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Crane PK, Groot C, Ossenkoppele R, Mukherjee S, Choi S, Lee M, Scollard P, Gibbons LE, Sanders RE, Trittschuh E, Saykin AJ, Mez J, Nakano C, Donald CM, Sohi H, Risacher S. Cognitively defined Alzheimer's dementia subgroups have distinct atrophy patterns. Alzheimers Dement 2024; 20:1739-1752. [PMID: 38093529 PMCID: PMC10984445 DOI: 10.1002/alz.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 10/16/2023] [Accepted: 11/03/2023] [Indexed: 03/03/2024]
Abstract
INTRODUCTION We sought to determine structural magnetic resonance imaging (MRI) characteristics across subgroups defined based on relative cognitive domain impairments using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and to compare cognitively defined to imaging-defined subgroups. METHODS We used data from 584 people with Alzheimer's disease (AD) (461 amyloid positive, 123 unknown amyloid status) and 118 amyloid-negative controls. We used voxel-based morphometry to compare gray matter volume (GMV) for each group compared to controls and to AD-Memory. RESULTS There was pronounced bilateral lower medial temporal lobe atrophy with relative cortical sparing for AD-Memory, lower left hemisphere GMV for AD-Language, anterior lower GMV for AD-Executive, and posterior lower GMV for AD-Visuospatial. Formal asymmetry comparisons showed substantially more asymmetry in the AD-Language group than any other group (p = 1.15 × 10-10 ). For overlap between imaging-defined and cognitively defined subgroups, AD-Memory matched up with an imaging-defined limbic predominant group. DISCUSSION MRI findings differ across cognitively defined AD subgroups.
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Affiliation(s)
- Paul K. Crane
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Colin Groot
- Clinical Memory Research UnitLund UniversityLundSweden
- Alzheimer centerAmsterdam UMC ‐ VU Medical CenterAmsterdamNetherlands
| | - Rik Ossenkoppele
- Clinical Memory Research UnitLund UniversityLundSweden
- Alzheimer centerAmsterdam UMC ‐ VU Medical CenterAmsterdamNetherlands
| | | | - Seo‐Eun Choi
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Michael Lee
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Phoebe Scollard
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura E. Gibbons
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Emily Trittschuh
- Department of Psychiatry and Behavioral SciencesUniversity of Washington, and Geriatrics ResearchEducation, and Clinical CenterVA Puget Sound Health Care SystemSeattleUSA
| | - Andrew J. Saykin
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisUSA
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
| | - Jesse Mez
- Department of NeurologyBoston UniversityBostonMassachusettsUSA
| | - Connie Nakano
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Harkirat Sohi
- Department of Biomedical Informatics and Medical EducationUniversity of WashingtonSeattleUSA
- Now Pacific Northwest National LaboratoryRichlandUSA
| | | | - Shannon Risacher
- Indiana Alzheimer's Disease Research CenterIndiana University School of MedicineIndianapolisUSA
- Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA
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Cho Y, Levendowski DJ, Walsh CM, Tsuang D, Lee-Iannotti JK, Berka C, Mazeika G, Salat D, Hamilton JM, Boeve BF, Neylan TC, St Louis EK. Autonomic dysregulation during sleep in Parkinsonian spectrum disorders - A proof of concept. Parkinsonism Relat Disord 2023; 117:105905. [PMID: 37939637 PMCID: PMC10842052 DOI: 10.1016/j.parkreldis.2023.105905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/09/2023] [Accepted: 10/22/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Autonomic dysfunction is common in α-synucleinopathies such as Lewy Body dementias (LBD), Parkinson's disease (PD), and isolated REM Sleep Behavior Disorder (iRBD). We analyzed pulse-rate changes during sleep to index autonomic nervous system (ANS) dysfunction in patients with α-synucleinopathies vs. non-synucleinopathy groups expected to have normal ANS function. METHODS Patients with LBD (n = 16), PD (PD, n = 14) or iRBD (n = 12) were compared to the non-synucleinopathy groups Alzheimers disease dementia (ADem, n = 26), mild cognitive impairment (MCI, n = 34) or controls (CG, n = 54). Sleep Profiler was used to derive a sleep autonomic activation index (AAI), i.e., ≥6 beat-per-minute increase/decrease, pulse rate coefficient of variation (PR-CV), and automated sleep staging with sleep-spindles and non-REM hypertonia (NRH). Analysis included statistical group comparisons and receiver operating characteristics curves to determine optimal classification of groups. RESULTS AAI and PR-CV were moderately correlated across all recordings (rs = 0.58, P < 0.0001), except in the LBD and PD groups. AAI but not PR-CV differentiated the LBD, PD and iRBD from non-Parkinsonian groups. AAI was decreased in LBD and PD patients compared to the CG (p < 0.003) and MCI (p < 0.03). AAI decreased based on age and its receiver operating characteristic area under the curve ranged from 0.63 to 0.75. AAI had a weak negative correlation to NRH (rs ≤ -0.26) but not sleep-spindles. CONCLUSION Synucleinopathy-related ANS dysfunction can reasonably discriminate prodromal and manifest PD/LBD diseased groups from non-synucleinopathies. Further studies incorporating AAI into a multivariate classifier of neurodegenerative disorders based on sleep characteristics acquired in the patient's home are planned.
