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Lui KK, Dave A, Sprecher KE, Chappel-Farley MG, Riedner BA, Heston MB, Taylor CE, Carlsson CM, Okonkwo OC, Asthana S, Johnson SC, Bendlin BB, Mander BA, Benca RM. Older adults at greater risk for Alzheimer's disease show stronger associations between sleep apnea severity in REM sleep and verbal memory. Alzheimers Res Ther 2024; 16:102. [PMID: 38725033 PMCID: PMC11080222 DOI: 10.1186/s13195-024-01446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/01/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) increases risk for cognitive decline and Alzheimer's disease (AD). While the underlying mechanisms remain unclear, hypoxemia during OSA has been implicated in cognitive impairment. OSA during rapid eye movement (REM) sleep is usually more severe than in non-rapid eye movement (NREM) sleep, but the relative effect of oxyhemoglobin desaturation during REM versus NREM sleep on memory is not completely characterized. Here, we examined the impact of OSA, as well as the moderating effects of AD risk factors, on verbal memory in a sample of middle-aged and older adults with heightened AD risk. METHODS Eighty-one adults (mean age:61.7 ± 6.0 years, 62% females, 32% apolipoprotein E ε4 allele (APOE4) carriers, and 70% with parental history of AD) underwent clinical polysomnography including assessment of OSA. OSA features were derived in total, NREM, and REM sleep. REM-NREM ratios of OSA features were also calculated. Verbal memory was assessed with the Rey Auditory Verbal Learning Test (RAVLT). Multiple regression models evaluated the relationships between OSA features and RAVLT scores while adjusting for sex, age, time between assessments, education years, body mass index (BMI), and APOE4 status or parental history of AD. The significant main effects of OSA features on RAVLT performance and the moderating effects of AD risk factors (i.e., sex, age, APOE4 status, and parental history of AD) were examined. RESULTS Apnea-hypopnea index (AHI), respiratory disturbance index (RDI), and oxyhemoglobin desaturation index (ODI) during REM sleep were negatively associated with RAVLT total learning and long-delay recall. Further, greater REM-NREM ratios of AHI, RDI, and ODI (i.e., more events in REM than NREM) were related to worse total learning and recall. We found specifically that the negative association between REM ODI and total learning was driven by adults 60 + years old. In addition, the negative relationships between REM-NREM ODI ratio and total learning, and REM-NREM RDI ratio and long-delay recall were driven by APOE4 carriers. CONCLUSION Greater OSA severity, particularly during REM sleep, negatively affects verbal memory, especially for people with greater AD risk. These findings underscore the potential importance of proactive screening and treatment of REM OSA even if overall AHI appears low.
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Affiliation(s)
- Kitty K Lui
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Kate E Sprecher
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Miranda G Chappel-Farley
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
| | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Margo B Heston
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Chase E Taylor
- Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Cynthia M Carlsson
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ozioma C Okonkwo
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
- Department of Cognitive Sciences, University of California, Irvine, CA, USA.
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA.
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA.
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Jonaitis EM, Jeffers B, VandenLangenberg M, Ma Y, Van Hulle C, Langhough R, Du L, Chin NA, Przybelski RJ, Hogan KJ, Christian BT, Betthauser TJ, Okonkwo OC, Bendlin BB, Asthana S, Carlsson CM, Johnson SC. CSF Biomarkers in Longitudinal Alzheimer Disease Cohorts: Pre-Analytic Challenges. Clin Chem 2024; 70:538-550. [PMID: 38431278 PMCID: PMC10908554 DOI: 10.1093/clinchem/hvad221] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 07/27/2023] [Accepted: 11/27/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND The sensitivity of amyloid to pre-analytic factors complicates cerebrospinal fluid (CSF) diagnostics for Alzheimer disease. We report reliability and validity evidence for automated immunoassays from frozen and fresh CSF samples in an ongoing, single-site research program. METHODS CSF samples were obtained from 2 Wisconsin cohorts (1256 measurements; 727 participants). Levels of amyloid beta 1-42 (Aβ42), phosphorylated tau 181 (pTau181), and total tau (tTau) were obtained using an Elecsys cobas e 601 platform. Repeatability and fixed effects of storage tube type, extraction method, and freezing were assessed via mixed models. Concordance with amyloid positron emission tomography (PET) was investigated with 238 participants having a temporally proximal PET scan. RESULTS Repeatability was high with intraclass correlation (ICC) ≥0.9, but tube type strongly affected measurements. Discriminative accuracy for PET amyloid positivity was strong across tube types (area under the curve [AUC]: Aβ42, 0.87; pTau181Aβ42 , 0.96), although optimal thresholds differed. CONCLUSIONS Under real-world conditions, the Elecsys platform had high repeatability. However, strong effects of pre-analytic factors suggest caution in drawing longitudinal inferences.
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Affiliation(s)
- Erin M Jonaitis
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Beckie Jeffers
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Monica VandenLangenberg
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Yue Ma
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Carol Van Hulle
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Lianlian Du
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Nathaniel A Chin
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Robert J Przybelski
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Kirk J Hogan
- Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Bradley T Christian
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Barbara B Bendlin
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Cynthia M Carlsson
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, United States
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
| | - Sterling C Johnson
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, United States
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin—Madison, Madison, WI, United States
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3
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Ashton NJ, Brum WS, Di Molfetta G, Benedet AL, Arslan B, Jonaitis E, Langhough RE, Cody K, Wilson R, Carlsson CM, Vanmechelen E, Montoliu-Gaya L, Lantero-Rodriguez J, Rahmouni N, Tissot C, Stevenson J, Servaes S, Therriault J, Pascoal T, Lleó A, Alcolea D, Fortea J, Rosa-Neto P, Johnson S, Jeromin A, Blennow K, Zetterberg H. Diagnostic Accuracy of a Plasma Phosphorylated Tau 217 Immunoassay for Alzheimer Disease Pathology. JAMA Neurol 2024; 81:255-263. [PMID: 38252443 PMCID: PMC10804282 DOI: 10.1001/jamaneurol.2023.5319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/10/2023] [Indexed: 01/23/2024]
Abstract
Importance Phosphorylated tau (p-tau) is a specific blood biomarker for Alzheimer disease (AD) pathology, with p-tau217 considered to have the most utility. However, availability of p-tau217 tests for research and clinical use has been limited. Expanding access to this highly accurate AD biomarker is crucial for wider evaluation and implementation of AD blood tests. Objective To determine the utility of a novel and commercially available immunoassay for plasma p-tau217 to detect AD pathology and evaluate reference ranges for abnormal amyloid β (Aβ) and longitudinal change across 3 selected cohorts. Design, Setting, and Participants This cohort study examined data from 3 single-center observational cohorts: cross-sectional and longitudinal data from the Translational Biomarkers in Aging and Dementia (TRIAD) cohort (visits October 2017-August 2021) and Wisconsin Registry for Alzheimer's Prevention (WRAP) cohort (visits February 2007-November 2020) and cross-sectional data from the Sant Pau Initiative on Neurodegeneration (SPIN) cohort (baseline visits March 2009-November 2021). Participants included individuals with and without cognitive impairment grouped by amyloid and tau (AT) status using PET or CSF biomarkers. Data were analyzed from February to June 2023. Exposures Magnetic resonance imaging, Aβ positron emission tomography (PET), tau PET, cerebrospinal fluid (CSF) biomarkers (Aβ42/40 and p-tau immunoassays), and plasma p-tau217 (ALZpath pTau217 assay). Main Outcomes and Measures Accuracy of plasma p-tau217 in detecting abnormal amyloid and tau pathology, longitudinal p-tau217 change according to baseline pathology status. Results The study included 786 participants (mean [SD] age, 66.3 [9.7] years; 504 females [64.1%] and 282 males [35.9%]). High accuracy was observed in identifying elevated Aβ (area under the curve [AUC], 0.92-0.96; 95% CI, 0.89-0.99) and tau pathology (AUC, 0.93-0.97; 95% CI, 0.84-0.99) across all cohorts. These accuracies were comparable with CSF biomarkers in determining abnormal PET signal. The detection of abnormal Aβ pathology using a 3-range reference yielded reproducible results and reduced confirmatory testing by approximately 80%. Longitudinally, plasma p-tau217 values showed an annual increase only in Aβ-positive individuals, with the highest increase observed in those with tau positivity. Conclusions and Relevance This study found that a commercially available plasma p-tau217 immunoassay accurately identified biological AD, comparable with results using CSF biomarkers, with reproducible cut-offs across cohorts. It detected longitudinal changes, including at the preclinical stage.
