data and at least two 18F-florbetapir scans, 335 (52.3%) were male. The early region of Aβ accumulation included the precuneus, posterior cingulate, isthmus cingulate, insula, and medial and lateral orbitofrontal cortices. The late region included the lingual, pericalcarine, paracentral, precentral, and postcentral cortices. The intermediate region included remaining brain regions with increased accumulation rates. In 2072 PET scans from 741 participants, 2039 (98.4%) were unambiguously staged. At baseline, participants with stage 0 (n = 402) had a 14.7% (95% CI, 11.2%-18.1%) probability of progression to a higher stage; stage 1 (n = 21), 71.4% (95% CI, 50.0%-90.9%); and stage 2 (n = 79), 53.1% (95% CI, 42.2%-64.0%). Seven of the 741 participants (0.9%) reverted to a lower stage. Higher stages were associated with lower CSF Aβ42 concentrations (from stage 1 at baseline), greater CSF P-tau (from stage 1) and CSF T-tau (from stage 2), and accelerated cognitive decline (from stage 2) and atrophy (from stage 3), even when adjusting for clinical diagnosis. Key findings were replicated in the BioFINDER cohort (N = 474). The regions of different stages differed by gene expression profiles when using the transcriptome from the Allen Human Brain Atlas, especially involving genes associated with voltage-gated ion channel activity especially involving genes associated with voltage-gated ion channel activity, but also blood circulation, axon guidance, and lipid transportation. Conclusions and Relevance Results of this study suggest that this robust staging system of Aβ accumulation may be useful for monitoring patients throughout the course of AD. Progression through stages may depend on underlying selective vulnerability in different brain regions.
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Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden.,Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jacob Vogel
- Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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30
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Nosheny RL, Insel PS, Mattsson N, Tosun D, Buckley S, Truran D, Schuff N, Aisen PS, Weiner MW. Associations among amyloid status, age, and longitudinal regional brain atrophy in cognitively unimpaired older adults. Neurobiol Aging 2019; 82:110-119. [PMID: 31437719 PMCID: PMC7198229 DOI: 10.1016/j.neurobiolaging.2019.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 05/02/2017] [Revised: 06/28/2019] [Accepted: 07/07/2019] [Indexed: 01/18/2023]
Abstract
The goal of this study was to compare regional brain atrophy patterns in cognitively unimpaired (CU) older adults with and without brain accumulation of amyloid-β (Aβ) to elucidate contributions of Aβ, age, and other variables to atrophy rates. In 80 CU participants from the Alzheimer's Disease Neuroimaging Initiative, we determined effects of Aβ and age on longitudinal, regional atrophy rates, while accounting for confounding variables including sex, APOE ε4 genotype, white matter lesions, and cerebrospinal fluid total and phosphorylated tau levels. We not only found overlapping patterns of atrophy in Aβ+ versus Aβ- participants but also identified regions where atrophy pattern differed between the 2 groups. Higher Aβ load was associated with increased longitudinal atrophy in the entorhinal cortex, amygdala, and hippocampus, even when accounting for age and other variables. Age was associated with atrophy in insula, fusiform gyrus, and isthmus cingulate, even when accounting for Aβ. We found age by Aβ interactions in the postcentral gyrus and lateral orbitofrontal cortex. These results elucidate the separate and related effects of age, Aβ, and other important variables on longitudinal brain atrophy rates in CU older adults.
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Affiliation(s)
- Rachel L Nosheny
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Psychiatry, University of California, CA, USA.
| | - Philip S Insel
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Niklas Mattsson
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Duygu Tosun
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, CA, USA
| | - Shannon Buckley
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Diana Truran
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - N Schuff
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Paul S Aisen
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, San Diego, CA, USA
| | - Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Psychiatry, University of California, CA, USA; Department of Radiology and Biomedical Imaging, University of California, CA, USA
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31
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Palmqvist S, Janelidze S, Stomrud E, Zetterberg H, Karl J, Zink K, Bittner T, Mattsson N, Eichenlaub U, Blennow K, Hansson O. Performance of Fully Automated Plasma Assays as Screening Tests for Alzheimer Disease-Related β-Amyloid Status. JAMA Neurol 2019; 76:1060-1069. [PMID: 31233127 PMCID: PMC6593637 DOI: 10.1001/jamaneurol.2019.1632] [Citation(s) in RCA: 250] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Accurate blood-based biomarkers for Alzheimer disease (AD) might improve the diagnostic accuracy in primary care, referrals to memory clinics, and screenings for AD trials. Objective To examine the accuracy of plasma β-amyloid (Aβ) and tau measured using fully automated assays together with other blood-based biomarkers to detect cerebral Aβ. Design, Setting, and Participants Two prospective, cross-sectional, multicenter studies. Study participants were consecutively enrolled between July 6, 2009, and February 11, 2015 (cohort 1), and between January 29, 2000, and October 11, 2006 (cohort 2). Data were analyzed in 2018. The first cohort comprised 842 participants (513 cognitively unimpaired [CU], 265 with mild cognitive impairment [MCI], and 64 with AD dementia) from the Swedish BioFINDER study. The validation cohort comprised 237 participants (34 CU, 109 MCI, and 94 AD dementia) from a German biomarker study. Main Outcome and Measures The cerebrospinal fluid (CSF) Aβ42/Aβ40 ratio was used as the reference standard for brain Aβ status. Plasma Aβ42, Aβ40 and tau were measured using Elecsys immunoassays (Roche Diagnostics) and examined as predictors of Aβ status in logistic regression models in cohort 1 and replicated in cohort 2. Plasma neurofilament light chain (NFL) and heavy chain (NFH) and APOE genotype were also examined in cohort 1. Results The mean (SD) age of the 842 participants in cohort 1 was 72 (5.6) years, with a range of 59 to 88 years, and 446 (52.5%) were female. For the 237 in cohort 2, mean (SD) age was 66 (10) years with a range of 23 to 85 years, and 120 (50.6%) were female. In cohort 1, plasma Aβ42 and Aβ40 predicted Aβ status with an area under the receiver operating characteristic curve (AUC) of 0.80 (95% CI, 0.77-0.83). When adding APOE, the AUC increased significantly to 0.85 (95% CI, 0.82-0.88). Slight improvements were seen when adding plasma tau (AUC, 0.86; 95% CI, 0.83-0.88) or tau and NFL (AUC, 0.87; 95% CI, 0.84-0.89) to Aβ42, Aβ40 and APOE. The results were similar in CU and cognitively impaired participants, and in younger and older participants. Applying the plasma Aβ42 and Aβ40 model from cohort 1 in cohort 2 resulted in slightly higher AUC (0.86; 95% CI, 0.81-0.91), but plasma tau did not contribute. Using plasma Aβ42, Aβ40, and APOE in an AD trial screening scenario reduced positron emission tomography costs up to 30% to 50% depending on cutoff. Conclusions and Relevance Plasma Aβ42 and Aβ40 measured using Elecsys immunoassays predict Aβ status in all stages of AD with similar accuracy in a validation cohort. Their accuracy can be further increased by analyzing APOE genotype. Potential future applications of these blood tests include prescreening of Aβ positivity in clinical AD trials to lower the costs and number of positron emission tomography scans or lumbar punctures.