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Affiliation(s)
- Yeilim Cho
- Mental Illness Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Christine M Walsh
- Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Debby Tsuang
- Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, WA, USA
| | | | - Chris Berka
- Advanced Brain Monitoring, Inc., Carlsbad, CA, USA
| | | | - David Salat
- Massachusetts General Hospital, Charlestown, MA, USA
| | | | - Bradley F Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Thomas C Neylan
- UCSF Weill Institute for Neurosciences, University of California, San Francisco, CA, USA
| | - Erik K St Louis
- Departments of Neurology and Medicine and Center for Sleep Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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Rahman‐Filipiak A, Sadaghiyani S, Davis K, Bhaumik AK, Paulson HL, Giordani B, Hampstead BM. Validation of the National Alzheimer's Coordinating Center (NACC) Lewy Body Disease Module neuropsychological tests. Alzheimers Dement (Amst) 2022; 14:e12279. [PMID: 35155734 PMCID: PMC8828993 DOI: 10.1002/dad2.12279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/05/2021] [Accepted: 01/12/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION This study assessed the construct validity and clinical utility of the National Alzheimer's Coordinating Center Lewy Body Dementia (LBD) Module, consisting of the Speeded Attention and Noise Pareidolia Tasks. METHODS Participants included 459 older adults diagnosed as cognitively normal (n = 202), or with non-amnestic mild cognitive impairment (n = 61), amnestic mild cognitive impairment (n = 96), Alzheimer's disease dementia (n = 44), or LBD (n = 56). RESULTS Speeded Attention demonstrated strong convergent validity and moderate discriminant validity when compared to established neuropsychological tests. Noise Pareidolia demonstrated strong discriminant validity, but limited convergent validity. Noise Pareidolia scores were significantly lower in those with reported hallucinations, delusions, or REM sleep behavior disorder symptoms. LBD Module tests discriminated well between cognitively normal adults and those with LBD. DISCUSSION The LBD Module demonstrates promising construct validity and clinical utility, which support its use across research and clinical settings.
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Affiliation(s)
- Annalise Rahman‐Filipiak
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | - Shima Sadaghiyani
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Katrail Davis
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | | | - Henry L. Paulson
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
- Department of NeurologyUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Bruno Giordani
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
| | - Benjamin M. Hampstead
- Department of PsychiatryUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
- Michigan Alzheimer's Disease Research CenterAnn ArborMichiganUSA
- Mental Health ServiceVA Ann Arbor Health Care SystemAnn ArborMichiganUSA
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Sanz C, Carrillo F, Slachevsky A, Forno G, Gorno Tempini ML, Villagra R, Ibáñez A, Tagliazucchi E, García AM. Automated text-level semantic markers of Alzheimer's disease. Alzheimers Dement (Amst) 2022; 14:e12276. [PMID: 35059492 PMCID: PMC8759093 DOI: 10.1002/dad2.12276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/04/2021] [Accepted: 11/15/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Automated speech analysis has emerged as a scalable, cost-effective tool to identify persons with Alzheimer's disease dementia (ADD). Yet, most research is undermined by low interpretability and specificity. METHODS Combining statistical and machine learning analyses of natural speech data, we aimed to discriminate ADD patients from healthy controls (HCs) based on automated measures of domains typically affected in ADD: semantic granularity (coarseness of concepts) and ongoing semantic variability (conceptual closeness of successive words). To test for specificity, we replicated the analyses on Parkinson's disease (PD) patients. RESULTS Relative to controls, ADD (but not PD) patients exhibited significant differences in both measures. Also, these features robustly discriminated between ADD patients and HC, while yielding near-chance classification between PD patients and HCs. DISCUSSION Automated discourse-level semantic analyses can reveal objective, interpretable, and specific markers of ADD, bridging well-established neuropsychological targets with digital assessment tools.
