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Apostolova LG, Hwang KS, Avila D, Elashoff D, Kohannim O, Teng E, Sokolow S, Jack CR, Jagust WJ, Shaw L, Trojanowski JQ, Weiner MW, Thompson PM. Brain amyloidosis ascertainment from cognitive, imaging, and peripheral blood protein measures. Neurology 2015; 84:729-37. [PMID: 25609767 DOI: 10.1212/wnl.0000000000001231] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The goal of this study was to identify a clinical biomarker signature of brain amyloidosis in the Alzheimer's Disease Neuroimaging Initiative 1 (ADNI1) mild cognitive impairment (MCI) cohort. METHODS We developed a multimodal biomarker classifier for predicting brain amyloidosis using cognitive, imaging, and peripheral blood protein ADNI1 MCI data. We used CSF β-amyloid 1-42 (Aβ42) ≤ 192 pg/mL as proxy measure for Pittsburgh compound B (PiB)-PET standard uptake value ratio ≥ 1.5. We trained our classifier in the subcohort with CSF Aβ42 but no PiB-PET data and tested its performance in the subcohort with PiB-PET but no CSF Aβ42 data. We also examined the utility of our biomarker signature for predicting disease progression from MCI to Alzheimer dementia. RESULTS The CSF training classifier selected Mini-Mental State Examination, Trails B, Auditory Verbal Learning Test delayed recall, education, APOE genotype, interleukin 6 receptor, clusterin, and ApoE protein, and achieved leave-one-out accuracy of 85% (area under the curve [AUC] = 0.8). The PiB testing classifier achieved an AUC of 0.72, and when classifier self-tuning was allowed, AUC = 0.74. The 36-month disease-progression classifier achieved AUC = 0.75 and accuracy = 71%. CONCLUSIONS Automated classifiers based on cognitive and peripheral blood protein variables can identify the presence of brain amyloidosis with a modest level of accuracy. Such methods could have implications for clinical trial design and enrollment in the near future. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that a classification algorithm based on cognitive, imaging, and peripheral blood protein measures identifies patients with brain amyloid on PiB-PET with moderate accuracy (sensitivity 68%, specificity 78%).
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Affiliation(s)
- Liana G Apostolova
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA.
| | - Kristy S Hwang
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - David Avila
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - David Elashoff
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Omid Kohannim
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Edmond Teng
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Sophie Sokolow
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Clifford R Jack
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - William J Jagust
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Leslie Shaw
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - John Q Trojanowski
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Michael W Weiner
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
| | - Paul M Thompson
- From the Departments of Neurology (L.G.A., K.S.H., D.A., O.K., E.T., P.M.T.), Medicine Statistics Core (D.E.), and School of Nursing (S.S.), David Geffen School of Medicine at University of California, Los Angeles; Institute for Neuroinformatics (P.M.T.), Keck School of Medicine, University of Southern California, Los Angeles; Veterans Affairs Greater Los Angeles Healthcare System (E.T.); Department of Diagnostic Radiology (C.R.J.), Mayo Clinic, Rochester, MN; Department of Public Health and Neuroscience (W.J.J.), University of California, Berkeley; Department of Pathology and Laboratory Medicine (L.S., J.Q.T.), University of Pennsylvania School of Medicine, Philadelphia; Department of Radiology (M.W.W.), University of California, San Francisco; and Department of Veterans Affairs Medical Center (M.W.W.), San Francisco, CA