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Affiliation(s)
- Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute at UCL, London, United Kingdom
| | | | | | - Tobias Bittner
- Genentech, a Member of the Roche Group, Basel, Switzerland
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Malmö, Sweden
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Svenningsson AL, Stomrud E, Insel PS, Mattsson N, Palmqvist S, Hansson O. β-amyloid pathology and hippocampal atrophy are independently associated with memory function in cognitively healthy elderly. Sci Rep 2019; 9:11180. [PMID: 31371787 PMCID: PMC6671981 DOI: 10.1038/s41598-019-47638-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 03/19/2019] [Accepted: 07/11/2019] [Indexed: 11/25/2022] Open
Abstract
The independent effects of different brain pathologies on age-dependent cognitive decline are unclear. We examined this in 300 cognitively unimpaired elderly individuals from the BioFINDER study. Using cognition as outcome we studied the effects of cerebrospinal fluid biomarkers for amyloid-β (Aβ42/40), neuroinflammation (YKL-40), and neurodegeneration and tau pathology (T-tau and P-tau) as well as MRI measures of white-matter lesions, hippocampal volume (HV), and regional cortical thickness. We found that Aβ positivity and HV were independently associated with memory. Results differed depending on age, with memory being associated with HV (but not Aβ) in older participants (73.3–88.4 years), and with Aβ (but not HV) in relatively younger participants (65.2–73.2 years). This indicates that Aβ and atrophy are independent contributors to memory variability in cognitively healthy elderly and that Aβ mainly affects memory in younger elderly individuals. With advancing age, the effect of brain atrophy overshadows the effect of Aβ on memory function.
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Affiliation(s)
- Anna L Svenningsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden. .,Memory Clinic, Skåne University Hospital, Malmö, Sweden.
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Philip S Insel
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden.,Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund/Malmö, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Insel PS, Weiner M, Mackin RS, Mormino E, Lim YY, Stomrud E, Palmqvist S, Masters CL, Maruff PT, Hansson O, Mattsson N. Determining clinically meaningful decline in preclinical Alzheimer disease. Neurology 2019; 93:e322-e333. [PMID: 31289148 PMCID: PMC6669933 DOI: 10.1212/wnl.0000000000007831] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 03/17/2019] [Indexed: 11/15/2022] Open
Abstract
Objective To determine the time required for a preclinical Alzheimer disease population to decline in a meaningful way, use estimates of decline to update previous clinical trial design assumptions, and identify factors that modify β-amyloid (Aβ)–related decline. Methods In 1,120 cognitively unimpaired individuals from 3 international cohorts, we estimated the relationship between Aβ status and longitudinal changes across multiple cognitive domains and assessed interactions between Aβ and baseline factors. Power analyses were performed to explore sample size as a function of treatment effect. Results Cognitively unimpaired Aβ+ participants approach mild cognitive impairment (MCI) levels of performance 6 years after baseline, on average. Achieving 80% power in a simulated 4-year treatment trial, assuming a 25% treatment effect, required 2,000 participants/group. Multiple factors interacted with Aβ to predict cognitive decline; however, these findings were all cohort-specific. Despite design differences across the cohorts, with large sample sizes and sufficient follow-up time, the Aβ+ groups declined consistently on cognitive composite measures. Conclusions A preclinical AD population declines to the cognitive performance of an early MCI population in 6 years. Slowing this rate of decline by 40%–50% delays clinically relevant impairment by 3 years—a potentially meaningful treatment effect. However, assuming a 40%–50% drug effect highlights the difficulties in preclinical AD trial design, as a more commonly assumed treatment effect of 25% results in a required sample size of 2,000/group. Designers of preclinical AD treatment trials need to prepare for larger and longer trials than are currently being considered. Interactions with Aβ status were inconsistent and not readily generalizable.
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Affiliation(s)
- Philip S Insel
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia.
| | - Michael Weiner
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - R Scott Mackin
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Elizabeth Mormino
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Yen Ying Lim
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Erik Stomrud
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Sebastian Palmqvist
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Colin L Masters
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Paul T Maruff
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Oskar Hansson
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
| | - Niklas Mattsson
- From the Center for Imaging of Neurodegenerative Diseases (M.W., R.S.M.), Department of Veterans Affairs Medical Center; Departments of Radiology and Biomedical Imaging (P.S.I., M.W.) and Psychiatry (P.S.I., R.S.M.), University of California, San Francisco; Clinical Memory Research Unit, Faculty of Medicine (P.S.I., E.S., S.P., O.H., N.M.), Memory Clinic (E.S., S.P., O.H.) and Department of Neurology (N.M.), Skåne University Hospital, and Wallenberg Center for Molecular Medicine (N.M.), Lund University, Sweden; Department of Neurology and Neurological Sciences (E.M.), Stanford University, CA; The Florey Institute (Y.Y.L., C.L.M., P.T.M.), The University of Melbourne; and CogState (P.T.M.), Melbourne, Australia
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Mattsson N, Andersson E, Ossenkoppele R, Palmqvist S, Zetterberg H, Blennow K, Strandberg O, Stomrud E, Smith R, Hansson O. F4-02-04: CSF AND PET MEASURES FOR TAU IN DIFFERENT STAGES OF ALZHEIMER'S DISEASE. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Lund University; Malmö Sweden
| | | | | | | | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Lund University; Malmö Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences; Lund University; Malmö Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Lund University; Malmö Sweden
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Mattsson N, Grinberg LT, Jonsson M, Seeley WW, Spina S, Janelidze S, Rosen HJ, Boxer AL, La Joie R, Lesman-Segev OH, Iaccarino L, Kollmorgen G, Eichenlaub U, Miller BL, Hansson O, Rabinovici GD. P4-536: CEREBROSPINAL FLUID BIOMARKERS FOR AMYLOID AND TAU USING FULLY AUTOMATED ASSAYS: ASSOCIATIONS WITH NEUROPATHOLOGY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.08.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit; Lund University; Malmö Sweden
| | - Lea T. Grinberg
- University of California San Francisco; San Francisco CA USA
| | | | | | - Salvatore Spina
- University of California San Francisco; San Francisco CA USA
| | | | - Howard J. Rosen
- University of California San Francisco; San Francisco CA USA
| | - Adam L. Boxer
- University of California San Francisco; San Francisco CA USA
| | - Renaud La Joie
- University of California San Francisco; San Francisco CA USA
| | | | | | | | | | - Bruce L. Miller
- University of California San Francisco; San Francisco CA USA
| | - Oskar Hansson
- Clinical Memory Research Unit; Lund University; Malmö Sweden
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36
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Hansson O, Janelidze S, Stomrud E, Zetterberg H, Karl J, Zink K, Bittner T, Mattsson N, Eichenlaub U, Blennow K, Palmqvist S. F2-07-03: FULLY AUTOMATED PLASMA ASSAYS AS SCREENING TESTS FOR EARLY ALZHEIMER-RELATED β-AMYLOID PATHOLOGY. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences; Lund University; Malmö Sweden
| | | | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences; Lund University; Malmö Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry; The Sahlgrenska Academy at University of Gothenburg; Mölndal Sweden
| | | | | | | | - Niklas Mattsson
- Clinical Memory Research Unit; Lund University; Malmö Sweden
| | | | - Kaj Blennow
- Institute of Neuroscience and Physiology; The Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
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Mattsson N, Palmqvist S, Hansson O. P4-278: STAGING β-AMYLOID PATHOLOGY WITH 18F-FLORBETAPIR PET IMAGING. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit; Lund University; Malmö Sweden
| | | | - Oskar Hansson
- Clinical Memory Research Unit; Lund University; Malmö Sweden
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Mattsson N, Hansson O. Primary fatty amides are potential plasma biomarkers for AD. Nat Rev Neurol 2019; 15:498-499. [PMID: 31253949 DOI: 10.1038/s41582-019-0229-6] [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: 11/10/2022]
Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.,Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
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Knopman DS, Haeberlein SB, Carrillo MC, Hendrix JA, Kerchner G, Margolin R, Maruff P, Miller DS, Tong G, Tome MB, Murray ME, Nelson PT, Sano M, Mattsson N, Sultzer DL, Montine TJ, Jack CR, Kolb H, Petersen RC, Vemuri P, Canniere MZ, Schneider JA, Resnick SM, Romano G, van Harten AC, Wolk DA, Bain LJ, Siemers E. The National Institute on Aging and the Alzheimer's Association Research Framework for Alzheimer's disease: Perspectives from the Research Roundtable. Alzheimers Dement 2019; 14:563-575. [PMID: 29653607 DOI: 10.1016/j.jalz.2018.03.002] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/07/2018] [Accepted: 03/08/2018] [Indexed: 12/14/2022]
Abstract
The Alzheimer's Association's Research Roundtable met in November 2017 to explore the new National Institute on Aging and the Alzheimer's Association Research Framework for Alzheimer's disease. The meeting allowed experts in the field from academia, industry, and government to provide perspectives on the new National Institute on Aging and the Alzheimer's Association Research Framework. This review will summarize the "A, T, N System" (Amyloid, Tau, and Neurodegeneration) using biomarkers and how this may be applied to clinical research and drug development. In addition, challenges and barriers to the potential adoption of this new framework will be discussed. Finally, future directions for research will be proposed.