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Affiliation(s)
- Camila Sanz
- Departamento de FísicaUniversidad de Buenos Aires and Instituto de Física de Buenos Aires (IFIBA‐CONICET)Pabellón ICiudad Universitaria (1428)CABABuenos AiresArgentina
| | - Facundo Carrillo
- Applied Artificial Intelligence Lab (ICC‐CONICET)Pabellón ICiudad Universitaria (1428)CABABuenos AiresArgentina
| | - Andrea Slachevsky
- Memory and Neuropsychiatric Clinic, Neurology Department, Hospital del Salvador (7500000), SSMO & Faculty of Medicine (8380000)University of ChileSantiagoChile
- Center for Brain Health and Metabolism (GERO) (7500922)SantiagoChile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile (7500922)University of ChileSantiagoChile
- Servicio de Neurología, Departamento de MedicinaClínica Alemana‐Universidad del Desarrollo (7550000)SantiagoChile
- East Neuroscience Department, Faculty of Medicine (7650567)University of ChileSantiagoChile
| | - Gonzalo Forno
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile (7500922)University of ChileSantiagoChile
- School of PsychologyUniversidad de los Andes (7550000)SantiagoChile
- Alzheimer's and other cognitive disorders groupInstitute of Neurosciences (08035)University of BarcelonaBarcelonaSpain
| | - Maria Luisa Gorno Tempini
- Memory and Aging CenterDepartment of Neurology (94143)University of CaliforniaSan FranciscoCaliforniaUSA
| | - Roque Villagra
- Center for Brain Health and Metabolism (GERO) (7500922)SantiagoChile
- East Neuroscience Department, Faculty of Medicine (7650567)University of ChileSantiagoChile
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat) (7550000)Universidad Adolfo IbáñezSantiagoChile
- Cognitive Neuroscience Center (1644)Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (1425)Buenos AiresArgentina
- Global Brain Health Institute (94143)University of California‐San Francisco, San Francisco, California, USA; and Trinity College Dublin (D02), Dublin, Ireland
| | - Enzo Tagliazucchi
- Departamento de FísicaUniversidad de Buenos Aires and Instituto de Física de Buenos Aires (IFIBA‐CONICET)Pabellón ICiudad Universitaria (1428)CABABuenos AiresArgentina
- Latin American Brain Health Institute (BrainLat) (7550000)Universidad Adolfo IbáñezSantiagoChile
| | - Adolfo M. García
- Cognitive Neuroscience Center (1644)Universidad de San AndrésBuenos AiresArgentina
- National Scientific and Technical Research Council (1425)Buenos AiresArgentina
- Global Brain Health Institute (94143)University of California‐San Francisco, San Francisco, California, USA; and Trinity College Dublin (D02), Dublin, Ireland
- Departamento de Lingüística y LiteraturaFacultad de Humanidades (9160000)Universidad de Santiago de ChileSantiagoChile
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Song R, Pan KY, Xu H, Qi X, Buchman AS, Bennett DA, Xu W. Association of cardiovascular risk burden with risk of dementia and brain pathologies: A population-based cohort study. Alzheimers Dement 2021; 17:1914-1922. [PMID: 34310004 PMCID: PMC10266491 DOI: 10.1002/alz.12343] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/03/2021] [Accepted: 03/11/2021] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The impact of cardiovascular risk burden on brain pathologies remains unclear. We aimed to examine the association of the Framingham General Cardiovascular Risk Score (FGCRS) with dementia risk, and brain pathologies. METHODS Within the Rush Memory and Aging Project, 1588 dementia-free participants were assessed on FGCRS at baseline and followed up to 21 years. During the follow-up, 621 participants died and underwent autopsies. RESULTS The multi-adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) of FGCRS were 1.03 (1.00-1.07) for dementia and 1.04 (1.01-1.07) for Alzheimer's disease (AD) dementia. Further, a higher FGCRS was associated with higher gross chronic cerebral infarctions (odds ratio [OR] 1.08, 95% CI 1.02-1.14), cerebral atherosclerosis (OR 1.10, 95% CI 1.03-1.17), and global AD pathology (OR 1.06, 95% CI 1.01-1.12). CONCLUSIONS A higher FGCRS is associated with an increased risk of dementia and AD dementia. Both vascular and AD pathologies in the brain may underlie this association.
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Affiliation(s)
- Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Kuan-Yu Pan
- Amsterdam University Medical Center, Vrije Universiteit, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, 60612, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, 60612, USA
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Huq AJ, Fulton‐Howard B, Riaz M, Laws S, Sebra R, Ryan J, Renton AE, Goate AM, Masters CL, Storey E, Shah RC, Murray A, McNeil J, Winship I, James PA, Lacaze P. Polygenic score modifies risk for Alzheimer's disease in APOE ε4 homozygotes at phenotypic extremes. Alzheimers Dement (Amst) 2021; 13:e12226. [PMID: 34386572 PMCID: PMC8339682 DOI: 10.1002/dad2.12226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/28/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Diversity in cognition among apolipoprotein E (APOE) ε4 homozygotes can range from early-onset Alzheimer's disease (AD) to a lifetime with no symptoms. METHODS We evaluated a phenotypic extreme polygenic risk score (PRS) for AD between cognitively healthy APOE ε4 homozygotes aged ≥75 years (n = 213) and early-onset APOE ε4 homozygote AD cases aged ≤65 years (n = 223) as an explanation for this diversity. RESULTS The PRS for AD was significantly higher in APOE ε4 homozygote AD cases compared to older cognitively healthy APOE ε4/ε4 controls (odds ratio [OR] 8.39; confidence interval [CI] 2.0-35.2; P = .003). The difference in the same PRS between APOE ε3/ε3 extremes was not as significant (OR 3.13; CI 0.98-9.92; P = .053) despite similar numbers and power. There was no statistical difference in an educational attainment PRS between these age extreme case-controls. DISCUSSION A PRS for AD contributes to modified cognitive expression of the APOE ε4/ε4 genotype at phenotypic extremes of risk.