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Affiliation(s)
- Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience Institute, London, United Kingdom
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Wagner S. Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Andrea L. Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Burak Arslan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
| | - Rebecca E. Langhough
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
| | - Karly Cody
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
| | - Rachael Wilson
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | | | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Nesrine Rahmouni
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Cecile Tissot
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Jenna Stevenson
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Stijn Servaes
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Tharick Pascoal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Alberto Lleó
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Daniel Alcolea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Juan Fortea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau, Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Sterling Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin–Madison, Madison
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
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4
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Cook JD, Malik A, Plante DT, Norton D, Langhough Koscik R, Du L, Bendlin BB, Kirmess KM, Holubasch MS, Meyer MR, Venkatesh V, West T, Verghese PB, Yarasheski KE, Thomas KV, Carlsson CM, Asthana S, Johnson SC, Gleason CE, Zuelsdorff M. Associations of sleep duration and daytime sleepiness with plasma amyloid beta and cognitive performance in cognitively unimpaired, middle-aged and older African Americans. Sleep 2024; 47:zsad302. [PMID: 38011629 PMCID: PMC10782500 DOI: 10.1093/sleep/zsad302] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/12/2023] [Revised: 09/01/2023] [Indexed: 11/29/2023] Open
Abstract
STUDY OBJECTIVES Given the established racial disparities in both sleep health and dementia risk for African American populations, we assess cross-sectional and longitudinal associations of self-report sleep duration (SRSD) and daytime sleepiness with plasma amyloid beta (Aβ) and cognition in an African American (AA) cohort. METHODS In a cognitively unimpaired sample drawn from the African Americans Fighting Alzheimer's in Midlife (AA-FAiM) study, data on SRSD, Epworth Sleepiness Scale, demographics, and cognitive performance were analyzed. Aβ40, Aβ42, and the Aβ42/40 ratio were quantified from plasma samples. Cross-sectional analyses explored associations between baseline predictors and outcome measures. Linear mixed-effect regression models estimated associations of SRSD and daytime sleepiness with plasma Aβ and cognitive performance levels and change over time. RESULTS One hundred and forty-seven participants comprised the cross-sectional sample. Baseline age was 63.2 ± 8.51 years. 69.6% self-identified as female. SRSD was 6.4 ± 1.1 hours and 22.4% reported excessive daytime sleepiness. The longitudinal dataset included 57 participants. In fully adjusted models, neither SRSD nor daytime sleepiness is associated with cross-sectional or longitudinal Aβ. Associations with level and trajectory of cognitive test performance varied by measure of sleep health. CONCLUSIONS SRSD was below National Sleep Foundation recommendations and daytime sleepiness was prevalent in this cohort. In the absence of observed associations with plasma Aβ, poorer self-reported sleep health broadly predicted poorer cognitive function but not accelerated decline. Future research is necessary to understand and address modifiable sleep mechanisms as they relate to cognitive aging in AA at disproportionate risk for dementia. CLINICAL TRIAL INFORMATION Not applicable.
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Affiliation(s)
- Jesse D Cook
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
| | - Ammara Malik
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
| | - David T Plante
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Derek Norton
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca Langhough Koscik
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Lianlian Du
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Barbara B Bendlin
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | | | | | | | | | - Tim West
- C2N Diagnostics, St. Louis, MO, USA
| | | | | | - Kevin V Thomas
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Carey E Gleason
- Madison VA GRECC, William S. Middleton Memorial Hospital, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
- School of Nursing, University of Wisconsin-Madison, Madison, WI, USA
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5
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Van Hulle C, Ince S, Okonkwo OC, Bendlin BB, Johnson SC, Carlsson CM, Asthana S, Love S, Blennow K, Zetterberg H, Scott Miners J. Elevated CSF angiopoietin-2 correlates with blood-brain barrier leakiness and markers of neuronal injury in early Alzheimer's disease. Transl Psychiatry 2024; 14:3. [PMID: 38182581 PMCID: PMC10770135 DOI: 10.1038/s41398-023-02706-w] [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: 04/04/2023] [Revised: 11/12/2023] [Accepted: 12/05/2023] [Indexed: 01/07/2024] Open
Abstract
Breakdown of the neurovascular unit is associated with blood-brain barrier (BBB) leakiness contributing to cognitive decline and disease pathology in the early stages of Alzheimer's disease (AD). Vascular stability depends on angiopoietin-1 (ANGPT-1) signalling, antagonised by angiopoietin-2 (ANGPT-2) expressed upon endothelial injury. We examined the relationship between CSF ANGPT-2 and CSF markers of BBB leakiness and core AD biomarkers across three independent cohorts: (i) 31 AD patients and 33 healthy controls grouped according to their biomarker profile (i.e., AD cases t-tau > 400 pg/mL, p-tau > 60 pg/mL and Aβ42 < 550 pg/mL); (ii) 121 participants in the Wisconsin Registry for Alzheimer's Prevention or Wisconsin Alzheimer's Disease Research study (84 participants cognitively unimpaired (CU) enriched for a parental history of AD, 20 participants with mild cognitive impairment (MCI), and 17 with AD); (iii) a neurologically normal cohort aged 23-78 years with paired CSF and serum samples. CSF ANGPT-2, sPDGFRβ, albumin and fibrinogen levels were measured by sandwich ELISA. In cohort (i), CSF ANGPT-2 was elevated in AD and correlated with CSF t-tau and p-tau181 but not Aβ42. ANGPT-2 also correlated positively with CSF sPDGFRβ and fibrinogen - markers of pericyte injury and BBB leakiness. In cohort (ii), CSF ANGPT-2 was highest in MCI and correlated with CSF albumin in the CU and MCI cohorts but not in AD. CSF ANGPT-2 also correlated with CSF t-tau and p-tau and with markers of neuronal injury (neurogranin and α-synuclein) and neuroinflammation (GFAP and YKL-40). In cohort (iii), CSF ANGPT-2 correlated strongly with the CSF/serum albumin ratio. Serum ANGPT-2 showed non-significant positive associations with CSF ANGPT-2 and the CSF/serum albumin ratio. Together, these data indicate that CSF and possibly serum ANGPT-2 is associated with BBB leakiness in early AD and is closely related to tau pathology and neuronal injury. The utility of serum ANGPT-2 as a biomarker of BBB damage in AD requires further study.
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Affiliation(s)
- Carol Van Hulle
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, University of Wisconsin-Madison, Madison, WI, USA
| | - Selvi Ince
- Dementia Research Group, Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Seth Love
- Dementia Research Group, Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- 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 Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - J Scott Miners
- Dementia Research Group, Clinical Neurosciences, Bristol Medical School, University of Bristol, Bristol, UK.
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Hale MR, Langhough R, Du L, Hermann BP, Van Hulle CA, Carboni M, Kollmorgen G, Basche KE, Bruno D, Sanson-Miles L, Jonaitis EM, Chin NA, Okonkwo OC, Bendlin BB, Carlsson CM, Zetterberg H, Blennow K, Betthauser TJ, Johnson SC, Mueller KD. Associations between recall of proper names in story recall and CSF amyloid and tau in adults without cognitive impairment. Neurobiol Aging 2024; 133:87-98. [PMID: 37925995 PMCID: PMC10842469 DOI: 10.1016/j.neurobiolaging.2023.09.018] [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: 01/18/2023] [Revised: 09/26/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023]
Abstract
Neuropsychological measures sensitive to decline in the preclinical phase of Alzheimer's disease are needed. We previously demonstrated that higher amyloid-beta (Aβ) assessed by positron emission tomography in adults without cognitive impairment was associated with recall of fewer proper names in Logical Memory story recall. The current study investigated the association between proper names and cerebrospinal fluid biomarkers (Aβ42/40, phosphorylated tau181 [pTau181], neurofilament light) in 223 participants from the Wisconsin Registry for Alzheimer's Prevention. We assessed associations between biomarkers and delayed Logical Memory total score and proper names using binary logistic regressions. Sensitivity analyses used multinomial logistic regression and stratified biomarker groups. Lower Logical Memory total score and proper names scores from the most recent visit were associated with biomarker positivity. Relatedly, there was a 27% decreased risk of being classified Aβ42/40+/pTau181+ for each additional proper name recalled. A linear mixed effects model found that longitudinal change in proper names recall was predicted by biomarker status. These results demonstrate a novel relationship between proper names and Alzheimer's disease-cerebrospinal fluid pathology.