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Affiliation(s)
| | | | | | | | | | | | - Paul Maruff
- Cogstate Ltd, Melbourne, Victoria, Australia
| | | | | | | | | | | | - Mary Sano
- Mount Sinai School of Medicine, New York, NY, USA
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - David L Sultzer
- David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | | | - Hartmuth Kolb
- Janssen Research and Development, San Diego, CA, USA
| | | | | | | | | | | | | | | | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa J Bain
- Independent Science Writer, Elverson, PA, USA
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Grand J, Kjaergaard J, Nielsen N, Friberg H, Cronberg T, Bro-Jeppesen J, Karsdal MA, Nielsen HB, Frydland M, Henriksen K, Mattsson N, Zetterberg H, Hassager C. Serum tau fragments as predictors of death or poor neurological outcome after out-of-hospital cardiac arrest. Biomarkers 2019; 24:584-591. [PMID: 31017476 DOI: 10.1080/1354750x.2019.1609580] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Background: Anoxic brain injury is the primary cause of death after resuscitation from out-of-hospital cardiac arrest (OHCA) and prognostication is challenging. The aim of this study was to evaluate the potential of two fragments of tau as serum biomarkers for neurological outcome. Methods: Single-center sub-study of 171 patients included in the Target Temperature Management (TTM) Trial randomly assigned to TTM at 33 °C or TTM at 36 °C for 24 h after OHCA. Fragments (tau-A and tau-C) of the neuronal protein tau were measured in serum 24, 48 and 72 h after OHCA. The primary endpoint was neurological outcome. Results: Median (quartile 1 - quartile 3) tau-A (ng/ml) values were 58 (43-71) versus 51 (43-67), 72 (57-84) versus 71 (59-82) and 76 (61-92) versus 75 (64-89) for good versus unfavourable outcome at 24, 48 and 72 h, respectively (pgroup = 0.95). Median tau C (ng/ml) values were 38 (29-50) versus 36 (29-49), 49 (38-58) versus 48 (33-59) and 48 (39-59) versus 48 (36-62) (pgroup = 0.95). Tau-A and tau-C did not predict neurological outcome (area under the receiver-operating curve at 48 h; tau-A: 0.51 and tau-C: 0.51). Conclusions: Serum levels of tau fragments were unable to predict neurological outcome after OHCA.
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Affiliation(s)
- Johannes Grand
- a Department of Cardiology, Copenhagen University Hospital , Copenhagen , Denmark
| | - Jesper Kjaergaard
- a Department of Cardiology, Copenhagen University Hospital , Copenhagen , Denmark
| | - Niklas Nielsen
- b Department of Anesthesia and Intensive Care, Helsingborg Hospital , Helsingborg , Sweden
| | - Hans Friberg
- c Department of Clinical Sciences, Anesthesia and Intensive Care, Lund University, Skåne University Hospital , Lund , Sweden
| | | | - John Bro-Jeppesen
- a Department of Cardiology, Copenhagen University Hospital , Copenhagen , Denmark
| | | | | | - Martin Frydland
- a Department of Cardiology, Copenhagen University Hospital , Copenhagen , Denmark
| | - Kim Henriksen
- e Biomarkers & Research, Nordic Bioscience , Herlev , Denmark
| | - Niklas Mattsson
- f Department of Clinical Sciences, Neurology, Lund University, Skåne University Hospital , Lund , Sweden.,g Clinical Memory Research Unit, Department of Clinical Sciences, Faculty of Medicine, Lund University , Lund , Sweden
| | - Henrik Zetterberg
- h Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital , Mölndal , Sweden.,i Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg , Mölndal , Sweden.,j UK Dementia Research Institute at UCL , London , UK.,k Department of Neurodegenerative Disease, UCL Institute of Neurology , London , UK
| | - Christian Hassager
- a Department of Cardiology, Copenhagen University Hospital , Copenhagen , Denmark
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Ebner F, Ullén S, Åneman A, Cronberg T, Mattsson N, Friberg H, Hassager C, Kjærgaard J, Kuiper M, Pelosi P, Undén J, Wise MP, Wetterslev J, Nielsen N. Associations between partial pressure of oxygen and neurological outcome in out-of-hospital cardiac arrest patients: an explorative analysis of a randomized trial. Crit Care 2019; 23:30. [PMID: 30691510 PMCID: PMC6348606 DOI: 10.1186/s13054-019-2322-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/11/2019] [Indexed: 12/31/2022]
Abstract
Objective Exposure to hyperoxemia and hypoxemia is common in out-of-hospital cardiac arrest (OHCA) patients following return of spontaneous circulation (ROSC), but its effects on neurological outcome are uncertain, and study results are inconsistent. Methods Exploratory post hoc substudy of the Target Temperature Management (TTM) trial, including 939 patients after OHCA with return of spontaneous circulation (ROSC). The association between serial arterial partial pressures of oxygen (PaO2) during 37 h following ROSC and neurological outcome at 6 months, evaluated by Cerebral Performance Category (CPC), dichotomized to good (CPC 1–2) and poor (CPC 3–5), was investigated. In our analyses, we tested the association of hyperoxemia and hypoxemia, time-weighted mean PaO2, maximum PaO2 difference, and gradually increasing PaO2 levels (13.3–53.3 kPa) with poor neurological outcome. A subsequent analysis investigated the association between PaO2 and a biomarker of brain injury, peak serum Tau levels. Results Eight hundred sixty-nine patients were eligible for analysis. Three hundred patients (35%) were exposed to hyperoxemia or hypoxemia at some time point after ROSC. Our analyses did not reveal a significant association between hyperoxemia, hypoxemia, time-weighted mean PaO2 exposure or maximum PaO2 difference and poor neurological outcome at 6-month follow-up after correction for co-variates (all analyses p = 0.146–0.847). We were not able to define a PaO2 level significantly associated with the onset of poor neurological outcome. Peak serum Tau levels at either 48 or 72 h after ROSC were not associated with PaO2. Conclusion Hyperoxemia or hypoxemia exposure occurred in one third of the patients during the first 37 h of hospitalization and was not significantly associated with poor neurological outcome after 6 months or with the peak s-Tau levels at either 48 or 72 h after ROSC. Electronic supplementary material The online version of this article (10.1186/s13054-019-2322-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florian Ebner
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, S-251 87, Helsingborg, Sweden.