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Affiliation(s)
- Aamira J. Huq
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
- Department of Genomic MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
- Department of MedicineRoyal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
| | - Brian Fulton‐Howard
- Nash Family Department of Neuroscience and Ronald Loeb Center for Alzheimer's DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Departments of Neurology and Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Moeen Riaz
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Simon Laws
- Collaborative Genomics GroupCentre of Excellence for Alzheimer's Disease Research and CareSchool of Medical and Health SciencesEdith Cowan UniversityJoondalupWestern AustraliaAustralia
- School of Pharmacy and Biomedical SciencesFaculty of Health SciencesCurtin Health InnovationPerthWestern AustraliaAustralia
| | - Robert Sebra
- Departments of Neurology and Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Joanne Ryan
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | | | - Alan E. Renton
- Nash Family Department of Neuroscience and Ronald Loeb Center for Alzheimer's DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Departments of Neurology and Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Alison M. Goate
- Nash Family Department of Neuroscience and Ronald Loeb Center for Alzheimer's DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
- Departments of Neurology and Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Colin L. Masters
- The Florey InstituteUniversity of MelbourneParkvilleVictoriaAustralia
| | - Elsdon Storey
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Anne Murray
- Berman Center for Outcomes and Clinical ResearchHennepin Healthcare Research InstituteHennepin Healthcareand University of MinnesotaMinneapolisMinnesotaUSA
| | - John McNeil
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Ingrid Winship
- Department of Genomic MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
| | - Paul A. James
- Department of Genomic MedicineRoyal Melbourne HospitalMelbourneVictoriaAustralia
| | - Paul Lacaze
- Department of Epidemiology and Preventive MedicineSchool of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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Boyle PA, Wang T, Yu L, Wilson RS, Dawe R, Arfanakis K, Schneider JA, Beck T, Rajan KB, Evans D, Bennett DA. The "cognitive clock": A novel indicator of brain health. Alzheimers Dement 2021; 17:1923-1937. [PMID: 34060702 DOI: 10.1002/alz.12351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We identified a "cognitive clock," a novel indicator of brain health that provides person-specific estimates of cognitive age, and tested the hypothesis that cognitive age is a better predictor of brain health than chronological age in two independent datasets. METHODS The initial analyses were based on 1057 participants from the Rush Memory and Aging Project and the Religious Orders Study who began without impairment and underwent cognitive assessments up to 24 years. A shape invariant model characterized the latent pattern of cognitive decline, conceptualized here as the "cognitive clock," and yielded person-specific estimates of cognitive age. Survival analyses examined cognitive versus chronological age for predicting Alzheimer's disease dementia, mild cognitive impairment and mortality, and regression analyses examined associations of cognitive versus chronological age with neuropathology and brain atrophy. Finally, we applied the cognitive clock to an independent validation sample of 2592 participants from the Chicago Health and Aging Project, a biracial population-based study, to confirm the predictive utility of cognitive age. RESULTS The "cognitive clock" showed that cognition remained stable until a cognitive age of about 80, then declined moderately until 90, then declined precipitously. In the initial dataset, cognitive age was a better predictor of dementia, mild cognitive impairment and mortality than chronological age, and was more strongly associated with neuropathology and brain atrophy. Application of the cognitive clock to the independent validation sample provided further support for the utility of cognitive age as a strong prognostic indicator of adverse outcomes. DISCUSSION Cognitive age is a robust prognostic indicator of adverse health outcomes and may serve as a useful biomarker in aging research.