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Affiliation(s)
- Madeline R Hale
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Rebecca Langhough
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Lianlian Du
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Bruce P Hermann
- Department of Neurology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Carol A Van Hulle
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | | | | | - Kristin E Basche
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Leah Sanson-Miles
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA
| | - Erin M Jonaitis
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Nathaniel A Chin
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA; VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Ozioma C Okonkwo
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Barbara B Bendlin
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA; VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Cynthia M Carlsson
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Henrik Zetterberg
- Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; 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 Neurodegenerative Disease, UCL Institute of Neurology, London, UK; UK Dementia Research Institute at UCL, London, UK; Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - 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
| | - Tobey J Betthauser
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA; VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Kimberly D Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA; Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA; School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
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7
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Panyard DJ, McKetney J, Deming YK, Morrow AR, Ennis GE, Jonaitis EM, Van Hulle CA, Yang C, Sung YJ, Ali M, Kollmorgen G, Suridjan I, Bayfield A, Bendlin BB, Zetterberg H, Blennow K, Cruchaga C, Carlsson CM, Johnson SC, Asthana S, Coon JJ, Engelman CD. Large-scale proteome and metabolome analysis of CSF implicates altered glucose and carbon metabolism and succinylcarnitine in Alzheimer's disease. Alzheimers Dement 2023; 19:5447-5470. [PMID: 37218097 PMCID: PMC10663389 DOI: 10.1002/alz.13130] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/10/2022] [Revised: 02/23/2023] [Accepted: 04/04/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION A hallmark of Alzheimer's disease (AD) is the aggregation of proteins (amyloid beta [A] and hyperphosphorylated tau [T]) in the brain, making cerebrospinal fluid (CSF) proteins of particular interest. METHODS We conducted a CSF proteome-wide analysis among participants of varying AT pathology (n = 137 participants; 915 proteins) with nine CSF biomarkers of neurodegeneration and neuroinflammation. RESULTS We identified 61 proteins significantly associated with the AT category (P < 5.46 × 10-5 ) and 636 significant protein-biomarker associations (P < 6.07 × 10-6 ). Proteins from glucose and carbon metabolism pathways were enriched among amyloid- and tau-associated proteins, including malate dehydrogenase and aldolase A, whose associations with tau were replicated in an independent cohort (n = 717). CSF metabolomics identified and replicated an association of succinylcarnitine with phosphorylated tau and other biomarkers. DISCUSSION These results implicate glucose and carbon metabolic dysregulation and increased CSF succinylcarnitine levels with amyloid and tau pathology in AD. HIGHLIGHTS Cerebrospinal fluid (CSF) proteome enriched for extracellular, neuronal, immune, and protein processing. Glucose/carbon metabolic pathways enriched among amyloid/tau-associated proteins. Key glucose/carbon metabolism protein associations independently replicated. CSF proteome outperformed other omics data in predicting amyloid/tau positivity. CSF metabolomics identified and replicated a succinylcarnitine-phosphorylated tau association.
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Affiliation(s)
- Daniel J. Panyard
- Department of Population Health Sciences, University of Wisconsin-Madison; 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Justin McKetney
- National Center for Quantitative Biology of Complex Systems, University of Wisconsin-Madison; Madison, WI 53706, United States of America
- Department of Biomolecular Chemistry, University of Wisconsin-Madison; Madison, WI 53506, United States of America
| | - Yuetiva K. Deming
- Department of Population Health Sciences, University of Wisconsin-Madison; 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - Autumn R. Morrow
- Department of Population Health Sciences, University of Wisconsin-Madison; 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Gilda E. Ennis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison; 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
| | - Carol A. Van Hulle
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - Chengran Yang
- Department of Psychiatry, Washington University School of Medicine; St Louis, MO 63110, United States of America
- NeuroGenomics and Informatics Center, Washington University School of Medicine; St Louis, MO 63110, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine; St Louis, MO 63110, United States of America
| | - Yun Ju Sung
- Department of Psychiatry, Washington University School of Medicine; St Louis, MO 63110, United States of America
- NeuroGenomics and Informatics Center, Washington University School of Medicine; St Louis, MO 63110, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine; St Louis, MO 63110, United States of America
| | - Muhammad Ali
- Department of Psychiatry, Washington University School of Medicine; St Louis, MO 63110, United States of America
- NeuroGenomics and Informatics Center, Washington University School of Medicine; St Louis, MO 63110, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine; St Louis, MO 63110, United States of America
| | | | | | | | - Barbara B. Bendlin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison; 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
- William S. Middleton Memorial Veterans Hospital; 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - 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 Neurodegenerative Disease, UCL Institute of Neurology; London, UK
- UK Dementia Research Institute at UCL; London, UK
- Hong Kong Center for Neurodegenerative Diseases; Hong Kong, China
| | - 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
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine; St Louis, MO 63110, United States of America
- NeuroGenomics and Informatics Center, Washington University School of Medicine; St Louis, MO 63110, United States of America
- Hope Center for Neurological Disorders, Washington University School of Medicine; St Louis, MO 63110, United States of America
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison; 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
- William S. Middleton Memorial Veterans Hospital; 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison; 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
- William S. Middleton Memorial Veterans Hospital; 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison; 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison; 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- William S. Middleton Memorial Veterans Hospital; 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Joshua J. Coon
- National Center for Quantitative Biology of Complex Systems, University of Wisconsin-Madison; Madison, WI 53706, United States of America
- Department of Biomolecular Chemistry, University of Wisconsin-Madison; Madison, WI 53506, United States of America
- Morgridge Institute for Research; Madison, WI 53706, United States of America
- Department of Chemistry, University of Wisconsin-Madison; Madison, WI 53506, United States of America
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin-Madison; 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
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8
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Walaszek A, Albrecht T, Schroeder M, LeCaire TJ, Houston S, Recinos M, Carlsson CM. Using Academic Detailing to Enhance the Knowledge, Skills, and Attitudes of Clinicians Caring for Persons with Behavioral and Psychological Symptoms of Dementia. J Am Med Dir Assoc 2023; 24:1981-1983. [PMID: 37837999 DOI: 10.1016/j.jamda.2023.09.005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 10/16/2023]
Abstract
Behavioral and psychological symptoms of dementia (BPSD) are highly prevalent in long-term care settings. We sought to enhance the knowledge, skills, and attitudes of primary care clinicians caring for patients with BPSD through academic detailing, an evidence-based approach for persuading health care professionals to make changes in their practice. We implemented academic detailing among physicians and nurse practitioners in 2 primary care settings, one an urban center serving a largely Black community and another a rural center serving a largely white community, within primary care-integrated dementia diagnostic clinics. Each of the 11 academic detailing visits included didactic content, case discussion, and patient consultation. Outcome measures included assessments of clinicians' knowledge, confidence, and acceptability of the intervention. Of 15 providers who participated at baseline, 13 participated in 1 or more academic detailing visits in the next 18 months, 12 completed a 6-month assessment, and 7 completed an 18-month assessment. Knowledge and attitudes about BPSD increased during the program, and there was high satisfaction with the program. Academic detailing thus is a feasible way of improving self-reported knowledge, skills, and attitudes of primary care clinicians caring for patients with BPSD. We plan to scale up the intervention to assess the impact on patient and caregiver outcomes.