| | - Susann Ullén
- Clinical Studies Sweden, Skane University Hospital, Remissgatan 4, S-221 85, Lund, Sweden
| | - Anders Åneman
- Department of Intensive Care, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, 1871, Australia
| | - Tobias Cronberg
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Niklas Mattsson
- Department of Clinical Sciences Lund, Neurology, Lund University, Skane University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Hans Friberg
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Skane University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Christian Hassager
- Department of Cardiology, Rigshospitalet, University of Copenhagen, DK 2100, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, DK 2100, Copenhagen, Denmark
| | - Jesper Kjærgaard
- Department of Cardiology, Rigshospitalet, University of Copenhagen, DK 2100, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, DK 2100, Copenhagen, Denmark
| | - Michael Kuiper
- Intensive Care Unit, Leeuwarden Medical Centrum, Borniastraat 38, NL8934 AD, Leeuwarden, Netherlands
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.,Department of Anesthesia and Intensive Care, IRCCS San Martino Policlinico Hospital, Genoa, Italy
| | - Johan Undén
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Hallands Hospital, S-30233, Halmstad, Sweden
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Heath Park, Cardiff, CF144XW, UK
| | - Jørn Wetterslev
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Dpt. 7812, Copenhagen University Hospital, Rigshospitalet, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Niklas Nielsen
- Department of Clinical Sciences Lund, Anesthesia and Intensive Care, Lund University, Helsingborg Hospital, S-251 87, Helsingborg, Sweden
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Mattsson N, Insel PS, Donohue M, Jögi J, Ossenkoppele R, Olsson T, Schöll M, Smith R, Hansson O. Predicting diagnosis and cognition with 18F-AV-1451 tau PET and structural MRI in Alzheimer's disease. Alzheimers Dement 2019; 15:570-580. [PMID: 30639421 DOI: 10.1016/j.jalz.2018.12.001] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/01/2018] [Accepted: 12/02/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION The relative importance of structural magnetic resonance imaging (MRI) and tau positron emission tomography (PET) to predict diagnosis and cognition in Alzheimer's disease (AD) is unclear. METHODS We tested 56 cognitively unimpaired controls (including 27 preclinical AD), 32 patients with prodromal AD, and 39 patients with AD dementia. Optimal classifiers were constructed using the least absolute shrinkage and selection operator with 18F-AV-1451 (tau) PET and structural MRI data (regional cortical thickness and subcortical volumes). RESULTS 18F-AV-1451 in the amygdala, entorhinal cortex, parahippocampal gyrus, fusiform, and inferior parietal lobule had 93% diagnostic accuracy for AD (prodromal or dementia). The MRI classifier involved partly the same regions plus the hippocampus, with 83% accuracy, but did not improve upon the tau classifier. 18F-AV-1451 retention and MRI were independently associated with cognition. DISCUSSION Optimized tau PET classifiers may diagnose AD with high accuracy, but both tau PET and structural brain MRI capture partly unique information relevant for the clinical deterioration in AD.
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Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden; Lund University, Skåne University Hospital, Department of Clinical Sciences, Neurology, Lund, Sweden.
| | - Philip S Insel
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; Center for Imaging of Neurodegenerative Diseases, Department of Veterans Affairs Medical Center, San Francisco, CA, USA; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Michael Donohue
- Department of Neurology, Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, CA, USA
| | - Jonas Jögi
- Department of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; VU University Medical Center, Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Tomas Olsson
- Department of Radiation Physics, Skåne University Hospital, Lund, Sweden
| | - Michael Schöll
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; Lund University, Skåne University Hospital, Department of Clinical Sciences, Neurology, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
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Ossenkoppele R, Smith R, Ohlsson T, Strandberg O, Mattsson N, Insel PS, Palmqvist S, Hansson O. Associations between tau, Aβ, and cortical thickness with cognition in Alzheimer disease. Neurology 2019; 92:e601-e612. [PMID: 30626656 PMCID: PMC6382060 DOI: 10.1212/wnl.0000000000006875] [Citation(s) in RCA: 159] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 10/03/2018] [Indexed: 01/01/2023] Open
Abstract
Objective To examine the cross-sectional associations between regional tau, β-amyloid (Aβ), and cortical thickness and neuropsychological function across the preclinical and clinical spectrum of Alzheimer disease (AD). Methods We included 106 participants from the Swedish Biomarkers for Identifying Neurodegenerative Disorders Early and Reliably (BioFINDER) study, of whom 33 had preclinical AD (Aβ-positive cognitively normal individuals), 25 had prodromal AD (Aβ-positive mild cognitive impairment), and 48 had probable AD dementia. All underwent [18F]flortaucipir (tau) and structural MRI (cortical thickness), and 88 of 106 underwent [18F]flutemetamol (Aβ) PET. Linear regression models adjusted for age, sex, and education were performed to examine associations between 7 regions of interest and 7 neuropsychological tests for all 3 imaging modalities. Results In preclinical AD, [18F]flortaucipir, but not [18F]flutemetamol or cortical thickness, was associated with decreased global cognition, memory, and processing speed (range standardized β = 0.35–0.52, p < 0.05 uncorrected for multiple comparisons). In the combined prodromal AD and AD dementia group, both increased [18F]flortaucipir uptake and reduced cortical thickness were associated with worse performance on a variety of neuropsychological tests (most regions of interest survived correction for multiple comparisons at p < 0.05), while increased [18F]flutemetamol uptake was specifically associated with lower scores on a delayed recall memory task (p < 0.05 uncorrected for multiple comparisons). The strongest effects for both [18F]flortaucipir and cortical thickness on cognition were found in the lateral and medial parietal cortex and lateral temporal cortex. The effect of [18F]flutemetamol on cognition was generally weaker and less region specific. Conclusion Our findings suggest that tau PET is more sensitive than Aβ PET and measures of cortical thickness for detecting early cognitive changes in preclinical AD. Furthermore, both [18F]flortaucipir PET and cortical thickness show strong cognitive correlates at the clinical stages of AD.
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Affiliation(s)
- Rik Ossenkoppele
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA.
| | - Ruben Smith
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Tomas Ohlsson
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Olof Strandberg
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Niklas Mattsson
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Philip S Insel
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Sebastian Palmqvist
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA
| | - Oskar Hansson
- From the Clinical Memory Research Unit (R.O., R.S., O.S., N.M., P.S.I., S.P., O.H.), Lund University, Sweden; Department of Neurology and Alzheimer Center (R.O.), VU University Medical Center, Amsterdam Neuroscience, the Netherlands; Department of Radiation Physics (T.O.), Skåne University Hospital, Lund; Memory Clinic (O.H.), Skåne University Hospital, Malmö, Sweden; and Center for Imaging of Neurodegenerative Diseases (P.S.I.), Department of Veterans Affairs Medical Center, San Francisco, CA.