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Affiliation(s)
- Patricia A Boyle
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Tianhao Wang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert Dawe
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Diagnostic Radiology and Nuclear Medicine, Chicago, Illinois, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Diagnostic Radiology and Nuclear Medicine, Chicago, Illinois, USA.,Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.,Department of Pathology, Rush University Medical Center, Chicago, Illinois, USA
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Campbell MR, Ashrafzadeh‐Kian S, Petersen RC, Mielke MM, Syrjanen JA, van Harten AC, Lowe VJ, Jack CR, Bornhorst JA, Algeciras‐Schimnich A. P-tau/Aβ42 and Aβ42/40 ratios in CSF are equally predictive of amyloid PET status. Alzheimers Dement (Amst) 2021; 13:e12190. [PMID: 34027020 PMCID: PMC8129859 DOI: 10.1002/dad2.12190] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/29/2021] [Accepted: 03/31/2021] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Measurement of amyloid beta (Aβ40 and Aβ42) and tau (phosphorylated tau [p-tau] and total tau [t-tau]) in cerebrospinal fluid (CSF) can be utilized to differentiate clinical and preclinical Alzheimer's disease dementia (AD) from other neurodegenerative processes. METHODS CSF biomarkers were measured in 150 participants from the Mayo Clinic Study of Aging and the Alzheimer's Disease Research Center. P-tau/Aβ42 (Roche Elecsys, Fujirebio LUMIPULSE) and Aβ42/40 (Fujirebio LUMIPULSE) ratios were compared to one another and to amyloid positron emission tomography (PET) classification. RESULTS Strong correlation was observed between LUMIPULSE p-tau/Aβ42 and Aβ42/40, as well as Elecsys and LUMIPULSE p-tau/Aβ42 and Aβ42/40 (Spearman's ρ = -0.827, -0.858, and 0.960, respectively). Concordance between LUMIPULSE p-tau/Aβ42 and Aβ42/40 was 96% and between Elecsys p-tau/Aβ42 and both LUMIPULSE ratios was 97%. All ratios had > 94% overall, positive, and negative percent agreement with amyloid PET classification. DISCUSSION These data suggest that p-tau/Aβ42 and Aβ42/40 ratios provide similar clinical information in the assessment of amyloid pathology.
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Affiliation(s)
| | | | | | - Michelle M. Mielke
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Argonde C. van Harten
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
- Alzheimer Center and Neurochemical laboratoryAmsterdam UMCAmsterdamthe Netherlands
| | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | | | - Joshua A. Bornhorst
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
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Banning LCP, Ramakers IHGB, Köhler S, Bron EE, Verhey FRJ, de Deyn PP, Claassen JAHR, Koek HL, Middelkoop HAM, van der Flier WM, van der Lugt A, Aalten P. The Association Between Biomarkers and Neuropsychiatric Symptoms Across the Alzheimer's Disease Spectrum. Am J Geriatr Psychiatry 2020; 28:735-744. [PMID: 32088096 DOI: 10.1016/j.jagp.2020.01.012] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the relationship between Alzheimer's disease biomarkers and neuropsychiatric symptoms. METHODS Data from two large cohort studies, the Dutch Parelsnoer Institute - Neurodegenerative Diseases and the Alzheimer's Disease Neuroimaging Initiative was used, including subjects with subjective cognitive decline (N = 650), mild cognitive impairment (N = 887), and Alzheimer's disease dementia (N = 626). Cerebrospinal fluid (CSF) levels of Aβ42, t-tau, p-tau, and hippocampal volume were associated with neuropsychiatric symptoms (measured with the Neuropsychiatric Inventory) using multiple logistic regression analyses. The effect of the Mini-Mental State Examination (as proxy for cognitive functioning) on these relationships was assessed with mediation analyses. RESULTS Alzheimer's disease biomarkers were not associated with depression, agitation, irritability, and sleep disturbances. Lower levels of CSF Aβ42, higher levels of t- and p-tau were associated with presence of anxiety. Lower levels of CSF Aβ42 and smaller hippocampal volumes were associated with presence of apathy. All associations were mediated by cognitive functioning. CONCLUSION The association between Alzheimer's disease pathology and anxiety and apathy is partly due to impairment in cognitive functioning.
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Affiliation(s)
- Leonie C P Banning
- Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands.
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Esther E Bron
- Departments of Radiology and Nuclear Medicine (EEB, AVDL), Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands
| | - Peter Paul de Deyn
- Department of Neurology (PPDD), Alzheimer Center, University of Groningen, University Medical Center, Groningen, the Netherlands
| | - Jurgen A H R Claassen
- Department of Geriatric Medicine (JAHRC), Radboudumc Alzheimer Center, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Huiberdina L Koek
- Department of Geriatrics (HLK), University Medical Center Utrecht, Utrecht, the Netherlands
| | - Huub A M Middelkoop
- Department of Neurology and Neuropsychology (HAMM), Leiden University Medical Center, Leiden, the Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, VU University Medical Center (WMVDF), Amsterdam, the Netherlands