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Affiliation(s)
- Art Walaszek
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA.
| | - Tammi Albrecht
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Molly Schroeder
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Tamara J LeCaire
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Stephanie Houston
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Miguel Recinos
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA; Madison VA Geriatric Research, Education and Clinical Center (GRECC), Madison, WI, USA
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9
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Gallagher RL, Koscik RL, Moody JF, Vogt NM, Adluru N, Kecskemeti SR, Van Hulle CA, Chin NA, Asthana S, Kollmorgen G, Suridjan I, Carlsson CM, Johnson SC, Dean DC, Zetterberg H, Blennow K, Alexander AL, Bendlin BB. Neuroimaging of tissue microstructure as a marker of neurodegeneration in the AT(N) framework: defining abnormal neurodegeneration and improving prediction of clinical status. Alzheimers Res Ther 2023; 15:180. [PMID: 37848950 PMCID: PMC10583332 DOI: 10.1186/s13195-023-01281-y] [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: 12/03/2021] [Accepted: 07/27/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Alzheimer's disease involves accumulating amyloid (A) and tau (T) pathology, and progressive neurodegeneration (N), leading to the development of the AD clinical syndrome. While several markers of N have been proposed, efforts to define normal vs. abnormal neurodegeneration based on neuroimaging have been limited. Sensitive markers that may account for or predict cognitive dysfunction for individuals in early disease stages are critical. METHODS Participants (n = 296) defined on A and T status and spanning the AD-clinical continuum underwent multi-shell diffusion-weighted magnetic resonance imaging to generate Neurite Orientation Dispersion and Density Imaging (NODDI) metrics, which were tested as markers of N. To better define N, we developed age- and sex-adjusted robust z-score values to quantify normal and AD-associated (abnormal) neurodegeneration in both cortical gray matter and subcortical white matter regions of interest. We used general logistic regression with receiver operating characteristic (ROC) and area under the curve (AUC) analysis to test whether NODDI metrics improved diagnostic accuracy compared to models that only relied on cerebrospinal fluid (CSF) A and T status (alone and in combination). RESULTS Using internal robust norms, we found that NODDI metrics correlate with worsening cognitive status and that NODDI captures early, AD neurodegenerative pathology in the gray matter of cognitively unimpaired, but A/T biomarker-positive, individuals. NODDI metrics utilized together with A and T status improved diagnostic prediction accuracy of AD clinical status, compared with models using CSF A and T status alone. CONCLUSION Using a robust norms approach, we show that abnormal AD-related neurodegeneration can be detected among cognitively unimpaired individuals. Metrics derived from diffusion-weighted imaging are potential sensitive markers of N and could be considered for trial enrichment and as outcomes in clinical trials. However, given the small sample sizes, the exploratory nature of the work must be acknowledged.
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Affiliation(s)
- Rigina L Gallagher
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Medical Scientist Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Rebecca Langhough Koscik
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Jason F Moody
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Nicholas M Vogt
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Medical Scientist Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Nagesh Adluru
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Waisman Research Center, Madison, WI, USA
| | | | - Carol A Van Hulle
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Nathaniel A Chin
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
| | - Sanjay Asthana
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Veterans Administration, Madison, WI, USA
| | | | | | - Cynthia M Carlsson
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Veterans Administration, Madison, WI, USA
| | - Sterling C Johnson
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- Wisconsin Alzheimer's Institute, Madison, WI, USA
- Veterans Administration, Madison, WI, USA
| | - Douglas C Dean
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Waisman Research Center, Madison, WI, USA
| | - Henrik Zetterberg
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA
- 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 Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Andrew L Alexander
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
- Waisman Research Center, Madison, WI, USA
| | - Barbara B Bendlin
- School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
- Wisconsin Alzheimer's Disease Research Center, Madison, WI, USA.
- Wisconsin Alzheimer's Institute, Madison, WI, USA.
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10
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Dong R, Lu Q, Kang H, Suridjan I, Kollmorgen G, Wild N, Deming Y, Van Hulle CA, Anderson RM, Zetterberg H, Blennow K, Carlsson CM, Asthana S, Johnson SC, Engelman CD. CSF metabolites associated with biomarkers of Alzheimer's disease pathology. Front Aging Neurosci 2023; 15:1214932. [PMID: 37719875 PMCID: PMC10499619 DOI: 10.3389/fnagi.2023.1214932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 07/17/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction Metabolomics technology facilitates studying associations between small molecules and disease processes. Correlating metabolites in cerebrospinal fluid (CSF) with Alzheimer's disease (AD) CSF biomarkers may elucidate additional changes that are associated with early AD pathology and enhance our knowledge of the disease. Methods The relative abundance of untargeted metabolites was assessed in 161 individuals from the Wisconsin Registry for Alzheimer's Prevention. A metabolome-wide association study (MWAS) was conducted between 269 CSF metabolites and protein biomarkers reflecting brain amyloidosis, tau pathology, neuronal and synaptic degeneration, and astrocyte or microglial activation and neuroinflammation. Linear mixed-effects regression analyses were performed with random intercepts for sample relatedness and repeated measurements and fixed effects for age, sex, and years of education. The metabolome-wide significance was determined by a false discovery rate threshold of 0.05. The significant metabolites were replicated in 154 independent individuals from then Wisconsin Alzheimer's Disease Research Center. Mendelian randomization was performed using genome-wide significant single nucleotide polymorphisms from a CSF metabolites genome-wide association study. Results Metabolome-wide association study results showed several significantly associated metabolites for all the biomarkers except Aβ42/40 and IL-6. Genetic variants associated with metabolites and Mendelian randomization analysis provided evidence for a causal association of metabolites for soluble triggering receptor expressed on myeloid cells 2 (sTREM2), amyloid β (Aβ40), α-synuclein, total tau, phosphorylated tau, and neurogranin, for example, palmitoyl sphingomyelin (d18:1/16:0) for sTREM2, and erythritol for Aβ40 and α-synuclein. Discussion This study provides evidence that CSF metabolites are associated with AD-related pathology, and many of these associations may be causal.
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Affiliation(s)
- Ruocheng Dong
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Hyunseung Kang
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | | | | | | | - Yuetiva Deming
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Carol A. Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Rozalyn M. Anderson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatrics Research Education and Clinical Center, Middleton VA Hospital, Madison, WI, United States
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, Hong Kong SAR, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Cynthia M. Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatrics Research Education and Clinical Center, Middleton VA Hospital, Madison, WI, United States
| | - Sanjay Asthana
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatrics Research Education and Clinical Center, Middleton VA Hospital, Madison, WI, United States
| | - Sterling C. Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Geriatrics Research Education and Clinical Center, Middleton VA Hospital, Madison, WI, United States
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
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11
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Deming Y, Vasiljevic E, Morrow A, Miao J, Van Hulle C, Jonaitis E, Ma Y, Whitenack V, Kollmorgen G, Wild N, Suridjan I, Shaw LM, Asthana S, Carlsson CM, Johnson SC, Zetterberg H, Blennow K, Bendlin BB, Lu Q, Engelman CD. Neuropathology-based APOE genetic risk score better quantifies Alzheimer's risk. Alzheimers Dement 2023; 19:3406-3416. [PMID: 36795776 PMCID: PMC10427737 DOI: 10.1002/alz.12990] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Apolipoprotein E (APOE) ε4-carrier status or ε4 allele count are included in analyses to account for the APOE genetic effect on Alzheimer's disease (AD); however, this does not account for protective effects of APOE ε2 or heterogeneous effect of ε2, ε3, and ε4 haplotypes. METHODS We leveraged results from an autopsy-confirmed AD study to generate a weighted risk score for APOE (APOE-npscore). We regressed cerebrospinal fluid (CSF) amyloid and tau biomarkers on APOE variables from the Wisconsin Registry for Alzheimer's Prevention (WRAP), Wisconsin Alzheimer's Disease Research Center (WADRC), and Alzheimer's Disease Neuroimaging Initiative (ADNI). RESULTS The APOE-npscore explained more variance and provided a better model fit for all three CSF measures than APOE ε4-carrier status and ε4 allele count. These findings were replicated in ADNI and observed in subsets of cognitively unimpaired (CU) participants. DISCUSSION The APOE-npscore reflects the genetic effect on neuropathology and provides an improved method to account for APOE in AD-related analyses.