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Schöll M, Maass A, Mattsson N, Ashton NJ, Blennow K, Zetterberg H, Jagust W. Biomarkers for tau pathology. Mol Cell Neurosci 2018; 97:18-33. [PMID: 30529601 PMCID: PMC6584358 DOI: 10.1016/j.mcn.2018.12.001] [Citation(s) in RCA: 139] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 12/01/2018] [Indexed: 12/14/2022] Open
Abstract
The aggregation of fibrils of hyperphosphorylated and C-terminally truncated microtubule-associated tau protein characterizes 80% of all dementia disorders, the most common neurodegenerative disorders. These so-called tauopathies are hitherto not curable and their diagnosis, especially at early disease stages, has traditionally proven difficult. A keystone in the diagnosis of tauopathies was the development of methods to assess levels of tau protein in vivo in cerebrospinal fluid, which has significantly improved our knowledge about these conditions. Tau proteins have also been measured in blood, but the importance of tau-related changes in blood is still unclear. The recent addition of positron emission tomography ligands to visualize, map and quantify tau pathology has further contributed with information about the temporal and spatial characteristics of tau accumulation in the living brain. Together, the measurement of tau with fluid biomarkers and positron emission tomography constitutes the basis for a highly active field of research. This review describes the current state of biomarkers for tau biomarkers derived from neuroimaging and from the analysis of bodily fluids and their roles in the detection, diagnosis and prognosis of tau-associated neurodegenerative disorders, as well as their associations with neuropathological findings, and aims to provide a perspective on how these biomarkers might be employed prospectively in research and clinical settings. Biomarkers for tau pathology are now essential to the research framework in the diagnosis of Alzheimer's disease (AD) Measurement of t- and p-tau has been possible in cerebrospinal fluid (CSF) for some time, the recent development of positron emission tomography (PET) ligands binding to tau has added the possibility to map and quantify tau in the living brain First-generation tau PET ligands bind predominantly to AD-typical 3R/4R tau isoforms and exhibit off-target binding that can limit accurate ligand uptake quantification Second-generation tau PET ligands appear to bind to comparable binding sites but exhibit fewer issues with brain off-target binding Biomarkers for tau derived from CSF analysis and PET could provide complementary information about disease state and stage At this time, T-tau, but not p-tau, can be reliably measured in plasma using ultra-sensitive immunoassays.
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Affiliation(s)
- Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden; Clinical Memory Research Unit, Lund University, Malmö, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK.
| | - Anne Maass
- German Center for Neurodegenerative Diseases, Magdeburg, Germany; Helen Wills Neuroscience Institute, University of California, Berkeley, USA
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Malmö, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden; King's College London, Institute of Psychiatry, Psychology & Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK; Department of Psychiatry and Neurochemistry, University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA; Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Bergeron D, Gorno-Tempini ML, Rabinovici GD, Santos-Santos MA, Seeley W, Miller BL, Pijnenburg Y, Keulen MA, Groot C, van Berckel BNM, van der Flier WM, Scheltens P, Rohrer JD, Warren JD, Schott JM, Fox NC, Sanchez-Valle R, Grau-Rivera O, Gelpi E, Seelaar H, Papma JM, van Swieten JC, Hodges JR, Leyton CE, Piguet O, Rogalski EJ, Mesulam MM, Koric L, Kristensen N, Pariente J, Dickerson B, Mackenzie IR, Hsiung GYR, Belliard S, Irwin DJ, Wolk DA, Grossman M, Jones M, Harris J, Mann D, Snowden JS, Chrem-Mendez P, Calandri IL, Amengual AA, Miguet-Alfonsi C, Magnin E, Magnani G, Santangelo R, Deramecourt V, Pasquier F, Mattsson N, Nilsson C, Hansson O, Keith J, Masellis M, Black SE, Matías-Guiu JA, Cabrera-Martin MN, Paquet C, Dumurgier J, Teichmann M, Sarazin M, Bottlaender M, Dubois B, Rowe CC, Villemagne VL, Vandenberghe R, Granadillo E, Teng E, Mendez M, Meyer PT, Frings L, Lleó A, Blesa R, Fortea J, Seo SW, Diehl-Schmid J, Grimmer T, Frederiksen KS, Sánchez-Juan P, Chételat G, Jansen W, Bouchard RW, Laforce RJ, Visser PJ, Ossenkoppele R. Prevalence of amyloid-β pathology in distinct variants of primary progressive aphasia. Ann Neurol 2018; 84:729-740. [PMID: 30255971 PMCID: PMC6354051 DOI: 10.1002/ana.25333] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 09/01/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To estimate the prevalence of amyloid positivity, defined by positron emission tomography (PET)/cerebrospinal fluid (CSF) biomarkers and/or neuropathological examination, in primary progressive aphasia (PPA) variants. METHODS We conducted a meta-analysis with individual participant data from 1,251 patients diagnosed with PPA (including logopenic [lvPPA, n = 443], nonfluent [nfvPPA, n = 333], semantic [svPPA, n = 401], and mixed/unclassifiable [n = 74] variants of PPA) from 36 centers, with a measure of amyloid-β pathology (CSF [n = 600], PET [n = 366], and/or autopsy [n = 378]) available. The estimated prevalence of amyloid positivity according to PPA variant, age, and apolipoprotein E (ApoE) ε4 status was determined using generalized estimating equation models. RESULTS Amyloid-β positivity was more prevalent in lvPPA (86%) than in nfvPPA (20%) or svPPA (16%; p < 0.001). Prevalence of amyloid-β positivity increased with age in nfvPPA (from 10% at age 50 years to 27% at age 80 years, p < 0.01) and svPPA (from 6% at age 50 years to 32% at age 80 years, p < 0.001), but not in lvPPA (p = 0.94). Across PPA variants, ApoE ε4 carriers were more often amyloid-β positive (58.0%) than noncarriers (35.0%, p < 0.001). Autopsy data revealed Alzheimer disease pathology as the most common pathologic diagnosis in lvPPA (76%), frontotemporal lobar degeneration-TDP-43 in svPPA (80%), and frontotemporal lobar degeneration-TDP-43/tau in nfvPPA (64%). INTERPRETATION This study shows that the current PPA classification system helps to predict underlying pathology across different cohorts and clinical settings, and suggests that age and ApoE genotype should be considered when interpreting amyloid-β biomarkers in PPA patients. Ann Neurol 2018;84:737-748.