| | - Aad van der Lugt
- Departments of Radiology and Nuclear Medicine (EEB, AVDL), Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology (LCPB, IHGBR, SK, FRJV, PA), Maastricht University, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht, the Netherlands
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Tripathi M, Tripathi M, Parida GK, Kumar R, Dwivedi S, Nehra A, Bal C. Biomarker-Based Prediction of Progression to Dementia: F-18 FDG-PET in Amnestic MCI. Neurol India 2020; 67:1310-1317. [PMID: 31744965 DOI: 10.4103/0028-3886.271245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Metabolic patterns on brain F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can predict the decline in amnestic mild cognitive impairment (aMCI) to Alzheimer's disease dementia (AD) or other dementias. Objective This study was undertaken to evaluate the diagnostic accuracy of baseline F-18 FDG-PET in aMCI for predicting conversion to AD or other dementias on follow-up. Patients and Methods A total of 87 patients with aMCI were enrolled in the study. Each patient underwent a detailed clinical and neuropsychological examination and FDG-PET at baseline. Each PET scan was visually classified based on predefined dementia patterns. Automated analysis of FDG PET was performed using Cortex ID (GE Healthcare). The mean follow-up duration was 30.4 ± 9.3 months (range: 18-48 months). Diagnosis of dementia at follow-up (obtained using clinical diagnostic criteria) constituted the reference standard, and all the included aMCI patients were divided into two groups: the aMCI converters (MCI-C) and MCI nonconverters (MCI-NC). Diagnostic accuracy of FDG PET was calculated using this reference standard. Results There were 23 MCI-C and 64 MCI-NC. Of the 23 MCI-C, 19 were diagnosed as probable AD, 1 as frontotemporal demetia (FTD), and 3 as vascular dementia (VD). Of the 64 MCI-NC, 9 had subjective improvement in cognition, and 55 remained stable. The conversion rate for all types of dementia in our series was 26.4% (23/87) and for Alzheimer's type dementia was 21.8% (19/87). The of PET-based visual interpretation was 91.9%. Sensitivity, specificity, positive predictive value, and negative predictive value for FDG-PET-based prediction of dementia conversion were 86.9% [confidence interval (CI) 66.4%-97.2%)], 93.7% (CI 84.7%-98.2%), 83.3% (CI 65.6%-92.9%), and 95.2% (CI 87.4%-98.9%), respectively. Kappa for agreement between visual and Cortex ID was 0.94 indicating excellent agreement. In the three aMCI patients progressing to VD, no specific abnormality in metabolic pattern was noted; however, there was marked cortical atrophy on computed tomography. Conclusion FDG-PET-based visual and cortex ID classification has a good accuracy in predicting progression to dementia including AD in the prodromal aMCI phase. Absence of typical metabolic patterns on FDG-PET can play an important exclusionary role for progression to dementia. Vascular cognitive impairment with cerebral atrophy needs further studies to confirm and uncover potential mechanisms.
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Affiliation(s)
- Madhavi Tripathi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Manjari Tripathi
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Girish Kumar Parida
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Sadanand Dwivedi
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Ashima Nehra
- Department of Neurology, Cardiothoracic and Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
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11
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Gleason CE, Norton D, Zuelsdorff M, Benton SF, Wyman MF, Nystrom N, Lambrou N, Salazar H, Koscik RL, Jonaitis E, Carter F, Harris B, Gee A, Chin N, Ketchum F, Johnson SC, Edwards DF, Carlsson CM, Kukull W, Asthana S. Association between enrollment factors and incident cognitive impairment in Blacks and Whites: Data from the Alzheimer's Disease Center. Alzheimers Dement 2019; 15:1533-1545. [PMID: 31601516 PMCID: PMC6925619 DOI: 10.1016/j.jalz.2019.07.015] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/02/2019] [Accepted: 07/14/2019] [Indexed: 01/06/2023]
Abstract
INTRODUCTION We examined the influence of enrollment factors demonstrated to differ by race on incident mild cognitive impairment and dementia using Alzheimer's Disease Center data. METHODS Differences in rates of incident impairment between non-Latino Whites and Blacks (n = 12,242) were examined with age-at-progression survival models. Models included race, sex, education, source of recruitment, health factors, and family history of dementia. RESULTS No significant race differences in progression were observed in cognitively unimpaired participants. In those with mild cognitive impairment at baseline, Whites evidenced greater risk for progression than Blacks. Enrollment factors, for example, referral source, were significantly related to progression. DISCUSSION The finding that Blacks demonstrated lower rate of progression than Whites is contrary to the extant literature. Nested-regression analyses suggested that selection-related factors, differing by race, may account for these findings and influence our ability to accurately estimate risk for progression. It is potentially problematic to make racial comparisons using Alzheimer's Disease Center data sets.