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Dimova I, Hlushchuk R, Makanya A, Djonov V, Theurl M, Schgoer W, Albrecht K, Beer A, Patsch JR, Schratzberger P, Mahata S, Kirchmair R, Didie M, Christalla P, Rau T, Eschenhagen T, Schumacher U, Lin Q, Zenke M, Zimmmermann W, Hoch M, Fischer P, Stapel B, Missol-Kolka E, Erschow S, Scherr M, Drexler H, Hilfiker-Kleiner D, Diebold I, Petry A, Kennel P, Djordjevic T, Hess J, Goerlach A, Castellano J, Aledo R, Sendra J, Costales P, Badimon L, Llorente-Cortes V, Dworatzek E, Mahmoodzadeh S, Regitz-Zagrosek V, Posa A, Varga C, Berko A, Veszelka M, Szablics P, Vari B, Pavo I, Laszlo F, Brandenburger M, Wenzel J, Bogdan R, Richardt D, Reppel M, Hescheler J, Terlau H, Dendorfer A, Heijman J, Rudy Y, Westra R, Volders P, Rasmusson R, Bondarenko V, Ertas Gokhan MD, Ural Ertan MD, Karaoz Erdal PHD, Aksoy Ayca PHD, Kilic Teoman MD, Kozdag Guliz MD, Vural Ahmet MD, Ural Dilek MD, Poulet C, Christ T, Wettwer E, Ravens U, Van Der Pouw Kraan C, Schirmer S, Fledderus J, Moerland P, Leyen T, Piek J, Van Royen N, Horrevoets A, Fleissner F, Jazbutyte V, Fiedler J, Galuppo P, Mayr M, Ertl G, Bauersachs J, Thum T, Protze S, Bussek A, Ravens U, Li F, Hoo R, Lam K, Xu A, Westenbrink B, Maass A, Sillje H, Van Veldhuisen D, Van Gilst W, De Boer R, Biesmans L, Bito V, Driessen R, Holemans P, Subramanian P, Lenaerts I, Huysmans C, Sipido K, Mourouzis I, Pantos C, Galanopoulos G, Gavra M, Perimenis P, Spanou D, Cokkinos D, Karshovska E, Berezin A, Panasenko T, Euler G, Partsch S, Harjung C, Heger J, Bogdanova A, Mihov D, Mocharla P, Yakushev S, Megens R, Vogel J, Gassmann M, Tavakoli R, Johansen D, Sanden E, Xi C, Sundset R, Ytrehus K, Bliksoen M, Rutkovskiy A, Akhtar S, Mariero L, Vaage I, Stenslokken K, Pisarenko O, Shulzhenko V, Studneva I, Serebryakova L, Tskitishvili O, Pelogeykina Y, Timoshin A, Heyll K, Vanin A, Ziberna L, Lunder M, Drevensek G, Passamonti S, Gorza L, Ravara B, Scapin C, Vitadello M, Zigrino F, Jansen Y, Gerosa G, Gwathmey J, Del Monte F, Vilahur G, Juan-Babot O, Onate B, Casani L, Badimon L, Lemoine S, Calmettes G, Weber C, Jaspard-Vinassa B, Duplaa C, Couffinhal T, Diolez P, Dos Santos P, Fusco A, Santulli G, Cipolletta E, Sorriento D, Cervero P, Schober A, Trimarco B, Feliciello A, Iaccarino G, Loganathan S, Barnucz E, Korkmaz S, Hirschberg K, Karck M, Szabo G, Kozichova K, Zafeiriou M, Hlavackova M, Neckar J, Kolar F, Novakova O, Novak F, Kusmic C, Matteucci M, Pelosi G, Vesentini N, Barsanti C, Noack C, Trivella M, Abraham N, L'abbate A, Muntean D, Mirica S, Duicu O, Raducan A, Hancu M, Fira-Mladinescu O, Ordodi V, Renger A, Voelkl J, Haubner B, Neely G, Moriell C, Seidl S, Pachinger O, Penninger J, Metzler B, Dietz R, Zelarayan L, Bergmann M, Meln I, Malashicheva A, Anisimov S, Kalinina N, Sysoeva V, Zaritskey A, Barbuti A, Scavone A, Mazzocchi N, Crespi A, Capilupo D, Difrancesco D, Qian L, Shim W, Gu Y, Mohammed S, Wong P, Noack C, Renger A, Zafiriou M, Dietz R, Schaeffer H, Bergmann M, Zelarayan L, Kovacs P, Simon J, Christ T, Wettwer E, Varro A, Ravens U, Athias P, Wolf J, Bouchot O, Vandroux D, Mathe A, De Carvalho A, Laurent G, Rainer P, Huber M, Edelmann F, Stojakovic T, Trantina-Yates A, Trauner M, Pieske B, Von Lewinski D, De Jong A, Maass A, Oberdorf-Maass S, Van Gelder I, Lin Y, Li J, Wang F, He Y, Li X, Xu H, Yang X, Coppini R, Ferrantini C, Ferrara C, Rossi A, Mugelli A, Poggesi C, Cerbai E, Rozmaritsa N, Voigt N, Christ T, Wettwer E, Dobrev D, Ravens U, Kienitz MC, Zoidl G, Bender K, Pott L, Kohajda Z, Kristof A, Kovacs P, Virag L, Varro A, Jost N, Voigt N, Trafford A, Ravens U, Dobrev D, Prnjavorac B, Mujaric E, Jukic J, Abduzaimovic K, Brack K, Patel V, Coote J, Ng G, Wilders R, Van Ginneken A, Verkerk A, Brack K, Coote J, Ng G, Xaplanteris P, Vlachopoulos C, Baou K, Vassiliadou C, Dima I, Ioakeimidis N, Stefanadis C, Ruifrok W, Qian C, Sillje H, Van Goor H, Van Veldhuisen D, Van Gilst W, De Boer R, Schmidt K, Kaiser F, Erdmann J, De Wit C, Barnett O, Kyyak Y, Cesana F, Boffi L, Mauri T, Alloni M, Betelli M, 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Pena E, Badimon L, Kobus K, Czyszek J, Kozlowska-Wiechowska A, Milkiewicz P, Milkiewicz M, Madonna R, Montebello E, Geng Y, De Caterina R, Chin-Dusting J, Michell D, Skilton M, Dixon J, Dart A, Moore X, Hlushchuk R, Ehrbar M, Reichmuth P, Heinimann N, Djonov V, Hewing B, Stangl V, Stangl K, Laule M, Baumann G, Ludwig A, Widmer-Teske R, Mueller A, Stieger P, Tillmanns H, Braun-Dullaeus R, Sedding D, Troidl K, Eller L, Benli I, Apfelbeck H, Schierling W, Troidl C, Schaper W, Schmitz-Rixen T, Hinkel R, Trenkwalder T, Pfosser A, Globisch F, Stachel G, Lebherz C, Bock-Marquette I, Kupatt C, Seyler C, Duthil-Straub E, Zitron E, Scholz E, Thomas D, Gierten J, Karle C, Fink R, Padro T, Lugano R, Garcia-Arguinzonis M, Badimon L, Schuchardt M, Pruefer J, Toelle M, Pruefer N, Jankowski V, Jankowski J, Zidek W, Van Der Giet M, Pena E, Arderiu G, Badimon L, Fransen P, Van Hove C, Michiels C, Van Langen J, Bult H, Quarck R, Wynants M, Alfaro-Moreno E, Rosario Sepulveda M, Wuytack F, Van Raemdonck D, 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Saturday, 17 July 2010. Cardiovasc Res 2010. [DOI: 10.1093/cvr/cvq174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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