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Affiliation(s)
- David Bergeron
- Interdisciplinary Clinic of Memory of the Child Jesus, Laval University, Quebec City, Quebec, Canada
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - Maria L Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA
| | - Miguel A Santos-Santos
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA
- Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute, Llobregat Hospital, Barcelona, Spain
- Llobregat Hospital, ACE Foundation, Catalan Institute of Applied Neurosciences, UIC Barcelona, Barcelona, Spain
| | - William Seeley
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA
| | - Yolande Pijnenburg
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - M Antoinette Keulen
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - Colin Groot
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - Philip Scheltens
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, United Kingdom
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Oriol Grau-Rivera
- Alzheimer's Disease and Other Cognitive Disorders Unit, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Ellen Gelpi
- Alzheimer's Disease and Other Cognitive Disorders Unit, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Harro Seelaar
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - Janne M Papma
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - John C van Swieten
- Alzheimer Center, Department of Neurology, Erasmus University Medical Center, Rotterdam, the Netherlands
| | - John R Hodges
- Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
- Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Cristian E Leyton
- Frontotemporal Dementia Unit, Department of Neurology, Massachusetts Alzheimer's Disease Research Center, Harvard Medical School, Boston, MA
| | - Olivier Piguet
- Brain and Mind Centre, School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
- Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, New South Wales, Australia
| | - Emily J Rogalski
- Neurological Sciences, Rush University, Chicago, IL
- Cognitive Neurology and Alzheimer Disease Center, Northwestern University Medical School, Chicago, IL
| | - Marsel M Mesulam
- Cognitive Neurology and Alzheimer Disease Center, Northwestern University Medical School, Chicago, IL
| | - Lejla Koric
- Department of Neurology and Neuropsychology, La Timone Hospital, Marseille, France
| | - Nora Kristensen
- Department of Neurology and Neuropsychology, La Timone Hospital, Marseille, France
| | - Jeéreémie Pariente
- University of Toulouse, INSERM, Toulouse Neuroimaging Center, Toulouse, France
| | - Bradford Dickerson
- Frontotemporal Dementia Unit, Department of Neurology, Massachusetts Alzheimer's Disease Research Center, Harvard Medical School, Boston, MA
| | - Ian R Mackenzie
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ging-Yuek R Hsiung
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Serge Belliard
- Division of Neurology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - David J Irwin
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA
| | - Matthew Jones
- Cerebral Function Unit, Greater Manchester Neurosciences Centre, Manchester, United Kingdom
- School of Community-Based Medicine, University of Manchester, Manchester, United Kingdom
| | - Jennifer Harris
- School of Community-Based Medicine, University of Manchester, Manchester, United Kingdom
| | - David Mann
- Division of Neuroscience and Experimental Psychology, School of Biological Sciences, University of Manchester, Manchester, United Kingdom
| | - Julie S Snowden
- School of Community-Based Medicine, University of Manchester, Manchester, United Kingdom
| | - Patricio Chrem-Mendez
- Center of Aging and Memory, Neurological Research Institute, Buenos Aires, Argentina
| | - Ismael L Calandri
- Center of Aging and Memory, Neurological Research Institute, Buenos Aires, Argentina
| | - Alejandra A Amengual
- Center of Aging and Memory, Neurological Research Institute, Buenos Aires, Argentina
| | - Carole Miguet-Alfonsi
- Department of Neurology, CHRU Besançon and Integrative and Clinical Neurosciences Laboratory, Regional Memory Center, University of Bourgogne Franche-Comté, Besançon, France
| | - Eloi Magnin
- Department of Neurology, CHRU Besançon and Integrative and Clinical Neurosciences Laboratory, Regional Memory Center, University of Bourgogne Franche-Comté, Besançon, France
| | - Giuseppe Magnani
- Department of Neurology, Vita Salute University and IRCCS San Raffaele Hospital, INSPE, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology, Vita Salute University and IRCCS San Raffaele Hospital, INSPE, Milan, Italy
| | | | - Florence Pasquier
- University of Lille Nord de France, INSERM U1171, DISTALZ, Lille, France
| | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Christer Nilsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
- Neuropsychiatric Clinic, Skåne University Hospital, Malmö, Sweden
| | - Julia Keith
- Anatomical Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Jordi A Matías-Guiu
- Department of Neurology and Nuclear Medicine, San Carlos Clinical Hospital, San Carlos Health Research Institute, Complutense University of Madrid, Madrid, Spain
| | - María-Nieves Cabrera-Martin
- Department of Neurology and Nuclear Medicine, San Carlos Clinical Hospital, San Carlos Health Research Institute, Complutense University of Madrid, Madrid, Spain
| | - Claire Paquet
- Memory Center, Department of Neurology, Lariboisière-Fernand-Widal Hospital, Paris, France
- Department of Pathology, Lariboisière-Fernand-Widal Hospital, Paris, France
| | - Julien Dumurgier
- Memory Center, Department of Neurology, Lariboisière-Fernand-Widal Hospital, Paris, France
| | - Marc Teichmann
- Department of Neurology, National Reference Center for PPA and rare dementias, Pitié Salpêtriére Hospital, AP-HP, Paris, France
| | - Marie Sarazin
- Frederic Joliot Hospital Service, ERL 9218 CNRS, CEA, Orsay, Île-de-France, France
- University of Paris-Sud, IMIV, UMR 1023 INSERM, CEA, Orsay, Île-de-France, France
| | - Michel Bottlaender
- Frederic Joliot Hospital Service, ERL 9218 CNRS, CEA, Orsay, Île-de-France, France
- University of Paris-Sud, IMIV, UMR 1023 INSERM, CEA, Orsay, Île-de-France, France
| | - Bruno Dubois
- Center for Cognitive and Behavioral Diseases, Pitié Salpêtrière University Hospital, Paris, France
| | - Christopher C Rowe
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging and Therapy, Austin Health, Melbourne, Victoria, Australia
- Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Rik Vandenberghe
- Department of Neurology, University Hospital Leuven, Leuven, Belgium
| | - Elias Granadillo
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA
| | - Edmond Teng
- Neurobehavior Service, Department of Neurology, University of California, Los Angeles, Los Angeles, CA
| | - Mario Mendez
- Neurobehavior Unit, West Los Angeles VA Medical Center, Los Angeles, CA
| | - Philipp T Meyer
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Freiburg, Freiburg, Germany
| | - Lars Frings
- Department of Nuclear Medicine, Faculty of Medicine, University Hospital of Freiburg, Freiburg, Germany
| | - Alberto Lleó
- Memory Unit, Department of Neurology, Santa Cruz and Saint Paul Hospital, Barcelona, Spain
- Saint Paul Biomedical Research Institute, Autonomous University of Barcelona, Barcelona, Spain
- Center for Biomedical Network Research on Neurodegenerative Diseases, Madrid, Spain
| | - Rafael Blesa
- Memory Unit, Department of Neurology, Santa Cruz and Saint Paul Hospital, Barcelona, Spain
- Saint Paul Biomedical Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Juan Fortea
- Memory Unit, Department of Neurology, Santa Cruz and Saint Paul Hospital, Barcelona, Spain
- Saint Paul Biomedical Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Janine Diehl-Schmid
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | | | | | - Gaël Chételat
- INSERM UMR-S U1237, University of Caen Normandy, Caen, France
| | - Willemijn Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Banner Alzheimer's Institute, Phoenix, AZ
| | - Rémi W Bouchard
- Interdisciplinary Clinic of Memory of the Child Jesus, Laval University, Quebec City, Quebec, Canada
| | - Robert Jr Laforce
- Interdisciplinary Clinic of Memory of the Child Jesus, Laval University, Quebec City, Quebec, Canada
- Clinique Interdisciplinaire de Mémoire de l'Enfant-Jésus, CHU de Québec, Université Laval, Québec, Canada
| | - Pieter Jelle Visser
- Llobregat Hospital, ACE Foundation, Catalan Institute of Applied Neurosciences, UIC Barcelona, Barcelona, Spain
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Alzheimer center Amsterdam, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, the Netherlands
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
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Palmqvist S, Insel PS, Zetterberg H, Blennow K, Brix B, Stomrud E, Mattsson N, Hansson O. Accurate risk estimation of β-amyloid positivity to identify prodromal Alzheimer's disease: Cross-validation study of practical algorithms. Alzheimers Dement 2018; 15:194-204. [PMID: 30365928 PMCID: PMC6374284 DOI: 10.1016/j.jalz.2018.08.014] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/14/2018] [Accepted: 08/21/2018] [Indexed: 12/21/2022]
Abstract
INTRODUCTION The aim was to create readily available algorithms that estimate the individual risk of β-amyloid (Aβ) positivity. METHODS The algorithms were tested in BioFINDER (n = 391, subjective cognitive decline or mild cognitive impairment) and validated in Alzheimer's Disease Neuroimaging Initiative (n = 661, subjective cognitive decline or mild cognitive impairment). The examined predictors of Aβ status were demographics; cognitive tests; white matter lesions; apolipoprotein E (APOE); and plasma Aβ42/Aβ40, tau, and neurofilament light. RESULTS Aβ status was accurately estimated in BioFINDER using age, 10-word delayed recall or Mini-Mental State Examination, and APOE (area under the receiver operating characteristics curve = 0.81 [0.77-0.85] to 0.83 [0.79-0.87]). When validated, the models performed almost identical in Alzheimer's Disease Neuroimaging Initiative (area under the receiver operating characteristics curve = 0.80-0.82) and within different age, subjective cognitive decline, and mild cognitive impairment populations. Plasma Aβ42/Aβ40 improved the models slightly. DISCUSSION The algorithms are implemented on http://amyloidrisk.com where the individual probability of being Aβ positive can be calculated. This is useful in the workup of prodromal Alzheimer's disease and can reduce the number needed to screen in Alzheimer's disease trials.