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Affiliation(s)
- Carey E Gleason
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
| | - Derek Norton
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Megan Zuelsdorff
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Susan F Benton
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mary F Wyman
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Naomi Nystrom
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Minnesota Department of Human Services, MN, USA
| | - Nickolas Lambrou
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Hector Salazar
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Rebecca L Koscik
- Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Erin Jonaitis
- Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Fabu Carter
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Brieanna Harris
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Alexander Gee
- Nehemiah Center for Urban Leadership Development, Madison, WI, USA
| | - Nathaniel Chin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Frederick Ketchum
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Dorothy F Edwards
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Department of Kinesiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Walter Kukull
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA; National Alzheimer's Coordinating Center, Seattle, WA, USA
| | - Sanjay Asthana
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Geriatric Research, Education and Clinical Center (11G), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA; Department of Medicine, Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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12
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Caminiti SP, Ballarini T, Sala A, Cerami C, Presotto L, Santangelo R, Fallanca F, Vanoli EG, Gianolli L, Iannaccone S, Magnani G, Perani D. FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort. Neuroimage Clin 2018; 18:167-177. [PMID: 29387532 PMCID: PMC5790816 DOI: 10.1016/j.nicl.2018.01.019] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 11/15/2017] [Accepted: 01/18/2018] [Indexed: 01/29/2023]
Abstract
Background/aims In this multicentre study in clinical settings, we assessed the accuracy of optimized procedures for FDG-PET brain metabolism and CSF classifications in predicting or excluding the conversion to Alzheimer's disease (AD) dementia and non-AD dementias. Methods We included 80 MCI subjects with neurological and neuropsychological assessments, FDG-PET scan and CSF measures at entry, all with clinical follow-up. FDG-PET data were analysed with a validated voxel-based SPM method. Resulting single-subject SPM maps were classified by five imaging experts according to the disease-specific patterns, as "typical-AD", "atypical-AD" (i.e. posterior cortical atrophy, asymmetric logopenic AD variant, frontal-AD variant), "non-AD" (i.e. behavioural variant FTD, corticobasal degeneration, semantic variant FTD; dementia with Lewy bodies) or "negative" patterns. To perform the statistical analyses, the individual patterns were grouped either as "AD dementia vs. non-AD dementia (all diseases)" or as "FTD vs. non-FTD (all diseases)". Aβ42, total and phosphorylated Tau CSF-levels were classified dichotomously, and using the Erlangen Score algorithm. Multivariate logistic models tested the prognostic accuracy of FDG-PET-SPM and CSF dichotomous classifications. Accuracy of Erlangen score and Erlangen Score aided by FDG-PET SPM classification was evaluated. Results The multivariate logistic model identified FDG-PET "AD" SPM classification (Expβ = 19.35, 95% C.I. 4.8-77.8, p < 0.001) and CSF Aβ42 (Expβ = 6.5, 95% C.I. 1.64-25.43, p < 0.05) as the best predictors of conversion from MCI to AD dementia. The "FTD" SPM pattern significantly predicted conversion to FTD dementias at follow-up (Expβ = 14, 95% C.I. 3.1-63, p < 0.001). Overall, FDG-PET-SPM classification was the most accurate biomarker, able to correctly differentiate either the MCI subjects who converted to AD or FTD dementias, and those who remained stable or reverted to normal cognition (Expβ = 17.9, 95% C.I. 4.55-70.46, p < 0.001). Conclusions Our results support the relevant role of FDG-PET-SPM classification in predicting progression to different dementia conditions in prodromal MCI phase, and in the exclusion of progression, outperforming CSF biomarkers.
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Key Words
- AD, Alzheimer's disease
- AUC, area under curve
- Alzheimer's disease dementia
- CBD, corticobasal degeneration
- CDR, Clinical Dementia Rating
- CSF, cerebrospinal fluid
- Clinical setting
- DLB, dementia with Lewy bodies
- EANM, European Association of Nuclear Medicine
- Erlangen Score
- FDG, fluorodeoxyglucose
- FTD, frontotemporal dementia
- Frontotemporal dementia
- LR+, positive likelihood ratio
- LR-, negative likelihood ratio
- MCI, mild cognitive impairment
- PET, positron emission tomography
- PSP, progressive supranuclear palsy
- Prognosis
- aMCI, single-domain amnestic mild cognitive impairment
- bvFTD, behavioral variant of frontotemporal dementia
- md aMCI, multi-domain amnestic mild cognitive impairment
- md naMCI, multi-domain non-amnestic mild cognitive impairment
- naMCI, single-domain non-amnestic mild cognitive impairment
- p-tau, phosphorylated tau
- t-tau, total tau
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Affiliation(s)
- Silvia Paola Caminiti
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Tommaso Ballarini
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Arianna Sala
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chiara Cerami
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Luca Presotto
- Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Roberto Santangelo
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | | | | | - Luigi Gianolli
- Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy
| | - Sandro Iannaccone
- Clinical Neuroscience Department, San Raffaele Turro Hospital, Milan, Italy
| | - Giuseppe Magnani
- Department of Neurology and INSPE, San Raffaele Scientific Institute, Milan, Italy
| | - Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy; Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Nuclear Medicine Unit, IRCCS San Raffaele Hospital, Milan, Italy.