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Affiliation(s)
- Yuetiva Deming
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Eva Vasiljevic
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Autumn Morrow
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Jiacheng Miao
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Carol Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Erin Jonaitis
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Yue Ma
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Vanessa Whitenack
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | | | | | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sanjay Asthana
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- William S. Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center, Madison, Wisconsin, USA
| | - Cynthia M Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- William S. Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center, Madison, Wisconsin, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- William S. Middleton Memorial Veterans Hospital, Geriatric Research Education and Clinical Center, Madison, Wisconsin, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Barbara B Bendlin
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Qiongshi Lu
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, Wisconsin, USA
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12
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Erickson P, Simrén J, Brum WS, Ennis GE, Kollmorgen G, Suridjan I, Langhough R, Jonaitis EM, Van Hulle CA, Betthauser TJ, Carlsson CM, Asthana S, Ashton NJ, Johnson SC, Shaw LM, Blennow K, Andreasson U, Bendlin BB, Zetterberg H. Prevalence and Clinical Implications of a β-Amyloid-Negative, Tau-Positive Cerebrospinal Fluid Biomarker Profile in Alzheimer Disease. JAMA Neurol 2023; 80:2807607. [PMID: 37523162 PMCID: PMC10391361 DOI: 10.1001/jamaneurol.2023.2338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/05/2023] [Indexed: 08/01/2023]
Abstract
Importance Knowledge is lacking on the prevalence and prognosis of individuals with a β-amyloid-negative, tau-positive (A-T+) cerebrospinal fluid (CSF) biomarker profile. Objective To estimate the prevalence of a CSF A-T+ biomarker profile and investigate its clinical implications. Design, Setting, and Participants This was a retrospective cohort study of the cross-sectional multicenter University of Gothenburg (UGOT) cohort (November 2019-January 2021), the longitudinal multicenter Alzheimer Disease Neuroimaging Initiative (ADNI) cohort (individuals with mild cognitive impairment [MCI] and no cognitive impairment; September 2005-May 2022), and 2 Wisconsin cohorts, Wisconsin Alzheimer Disease Research Center and Wisconsin Registry for Alzheimer Prevention (WISC; individuals without cognitive impairment; February 2007-November 2020). This was a multicenter study, with data collected from referral centers in clinical routine (UGOT) and research settings (ADNI and WISC). Eligible individuals had 1 lumbar puncture (all cohorts), 2 or more cognitive assessments (ADNI and WISC), and imaging (ADNI only) performed on 2 separate occasions. Data were analyzed on August 2022 to April 2023. Exposures Baseline CSF Aβ42/40 and phosphorylated tau (p-tau)181; cognitive tests (ADNI: modified preclinical Alzheimer cognitive composite [mPACC]; WISC: modified 3-test PACC [PACC-3]). Exposures in the ADNI cohort included [18F]-florbetapir amyloid positron emission tomography (PET), magnetic resonance imaging (MRI), [18F]-fluorodeoxyglucose PET (FDG-PET), and cross-sectional tau-PET (ADNI: [18F]-flortaucipir, WISC: [18F]-MK6240). Main Outcomes and Measures Primary outcomes were the prevalence of CSF AT biomarker profiles and continuous longitudinal global cognitive outcome and imaging biomarker trajectories in A-T+ vs A-T- groups. Secondary outcomes included cross-sectional tau-PET. Results A total of 7679 individuals (mean [SD] age, 71.0 [8.4] years; 4101 male [53%]) were included in the UGOT cohort, 970 individuals (mean [SD] age, 73 [7.0] years; 526 male [54%]) were included in the ADNI cohort, and 519 individuals (mean [SD] age, 60 [7.3] years; 346 female [67%]) were included in the WISC cohort. The prevalence of an A-T+ profile in the UGOT cohort was 4.1% (95% CI, 3.7%-4.6%), being less common than the other patterns. Longitudinally, no significant differences in rates of worsening were observed between A-T+ and A-T- profiles for cognition or imaging biomarkers. Cross-sectionally, A-T+ had similar tau-PET uptake to individuals with an A-T- biomarker profile. Conclusion and Relevance Results suggest that the CSF A-T+ biomarker profile was found in approximately 5% of lumbar punctures and was not associated with a higher rate of cognitive decline or biomarker signs of disease progression compared with biomarker-negative individuals.
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Affiliation(s)
- Pontus Erickson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Joel Simrén
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Wagner S. Brum
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Gilda E. Ennis
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | | | | | - Rebecca Langhough
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Erin M. Jonaitis
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Carol A. Van Hulle
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Tobey J. Betthauser
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Cynthia M. Carlsson
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Sanjay Asthana
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Nicholas J. Ashton
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, King’s College London, London, England
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, England
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Sterling C. Johnson
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulf Andreasson
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Barbara B. Bendlin
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Gothenburg, Sweden
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison
- Institute of Neurology, Department of Neurodegenerative Disease, University College London, London, England
- UK Dementia Research Institute, University College London, London, England
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
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13
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Ashton NJ, Brum WS, Di Molfetta G, Benedet AL, Arslan B, Jonatis E, Langhough RE, Cody K, Wilson R, Carlsson CM, Vanmechelen E, Montoliu-Gaya L, Lantero-Rodriguez J, Rahmouni N, Tissot C, Stevenson J, Servaes S, Therriault J, Pascoal T, Lleó A, Alcolea D, Fortea J, Rosa-Neto P, Johnson S, Jeromin A, Blennow K, Zetterberg H. Diagnostic accuracy of the plasma ALZpath pTau217 immunoassay to identify Alzheimer's disease pathology. medRxiv 2023:2023.07.11.23292493. [PMID: 37502842 PMCID: PMC10370224 DOI: 10.1101/2023.07.11.23292493] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
Importance Phosphorylated tau (pTau) is a specific blood biomarker for Alzheimer's disease (AD) pathology, with pTau217 considered to have the most utility. However, availability of pTau217 tests for research and clinical use has been limited. Expanding access to this highly accurate AD biomarker is crucial for wider evaluation and implementation of AD blood tests. Objective To determine the utility of a novel and commercially available Single molecule array (Simoa) for plasma pTau217 (ALZpath) to detect AD pathology. To evaluate references ranges for abnormal Aβ across three selected cohorts. Design Setting Participants Three single-centre observational cohorts were involved in the study: Translational Biomarkers in Aging and Dementia (TRIAD), Wisconsin Registry for Alzheimer's Prevention (WRAP), and Sant Pau Initiative on Neurodegeneration (SPIN). MRI, Aβ-PET, and tau-PET data were available for TRIAD and WRAP, while CSF biomarkers were additionally measured in a subset of TRIAD and SPIN. Plasma measurements of pTau181, pTau217 (ALZpath), pTau231, Aβ42/40, GFAP, and NfL, were available for all cohorts. Longitudinal blood biomarker data spanning 3 years for TRIAD and 8 years for WRAP were included. Exposures MRI, Aβ-PET, tau-PET, CSF biomarkers (Aβ42/40 and pTau immunoassays) and plasma pTau217 (ALZpath Simoa). Main Outcomes and Measures The accuracy of plasma pTau217 for detecting abnormal amyloid and tau pathology. Longitudinal pTau217 change according to baseline pathology status. Results The study included 786 participants (mean [SD] age, 66.3 [9.7] years; 504 females [64.1%]) were included in the study. High accuracy was observed in identifying elevated Aβ (AUC, 0.92-0.96; 95%CI 0.89-0.99) and tau pathology (AUC, 0.93-0.97; 95%CI 0.84-0.99) across all cohorts. These accuracies were significantly higher than other plasma biomarker combinations and comparable to CSF biomarkers. The detection of abnormal Aβ pathology using binary or three-range references yielded reproducible results. Longitudinally, plasma pTau217 showed an annual increase only in Aβ-positive individuals, with the highest increase observed in those with tau-positivity. Conclusions and Relevance The ALZpath plasma pTau217 Simoa assay accurately identifies biological AD, comparable to CSF biomarkers, with reproducible cut-offs across cohorts. It detects longitudinal changes, including at the preclinical stage, and is the first widely available, accessible, and scalable blood test for pTau217 detection.