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Affiliation(s)
- Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden.
| | - Philip S Insel
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | | | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | | | | | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Vogel JW, Mattsson N, Iturria-Medina Y, Strandberg OT, Schöll M, Dansereau C, Villeneuve S, van der Flier WM, Scheltens P, Bellec P, Evans AC, Hansson O, Ossenkoppele R. Data-driven approaches for tau-PET imaging biomarkers in Alzheimer's disease. Hum Brain Mapp 2018; 40:638-651. [PMID: 30368979 DOI: 10.1002/hbm.24401] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 08/09/2018] [Accepted: 09/04/2018] [Indexed: 12/14/2022] Open
Abstract
Previous positron emission tomography (PET) studies have quantified filamentous tau pathology using regions-of-interest (ROIs) based on observations of the topographical distribution of neurofibrillary tangles in post-mortem tissue. However, such approaches may not take full advantage of information contained in neuroimaging data. The present study employs an unsupervised data-driven method to identify spatial patterns of tau-PET distribution, and to compare these patterns to previously published "pathology-driven" ROIs. Tau-PET patterns were identified from a discovery sample comprised of 123 normal controls and patients with mild cognitive impairment or Alzheimer's disease (AD) dementia from the Swedish BioFINDER cohort, who underwent [18 F]AV1451 PET scanning. Associations with cognition were tested in a separate sample of 90 individuals from ADNI. BioFINDER [18 F]AV1451 images were entered into a robust voxelwise stable clustering algorithm, which resulted in five clusters. Mean [18 F]AV1451 uptake in the data-driven clusters, and in 35 previously published pathology-driven ROIs, was extracted from ADNI [18 F]AV1451 scans. We performed linear models comparing [18 F]AV1451 signal across all 40 ROIs to tests of global cognition and episodic memory, adjusting for age, sex, and education. Two data-driven ROIs consistently demonstrated the strongest or near-strongest effect sizes across all cognitive tests. Inputting all regions plus demographics into a feature selection routine resulted in selection of two ROIs (one data-driven, one pathology-driven) and education, which together explained 28% of the variance of a global cognitive composite score. Our findings suggest that [18 F]AV1451-PET data naturally clusters into spatial patterns that are biologically meaningful and that may offer advantages as clinical tools.
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Affiliation(s)
- Jacob W Vogel
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Niklas Mattsson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | | | | | - Michael Schöll
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Christian Dansereau
- Department of Computer Science and Operations Research, Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Pierre Bellec
- Department of Computer Science and Operations Research, Université de Montréal, Montreal, Quebec, Canada.,Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, University of Montreal, Montreal, Quebec, Canada
| | - Alan C Evans
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Oskar Hansson
- Clinical Memory Research Unit, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, Netherlands.,Clinical Memory Research Unit, Lund University, Lund, Sweden
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Gonzales MM, Insel PS, Nelson C, Tosun D, Schöll M, Mattsson N, Sacuiu S, Bickford D, Weiner MW, Mackin RS. Chronic depressive symptomatology and CSF amyloid beta and tau levels in mild cognitive impairment. Int J Geriatr Psychiatry 2018; 33:1305-1311. [PMID: 29953668 DOI: 10.1002/gps.4926] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/04/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To investigate the association between chronic subsyndromal symptoms of depression (SSD), cerebrospinal fluid (CSF) biomarkers, and neuropsychological performance in individuals with mild cognitive impairment (MCI). METHODS Participants included 238 older adults diagnosed with MCI from the Alzheimer's Disease Neuroimaging Initiative repository with cognitive and CSF amyloid beta (Aβ1-42 ), total tau (t-tau), and phosphorylated tau (p-tau) data. The Neuropsychiatric Inventory identified individuals with chronic endorsement (SSD group N = 80) or no endorsement (non-SSD group N = 158) of depressive symptoms across timepoints. CSF biomarker and cognitive performance were evaluated with linear regression models adjusting for age, education, gender, APOE genotype, global cognitive status, and SSD group. RESULTS As compared to the non-SSD group, the SSD group displayed lower CSF Aβ1-42 levels (β = -24.293, S.E. = 6.345, P < 0.001). No group differences were observed for CSF t-tau (P = 0.497) or p-tau levels (P = 0.392). Lower CSF Aβ1-42 levels were associated with poorer performance on learning (β = 0.041, S.E. = 0.018, P = 0.021) and memory (β = -0.012, S.E. = 0.005, P = 0.031) measures, whereas higher CSF t-tau levels were associated with poorer performance on measures of global cognition (β = 0.022, S.E = 0.008, P = 0.007) and language (β = -0.010, S.E = 0.004, P = 0.019). SSD was independently associated with diminished global cognition, learning and memory, language, and executive function performance over and above the effects of CSF biomarkers (all P < 0.05). CONCLUSIONS MCI participants with SSD displayed diminished CSF Aβ1-42 levels but did not differ from non-SSD controls in CSF tau levels. Additionally, CSF biomarkers and SSD independently accounted for variance in cognitive performance, suggesting that these factors may uniquely confer cognitive risk in MCI.