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Hampel H, Toschi N, Baldacci F, Zetterberg H, Blennow K, Kilimann I, Teipel SJ, Cavedo E, Melo Dos Santos A, Epelbaum S, Lamari F, Genthon R, Dubois B, Floris R, Garaci F, Lista S; Alzheimer Precision Medicine Initiative (APMI). Alzheimer's disease biomarker-guided diagnostic workflow using the added value of six combined cerebrospinal fluid candidates: Aβ 1-42, total-tau, phosphorylated-tau, NFL, neurogranin, and YKL-40. Alzheimers Dement 2018; 14:492-501. [PMID: 29328927 DOI: 10.1016/j.jalz.2017.11.015] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 10/29/2017] [Accepted: 11/27/2017] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The diagnostic and classificatory performances of all combinations of three core (amyloid β peptide [i.e., Aβ1-42], total tau [t-tau], and phosphorylated tau) and three novel (neurofilament light chain protein, neurogranin, and YKL-40) cerebrospinal fluid biomarkers of neurodegeneration were compared among individuals with mild cognitive impairment (n = 41), Alzheimer's disease dementia (ADD; n = 35), frontotemporal dementia (FTD; n = 9), and cognitively healthy controls (HC; n = 21), using 10-fold cross-validation. METHODS The combinations ranking in the top 10 according to diagnostic accuracy in differentiating between distinct diagnostic categories were identified. RESULTS The single biomarkers or biomarker combinations generating the best area under the receiver operating characteristics (AUROCs) were the following: the combination [amyloid β peptide + phosphorylated tau + neurofilament light chain] for distinguishing between ADD patients and HC (AUROC = 0.86), t-tau for distinguishing between ADD and FTD patients (AUROC = 0.82), and t-tau for distinguishing between FTD patients and HC (AUROC = 0.78). CONCLUSIONS Novel and established cerebrospinal fluid markers perform with at least fair accuracy in the discrimination between ADD and FTD. The classification of mild cognitive impairment individuals was poor.
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14
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Leuzy A, Rodriguez-Vieitez E, Saint-Aubert L, Chiotis K, Almkvist O, Savitcheva I, Jonasson M, Lubberink M, Wall A, Antoni G, Nordberg A. Longitudinal uncoupling of cerebral perfusion, glucose metabolism, and tau deposition in Alzheimer's disease. Alzheimers Dement 2017; 14:652-663. [PMID: 29268078 DOI: 10.1016/j.jalz.2017.11.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 11/14/2017] [Accepted: 11/16/2017] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Cross-sectional findings using the tau tracer [18F]THK5317 (THK5317) have shown that [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) data can be approximated using perfusion measures (early-frame standardized uptake value ratio; ratio of tracer delivery in target to reference regions). In this way, a single PET study can provide both functional and molecular information. METHODS We included 16 patients with Alzheimer's disease who completed follow-up THK5317 and FDG studies 17 months after baseline investigations. Linear mixed-effects models and annual percentage change maps were used to examine longitudinal change. RESULTS Limited spatial overlap was observed between areas showing declines in THK5317 perfusion measures and FDG. Minimal overlap was seen between areas showing functional change and those showing increased retention of THK5317. DISCUSSION Our findings suggest a spatiotemporal offset between functional changes and tau pathology and a partial uncoupling between perfusion and metabolism, possibly as a function of Alzheimer's disease severity.
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Affiliation(s)
- Antoine Leuzy
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Elena Rodriguez-Vieitez
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Laure Saint-Aubert
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Konstantinos Chiotis
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ove Almkvist
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden; Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Irina Savitcheva
- Department of Radiology, Karolinska University Hospital, Huddinge, Sweden
| | - My Jonasson
- Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Mark Lubberink
- Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Medical Physics, Uppsala University Hospital, Uppsala, Sweden
| | - Anders Wall
- Radiology, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Gunnar Antoni
- Department of Medicinal Chemistry, Uppsala University, Uppsala, Sweden
| | - Agneta Nordberg
- Division of Translational Alzheimer Neurobiology, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden.
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15
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Jessen F, Wolfsgruber S, Wiese B, Bickel H, Mösch E, Kaduszkiewicz H, Pentzek M, Riedel-Heller SG, Luck T, Fuchs A, Weyerer S, Werle J, van den Bussche H, Scherer M, Maier W, Wagner M; German Study on Aging, Cognition and Dementia in Primary Care Patients. AD dementia risk in late MCI, in early MCI, and in subjective memory impairment. Alzheimers Dement 2014; 10:76-83. [PMID: 23375567 DOI: 10.1016/j.jalz.2012.09.017] [Citation(s) in RCA: 341] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 09/12/2012] [Accepted: 09/19/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To compare the risk of developing Alzheimer's disease (AD) dementia in late mild cognitive impairment (LMCI), early MCI (EMCI), and subjective memory impairment (SMI) with normal test performance. METHODS The baseline sample (n = 2892) of the prospective cohort study in nondemented individuals (German Study on Aging, Cognition and Dementia in Primary Care Patients) was divided into LMCI, EMCI, SMI, and control subjects by delayed recall performance. These groups were subdivided by the presence of self-reported concerns associated with experienced memory impairment. AD dementia risk was assessed over 6 years. RESULTS Across all groups, risk of AD dementia was greatest in LMCI. In those with self-reported concerns regarding their memory impairment, SMI and EMCI were associated with a similarly increased risk of AD dementia. In those subgroups without concerns, SMI was not associated with increased risk of AD dementia, but EMCI remained an at-risk condition. CONCLUSIONS SMI and EMCI with self-reported concerns were associated with the same risk of AD dementia, suggesting that pre-LMCI risk conditions should be extended to SMI with concerns.
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