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Affiliation(s)
- Nicholas J. Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience Institute London UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation London UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Wagner S. Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Andrea L. Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Burak Arslan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Erin Jonatis
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Rebecca E. Langhough
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Karly Cody
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Rachael Wilson
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Department of Medicine, Division of Geriatrics and Gerontology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
| | | | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Nesrine Rahmouni
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Cecile Tissot
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Jenna Stevenson
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Stijn Servaes
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Joseph Therriault
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Tharick Pascoal
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Alberto Lleó
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Daniel Alcolea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Juan Fortea
- Department of Neurology, Institut d’Investigacions Biomèdiques Sant Pau - Hospital de Sant Pau, Universitat Autònoma de Barcelona, Hospital de la Santa Creu i Sant Pau, Barcelona, Catalunya
- Centro de Investigación Biomédica en Red en Enfermedades Neurodegenerativas, CIBERNED, Madrid, Spain
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer’s Disease Research Unit, Douglas Research Institute, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l’Ouest-de-l’Île-de-Montréal
- Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, Montreal, Quebec, Canada
| | - Sterling Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
- 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
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
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Rajabli F, Benchek P, Tosto G, Kushch N, Sha J, Bazemore K, Zhu C, Lee WP, Haut J, Hamilton-Nelson KL, Wheeler NR, Zhao Y, Farrell JJ, Grunin MA, Leung YY, Kuksa PP, Li D, Lucio da Fonseca E, Mez JB, Palmer EL, Pillai J, Sherva RM, Song YE, Zhang X, Iqbal T, Pathak O, Valladares O, Kuzma AB, Abner E, Adams PM, Aguirre A, Albert MS, Albin RL, Allen M, Alvarez L, Apostolova LG, Arnold SE, Asthana S, Atwood CS, Ayres G, Baldwin CT, Barber RC, Barnes LL, Barral S, Beach TG, Becker JT, Beecham GW, Beekly D, Benitez BA, Bennett D, Bertelson J, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Brewer J, Burke JR, Burns JM, Buxbaum JD, Cairns NJ, Cantwell LB, Cao C, Carlson CS, Carlsson CM, Carney RM, Carrasquillo MM, Chasse S, Chesselet MF, Chin NA, Chui HC, Chung J, Craft S, Crane PK, Cribbs DH, Crocco EA, Cruchaga C, Cuccaro ML, Cullum M, Darby E, Davis B, De Jager PL, DeCarli C, DeToledo J, Dick M, Dickson DW, Dombroski BA, Doody RS, Duara R, Ertekin-Taner NI, Evans DA, Faber KM, Fairchild TJ, Fallon KB, Fardo DW, Farlow MR, Fernandez-Hernandez V, Ferris S, Foroud TM, Frosch MP, Fulton-Howard B, Galasko DR, Gamboa A, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Goate AM, Grabowski TJ, Graff-Radford NR, Green RC, Growdon JH, Hakonarson H, Hall J, Hamilton RL, Harari O, Hardy J, Harrell LE, Head E, Henderson VW, Hernandez M, Hohman T, Honig LS, Huebinger RM, Huentelman MJ, Hulette CM, Hyman BT, Hynan LS, Ibanez L, Jarvik GP, Jayadev S, Jin LW, Johnson K, Johnson L, Kamboh MI, Karydas AM, Katz MJ, Kauwe JS, Kaye JA, Keene CD, Khaleeq A, Kim R, Knebl J, Kowall NW, Kramer JH, Kukull WA, LaFerla FM, Lah JJ, Larson EB, Lerner A, Leverenz JB, Levey AI, Lieberman AP, Lipton RB, Logue M, Lopez OL, Lunetta KL, Lyketsos CG, Mains D, Margaret FE, Marson DC, Martin ERR, Martiniuk F, Mash DC, Masliah E, Massman P, Masurkar A, McCormick WC, McCurry SM, McDavid AN, McDonough S, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Montine TJ, Monuki ES, Morris JC, Mukherjee S, Myers AJ, Nguyen T, O'Bryant S, Olichney JM, Ory M, Palmer R, Parisi JE, Paulson HL, Pavlik V, Paydarfar D, Perez V, Peskind E, Petersen RC, Pierce A, Polk M, Poon WW, Potter H, Qu L, Quiceno M, Quinn JF, Raj A, Raskind M, Reiman EM, Reisberg B, Reisch JS, Ringman JM, Roberson ED, Rodriguear M, Rogaeva E, Rosen HJ, Rosenberg RN, Royall DR, Sager MA, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Slifer SH, Small S, Smith AG, Smith JP, Sonnen JA, Spina S, St George-Hyslop P, Stern RA, Stevens AB, Strittmatter SM, Sultzer D, Swerdlow RH, Tanzi RE, Tilson JL, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, van Eldik LJ, Vance JM, Vardarajan BN, Vassar R, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Whitehead PL, Wijsman EM, Wilhelmsen KC, Williams B, Williamson J, Wilms H, Wingo TS, Wisniewski T, Woltjer RL, Woon M, Wright CB, Wu CK, Younkin SG, Yu CE, Yu L, Zhu X, Kunkle BW, Bush WS, Wang LS, Farrer LA, Haines JL, Mayeux R, Pericak-Vance MA, Schellenberg GD, Jun GR, Reitz C, Naj AC. Multi-ancestry genome-wide meta-analysis of 56,241 individuals identifies LRRC4C, LHX5-AS1 and nominates ancestry-specific loci PTPRK , GRB14 , and KIAA0825 as novel risk loci for Alzheimer's disease: the Alzheimer's Disease Genetics Consortium. medRxiv 2023:2023.07.06.23292311. [PMID: 37461624 PMCID: PMC10350126 DOI: 10.1101/2023.07.06.23292311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer's Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loci and evaluate underlying genetic architecture in 37,382 non-Hispanic White (NHW), 6,728 African American, 8,899 Hispanic (HIS), and 3,232 East Asian individuals, performing within-ancestry fixed-effects meta-analysis followed by a cross-ancestry random-effects meta-analysis. We identified 13 loci with cross-ancestry associations including known loci at/near CR1 , BIN1 , TREM2 , CD2AP , PTK2B , CLU , SHARPIN , MS4A6A , PICALM , ABCA7 , APOE and two novel loci not previously reported at 11p12 ( LRRC4C ) and 12q24.13 ( LHX5-AS1 ). Reflecting the power of diverse ancestry in GWAS, we observed the SHARPIN locus using 7.1% the sample size of the original discovering single-ancestry GWAS (n=788,989). We additionally identified three GWS ancestry-specific loci at/near ( PTPRK ( P =2.4×10 -8 ) and GRB14 ( P =1.7×10 -8 ) in HIS), and KIAA0825 ( P =2.9×10 -8 in NHW). Pathway analysis implicated multiple amyloid regulation pathways (strongest with P adjusted =1.6×10 -4 ) and the classical complement pathway ( P adjusted =1.3×10 -3 ). Genes at/near our novel loci have known roles in neuronal development ( LRRC4C, LHX5-AS1 , and PTPRK ) and insulin receptor activity regulation ( GRB14 ). These findings provide compelling support for using traditionally-underrepresented populations for gene discovery, even with smaller sample sizes.