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Affiliation(s)
- Mitzi M Gonzales
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Philip S Insel
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, CA, USA
| | - Craig Nelson
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Duygu Tosun
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, CA, USA.,Department of Radiology, University of California, San Francisco, CA, USA
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden.,Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Neurology, Skane University Hospital, Lund, Sweden
| | - Simona Sacuiu
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - David Bickford
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Michael W Weiner
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA.,Department of Radiology, University of California, San Francisco, CA, USA.,Department of Medicine, University of California, San Francisco, CA, USA
| | - R Scott Mackin
- Center for Imaging of Neurodegenerative Diseases, Veterans Administration Medical Center, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA
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Ossenkoppele R, Rabinovici GD, Smith R, Cho H, Schöll M, Strandberg O, Palmqvist S, Mattsson N, Janelidze S, Santillo A, Ohlsson T, Jögi J, Tsai R, La Joie R, Kramer J, Boxer AL, Gorno-Tempini ML, Miller BL, Choi JY, Ryu YH, Lyoo CH, Hansson O. Discriminative Accuracy of [18F]flortaucipir Positron Emission Tomography for Alzheimer Disease vs Other Neurodegenerative Disorders. JAMA 2018; 320:1151-1162. [PMID: 30326496 PMCID: PMC6233630 DOI: 10.1001/jama.2018.12917] [Citation(s) in RCA: 247] [Impact Index Per Article: 41.2] [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: 01/14/2023]
Abstract
IMPORTANCE The positron emission tomography (PET) tracer [18F]flortaucipir allows in vivo quantification of paired helical filament tau, a core neuropathological feature of Alzheimer disease (AD), but its diagnostic utility is unclear. OBJECTIVE To examine the discriminative accuracy of [18F]flortaucipir for AD vs non-AD neurodegenerative disorders. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, 719 participants were recruited from 3 dementia centers in South Korea, Sweden, and the United States between June 2014 and November 2017 (160 cognitively normal controls, 126 patients with mild cognitive impairment [MCI], of whom 65.9% were amyloid-β [Aβ] positive [ie, MCI due to AD], 179 patients with AD dementia, and 254 patients with various non-AD neurodegenerative disorders). EXPOSURES The index test was the [18F]flortaucipir PET standardized uptake value ratio (SUVR) in 5 predefined regions of interest (ROIs). Cut points for tau positivity were determined using the mean +2 SDs observed in controls and Youden Index for the contrast AD dementia vs controls. MAIN OUTCOMES AND MEASURES The reference standard was the clinical diagnosis determined at the specialized memory centers. In the primary analysis, the discriminative accuracy (ie, sensitivity and specificity) of [18F]flortaucipir was examined for AD dementia vs all non-AD neurodegenerative disorders. In secondary analyses, the area under the curve (AUC) of [18F]flortaucipir SUVR was compared with 3 established magnetic resonance imaging measures (hippocampal volumes and AD signature and whole-brain cortical thickness), and sensitivity and specificity of [18F]flortaucipir in MCI due to AD vs non-AD neurodegenerative disorders were determined. RESULTS Among 719 participants, the overall mean (SD) age was 68.8 (9.2) years and 48.4% were male. The proportions of patients who were amyloid-β positive were 26.3%, 65.9%, 100%, and 23.8% among cognitively normal controls, patients with MCI, patients with AD dementia, and patients with non-AD neurodegenerative disorders, respectively. [18F]flortaucipir uptake in the medial-basal and lateral temporal cortex showed 89.9% (95% CI, 84.6%-93.9%) sensitivity and 90.6% (95% CI, 86.3%-93.9%) specificity using the threshold based on controls (SUVR, 1.34), and 96.8% (95% CI, 92.0%-99.1%) sensitivity and 87.9% (95% CI, 81.9%-92.4%) specificity using the Youden Index-derived cutoff (SUVR, 1.27) for distinguishing AD dementia from all non-AD neurodegenerative disorders. The AUCs for all 5 [18F]flortaucipir ROIs were higher (AUC range, 0.92-0.95) compared with the 3 volumetric MRI measures (AUC range, 0.63-0.75; all ROIs P < .001). Diagnostic performance of the 5 [18F]flortaucipir ROIs were lower in MCI due to AD (AUC range, 0.75-0.84). CONCLUSIONS AND RELEVANCE Among patients with established diagnoses at a memory disorder clinic, [18F]flortaucipir PET was able to discriminate AD from other neurodegenerative diseases. The accuracy and potential utility of this test in patient care require further research in clinically more representative populations.
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Affiliation(s)
- Rik Ossenkoppele
- Lund University, Clinical Memory Research Unit, Lund, Sweden
- VU University Medical Center, Department of Neurology and Alzheimer Center, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Gil D. Rabinovici
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Ruben Smith
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - Hanna Cho
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Michael Schöll
- Lund University, Clinical Memory Research Unit, Lund, Sweden
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Olof Strandberg
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | | | - Niklas Mattsson
- Lund University, Clinical Memory Research Unit, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | | | | | - Tomas Ohlsson
- Skåne University Hospital, Department of Radiation Physics, Lund, Sweden
| | - Jonas Jögi
- Skåne University Hospital, Department of Clinical Physiology and Nuclear Medicine, Lund, Sweden
| | - Richard Tsai
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Joel Kramer
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Adam L. Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Maria L. Gorno-Tempini
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco
| | - Jae Y. Choi
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Division of RI-Convergence Research, Korea Institute Radiological and Medical Sciences, Seoul, South Korea
| | - Young H. Ryu
- Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Chul H. Lyoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Oskar Hansson
- Lund University, Clinical Memory Research Unit, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
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50
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Ebner F, Harmon MBA, Aneman A, Cronberg T, Friberg H, Hassager C, Juffermans N, Kjærgaard J, Kuiper M, Mattsson N, Pelosi P, Ullén S, Undén J, Wise MP, Nielsen N. Carbon dioxide dynamics in relation to neurological outcome in resuscitated out-of-hospital cardiac arrest patients: an exploratory Target Temperature Management Trial substudy. Crit Care 2018; 22:196. [PMID: 30119692 PMCID: PMC6098627 DOI: 10.1186/s13054-018-2119-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 07/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background Dyscarbia is common in out-of-hospital cardiac arrest (OHCA) patients and its association to neurological outcome is undetermined. Methods This is an exploratory post-hoc substudy of the Target Temperature Management (TTM) trial, including resuscitated OHCA patients, investigating the association between serial measurements of arterial partial carbon dioxide pressure (PaCO2) and neurological outcome at 6 months, defined by the Cerebral Performance Category (CPC) scale, dichotomized to good outcome (CPC 1 and 2) and poor outcome (CPC 3–5). The effects of hypercapnia and hypocapnia, and the time-weighted mean PaCO2 and absolute PaCO2 difference were analyzed. Additionally, the association between mild hypercapnia (6.0–7.30 kPa) and neurological outcome, its interaction with target temperature (33 °C and 36 °C), and the association between PaCO2 and peak serum-Tau were evaluated. Results Of the 939 patients in the TTM trial, 869 were eligible for analysis. Ninety-six percent of patients were exposed to hypocapnia or hypercapnia. None of the analyses indicated a statistical significant association between PaCO2 and neurological outcome (P = 0.13–0.96). Mild hypercapnia was not associated with neurological outcome (P = 0.78) and there was no statistically significant interaction with target temperature (Pinteraction = 0.95). There was no association between PaCO2 and peak serum-Tau levels 48 or 72 h after return of spontaneous circulation (ROSC). Conclusions Dyscarbia is common after ROSC. No statistically significant association between PaCO2 in the post-cardiac arrest phase and neurological outcome at 6 months after cardiac arrest was detected. There was no significant interaction between mild hypercapnia and temperature in relation to neurological outcome. Electronic supplementary material The online version of this article (10.1186/s13054-018-2119-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Florian Ebner
- Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
| | - Matt B A Harmon
- Department of Intensive Care Medicine, Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Anders Aneman
- Department of Intensive Care, Liverpool Hospital, Locked Bag 7103, Liverpool BC, Sydney, NSW, 1871, Australia
| | - Tobias Cronberg
- Department of Clinical Sciences, Neurology, Skåne University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Hans Friberg
- Department of Anaesthesia and Intensive Care, Skåne University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Christian Hassager
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nicole Juffermans
- Department of Intensive Care Medicine, Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105 AZ, The Netherlands
| | - Jesper Kjærgaard
- Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Michael Kuiper
- Intensive Care Unit, Leeuwarden Medical Centrum, Borniastraat 38, NL8934 AD, Leeuwarden, The Netherlands
| | - Niklas Mattsson
- Department of Clinical Sciences, Neurology, Skåne University Hospital, Getingevägen 5, 221 85, Lund, Sweden
| | - Paolo Pelosi
- Department of Surgical Sciences and Integrated Diagnostics, Anesthesia and Intensive Care, San Martino Policlinico Hospital, University of Genoa, Genoa, Italy
| | - Susann Ullén
- Clinical Studies Sweden, Skåne University Hospital, Remissgatan 4, 221 85, Lund, Sweden
| | - Johan Undén
- Department of Anaesthesia and Intensive Care, Hallands Hospital, Halmstad, Sweden
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Heath Park, Cardiff, CF144XW, UK
| | - Niklas Nielsen
- Department of Anesthesia and Intensive Care, Helsingborg Hospital, Helsingborg, Sweden.
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