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15
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Fischer B, Van Hulle CA, Langhough R, Norton D, Zuelsdorff M, Gooding DC, Wyman MF, Johnson A, Lambrou N, James T, Bouges S, Carter FP, Salazar H, Kirmess K, Holubasch M, Meyer M, Venkatesh V, West T, Verghese P, Yarasheski K, Carlsson CM, Johnson SC, Asthana S, Gleason CE. Plasma Aβ42/40 and cognitive variability are associated with cognitive function in Black Americans: Findings from the AA-FAIM cohort. Alzheimers Dement (N Y) 2023; 9:e12414. [PMID: 37752907 PMCID: PMC10519622 DOI: 10.1002/trc2.12414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/25/2023] [Indexed: 09/28/2023]
Abstract
Introduction It is critical to develop more inclusive Alzheimer's disease (AD) research protocols to ensure that historically excluded groups are included in preclinical research and have access to timely diagnosis and treatment. If validated in racialized groups, plasma AD biomarkers and measures of subtle cognitive dysfunction could provide avenues to expand diversity in preclinical AD research. We sought to evaluate the utility of two easily obtained, low-burden disease markers, plasma amyloid beta (Aβ)42/40, and intra-individual cognitive variability (IICV), to predict concurrent and longitudinal cognitive performance in a sample of Black adults. Methods Two hundred fifty-seven Black participants enrolled in the African Americans Fighting Alzheimer's in Midlife (AA-FAIM) study underwent at least one cognitive assessment visit; a subset of n = 235 had plasma samples. Baseline IICV was calculated as the standard deviation across participants' z scores on five cognitive measures: Rey Auditory Verbal Learning Test Delayed Recall, Trail Making Test Parts A and B (Trails A and B), and Boston Naming Test. Using mixed effects regression models, we compared concurrent and longitudinal models to baseline plasma Aβ42/40 or IICV by age interactions. PrecivityAD assays quantified baseline plasma Aβ42/40. Results IICV was associated with concurrent/baseline performance on several outcomes but did not modify associations between age and cognitive decline. In contrast, plasma Aβ42/40 was unrelated to baseline cognitive performance, but a pattern emerged in interactions with age in longitudinal models of Trails A and B and Rey Auditory Verbal Learning Test total learning trials. Although not significant after correcting for multiple comparisons, low Aβ42/40 was associated with faster cognitive declines over time. Discussion Our results are promising as they extend existing findings to an Black American sample using low-cost, low-burden methods that can be implemented outside of a research center, thus supporting efforts for inclusive AD biomarker research.
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Affiliation(s)
- Barbara Fischer
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of NeurologyUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Carol Ann Van Hulle
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Rebecca Langhough
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Derek Norton
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Department of Biostatistics and Medical InformaticsUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- School of NursingUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Diane Carol Gooding
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Department of PsychologyUniversity of Wisconsin–MadisonMadison, WisconsinUSA
- Department of PsychiatryUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mary F. Wyman
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Adrienne Johnson
- Center for Tobacco Research and InterventionSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Nickolas Lambrou
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Taryn James
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Shenikqua Bouges
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Fabu Phillis Carter
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | - Hector Salazar
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
| | | | | | | | | | - Tim West
- C2N DiagnosticsSt. LouisMissouriUSA
| | | | | | - Cynthia M. Carlsson
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Sterling C. Johnson
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Sanjay Asthana
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's InstituteUniversity of WisconsinMadisonWisconsinUSA
| | - Carey E. Gleason
- Madison VA GRECCWilliam S. Middleton Memorial HospitalMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin–Madison School of Medicine and Public HealthMadisonWisconsinUSA
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16
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Dong R, Denier-Fields DN, Van Hulle CA, Kollmorgen G, Suridjan I, Wild N, Lu Q, Anderson RM, Zetterberg H, Blennow K, Carlsson CM, Johnson SC, Engelman CD. Identification of plasma metabolites associated with modifiable risk factors and endophenotypes reflecting Alzheimer's disease pathology. Eur J Epidemiol 2023; 38:559-571. [PMID: 36964431 PMCID: PMC11070200 DOI: 10.1007/s10654-023-00988-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/05/2023] [Indexed: 03/26/2023]
Abstract
Modifiable factors can influence the risk for Alzheimer's disease (AD) and serve as targets for intervention; however, the biological mechanisms linking these factors to AD are unknown. This study aims to identify plasma metabolites associated with modifiable factors for AD, including MIND diet, physical activity, smoking, and caffeine intake, and test their association with AD endophenotypes to identify their potential roles in pathophysiological mechanisms. The association between each of the 757 plasma metabolites and four modifiable factors was tested in the wisconsin registry for Alzheimer's prevention cohort of initially cognitively unimpaired, asymptomatic middle-aged adults. After Bonferroni correction, the significant plasma metabolites were tested for association with each of the AD endophenotypes, including twelve cerebrospinal fluid (CSF) biomarkers, reflecting key pathophysiologies for AD, and four cognitive composite scores. Finally, causal mediation analyses were conducted to evaluate possible mediation effects. Analyses were performed using linear mixed-effects regression. A total of 27, 3, 23, and 24 metabolites were associated with MIND diet, physical activity, smoking, and caffeine intake, respectively. Potential mediation effects include beta-cryptoxanthin in the association between MIND diet and preclinical Alzheimer cognitive composite score, hippurate between MIND diet and immediate learning, glutamate between physical activity and CSF neurofilament light, and beta-cryptoxanthin between smoking and immediate learning. Our study identified several plasma metabolites that are associated with modifiable factors. These metabolites can be employed as biomarkers for tracking these factors, and they provide a potential biological pathway of how modifiable factors influence the human body and AD risk.
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Affiliation(s)
- Ruocheng Dong
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA
| | - Diandra N Denier-Fields
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA
- Department of Nutrition Science, University of Wisconsin-Madison, Madison, WI, 53706, USA
| | - Carol A Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | | | | | - Norbert Wild
- Roche Diagnostics GmbH, 82377, Penzberg, Germany
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Rozalyn M Anderson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, S-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-43180, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1H 0AL, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, S-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-43180, Mölndal, Sweden
| | - Cynthia M Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
- Geriatric Research Education and Clinical Center, William. S. Middleton Memorial Veterans Hospital, Madison, WI, 53705, USA
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53719, USA
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53726, USA.
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA.
- Wisconsin Alzheimer's Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53719, USA.
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17
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Rowley PA, Paukner MJ, Eisenmenger LB, Field AS, Davidson RJ, Johnson SC, Asthana S, Chin NA, Prabhakaran V, Bendlin BB, Postle BR, Goldsmith HH, Carlsson CM, Brooks MA, Kalin NH, Williams LE, Rowley HA. Incidental Findings from 16,400 Brain MRI Examinations of Research Volunteers. AJNR Am J Neuroradiol 2023; 44:417-423. [PMID: 36927761 PMCID: PMC10084899 DOI: 10.3174/ajnr.a7821] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/16/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND AND PURPOSE Incidental findings are discovered in neuroimaging research, ranging from trivial to life-threatening. We describe the prevalence and characteristics of incidental findings from 16,400 research brain MRIs, comparing spontaneous detection by nonradiology scanning staff versus formal neuroradiologist interpretation. MATERIALS AND METHODS We prospectively collected 16,400 brain MRIs (7782 males, 8618 females; younger than 1 to 94 years of age; median age, 38 years) under an institutional review board directive intended to identify clinically relevant incidental findings. The study population included 13,150 presumed healthy volunteers and 3250 individuals with known neurologic diagnoses. Scanning staff were asked to flag concerning imaging findings seen during the scan session, and neuroradiologists produced structured reports after reviewing every scan. RESULTS Neuroradiologists reported 13,593/16,400 (83%) scans as having normal findings, 2193/16,400 (13.3%) with abnormal findings without follow-up recommended, and 614/16,400 (3.7%) with "abnormal findings with follow-up recommended." The most common abnormalities prompting follow-up were vascular (263/614, 43%), neoplastic (130/614, 21%), and congenital (92/614, 15%). Volunteers older than 65 years of age were significantly more likely to have scans with abnormal findings (P < .001); however, among all volunteers with incidental findings, those younger than 65 years of age were more likely to be recommended for follow-up. Nonradiologists flagged <1% of MRIs containing at least 1 abnormality reported by the neuroradiologists to be concerning enough to warrant further evaluation. CONCLUSIONS Four percent of individuals who undergo research brain MRIs have an incidental, potentially clinically significant finding. Routine neuroradiologist review of all scans yields a much higher rate of significant lesion detection than selective referral from nonradiologists who perform the examinations. Workflow and scan review processes need to be carefully considered when designing research protocols.
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Affiliation(s)
- P A Rowley
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | | | - L B Eisenmenger
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - A S Field
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - R J Davidson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - S C Johnson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - S Asthana
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - N A Chin
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - V Prabhakaran
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
| | - B B Bendlin
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - B R Postle
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - H H Goldsmith
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychology (R.J.D., B.R.P., H.H.G.)
| | - C M Carlsson
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Wisconsin Alzheimer's Disease Research Center (S.C.J., S.A., B.B.B., C.M.C.)
- Departments of Medicine (S.C.J., S.A., N.A.C., B.B.B., C.M.C.)
| | - M A Brooks
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Orthopedics (M.A.B.)
| | - N H Kalin
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychiatry (N.H.K., L.E.W.), University of Wisconsin-Madison, Madison, Wisconsin
| | - L E Williams
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Psychiatry (N.H.K., L.E.W.), University of Wisconsin-Madison, Madison, Wisconsin
| | - H A Rowley
- From the University of Wisconsin School of Medicine and Public Health (P.A.R., L.B.E., A.S.F., R.J.D., S.C.J., S.A., V.P., B.B.B., B.R.P., H.H.G., C.M.C., M.A.B., N.H.K., L.E.W., H.A.R.)
- Departments of Radiology (P.A.R., LB.E., A.S.F., V.P., H.A.R.)
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Xu Y, Vasiljevic E, Deming YK, Jonaitis EM, Koscik RL, Van Hulle CA, Lu Q, Carboni M, Kollmorgen G, Wild N, Carlsson CM, Johnson SC, Zetterberg H, Blennow K, Engelman CD. Effect of Pathway-specific Polygenic Risk Scores for Alzheimer's Disease (AD) on Rate of Change in Cognitive Function and AD-related Biomarkers among Asymptomatic Individuals. medRxiv 2023:2023.01.30.23285142. [PMID: 36778431 PMCID: PMC9915839 DOI: 10.1101/2023.01.30.23285142] [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] [Indexed: 02/05/2023]
Abstract
Background Genetic scores for late-onset Alzheimer's disease (LOAD) have been associated with preclinical cognitive decline and biomarker variations. Compared with an overall polygenic risk score (PRS), a pathway-specific PRS (p-PRS) may be more appropriate in predicting a specific biomarker or cognitive component underlying LOAD pathology earlier in the lifespan. Objective In this study, we leveraged 10 years of longitudinal data from initially cognitively unimpaired individuals in the Wisconsin Registry for Alzheimer's Prevention and explored changing patterns in cognition and biomarkers at various age points along six biological pathways. Methods PRS and p-PRSs with and without apolipoprotein E ( APOE ) were constructed separately based on the significant SNPs associated with LOAD in a recent genome-wide association study meta-analysis and compared to APOE alone. We used a linear mixed-effects model to assess the association between PRS/p-PRSs and global/domain-specific cognitive trajectories among 1,175 individuals. We also applied the model to the outcomes of cerebrospinal fluid biomarkers for beta-amyloid 42 (Aβ42), Aβ42/40 ratio, total tau, and phosphorylated tau in a subset. Replication analyses were performed in an independent sample. Results We found p-PRSs and the overall PRS can predict preclinical changes in cognition and biomarkers. The effects of p-PRSs/PRS on rate of change in cognition, beta-amyloid, and tau outcomes are dependent on age and appear earlier in the lifespan when APOE is included in these risk scores compared to when APOE is excluded. Conclusion In addition to APOE , the p-PRSs can predict age-dependent changes in beta-amyloid, tau, and cognition. Once validated, they could be used to identify individuals with an elevated genetic risk of accumulating beta-amyloid and tau, long before the onset of clinical symptoms.
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Affiliation(s)
- Yuexuan Xu
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | - Eva Vasiljevic
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, WI, USA
| | - Yuetiva K. Deming
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Rebecca L. Koscik
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Carol A. Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | | | | | | | - Cynthia M. Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sterling C. Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
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19
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Panyard DJ, Deming YK, Darst BF, Van Hulle CA, Zetterberg H, Blennow K, Kollmorgen G, Suridjan I, Carlsson CM, Johnson SC, Asthana S, Engelman CD, Lu Q. Liver-Specific Polygenic Risk Score Is Associated with Alzheimer's Disease Diagnosis. J Alzheimers Dis 2023; 92:395-409. [PMID: 36744333 PMCID: PMC10050104 DOI: 10.3233/jad-220599] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND Our understanding of the pathophysiology underlying Alzheimer's disease (AD) has benefited from genomic analyses, including those that leverage polygenic risk score (PRS) models of disease. The use of functional annotation has been able to improve the power of genomic models. OBJECTIVE We sought to leverage genomic functional annotations to build tissue-specific AD PRS models and study their relationship with AD and its biomarkers. METHODS We built 13 tissue-specific AD PRS and studied the scores' relationships with AD diagnosis, cerebrospinal fluid (CSF) amyloid, CSF tau, and other CSF biomarkers in two longitudinal cohort studies of AD. RESULTS The AD PRS model that was most predictive of AD diagnosis (even without APOE) was the liver AD PRS: n = 1,115; odds ratio = 2.15 (1.67-2.78), p = 3.62×10-9. The liver AD PRS was also statistically significantly associated with cerebrospinal fluid biomarker evidence of amyloid-β (Aβ42:Aβ40 ratio, p = 3.53×10-6) and the phosphorylated tau:amyloid-β ratio (p = 1.45×10-5). CONCLUSION These findings provide further evidence of the role of the liver-functional genome in AD and the benefits of incorporating functional annotation into genomic research.
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Affiliation(s)
- Daniel J. Panyard
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Yuetiva K. Deming
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - Burcu F. Darst
- Center for Genetic Epidemiology, Keck School of Medicine, University of Southern California, 1450 Biggy Street, Los Angeles, CA 90033, United States of America
| | - Carol A. Van Hulle
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - 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 Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - 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
| | | | | | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, 610 Walnut Street, 9 Floor, Madison, WI 53726, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, WARF Room 201, 610 Walnut Street, Madison, WI 53726, United States of America
- Department of Statistics, University of Wisconsin-Madison, 1300 University Avenue, Madison, WI 53706, United States of America
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Xu Y, Vasiljevic E, Deming YK, Jonaitis EM, Koscik RL, Van Hulle CA, Lu Q, Carboni M, Kollmorgen G, Wild N, Carlsson CM, Johnson SC, Zetterberg H, Blennow K, Engelman CD. Effect of Pathway-Specific Polygenic Risk Scores for Alzheimer's Disease (AD) on Rate of Change in Cognitive Function and AD-Related Biomarkers Among Asymptomatic Individuals. J Alzheimers Dis 2023; 94:1587-1605. [PMID: 37482996 PMCID: PMC10468904 DOI: 10.3233/jad-230097] [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] [Indexed: 07/25/2023]
Abstract
BACKGROUND Genetic scores for late-onset Alzheimer's disease (LOAD) have been associated with preclinical cognitive decline and biomarker variations. Compared with an overall polygenic risk score (PRS), a pathway-specific PRS (p-PRS) may be more appropriate in predicting a specific biomarker or cognitive component underlying LOAD pathology earlier in the lifespan. OBJECTIVE In this study, we leveraged longitudinal data from the Wisconsin Registry for Alzheimer's Prevention and explored changing patterns in cognition and biomarkers at various age points along six biological pathways. METHODS PRS and p-PRSs with and without APOE were constructed separately based on the significant SNPs associated with LOAD in a recent genome-wide association study meta-analysis and compared to APOE alone. We used a linear mixed-effects model to assess the association between PRS/p-PRSs and cognitive trajectories among 1,175 individuals. We also applied the model to the outcomes of cerebrospinal fluid biomarkers in a subset. Replication analyses were performed in an independent sample. RESULTS We found p-PRSs and the overall PRS can predict preclinical changes in cognition and biomarkers. The effects of PRS/p-PRSs on rate of change in cognition, amyloid-β, and tau outcomes are dependent on age and appear earlier in the lifespan when APOE is included in these risk scores compared to when APOE is excluded. CONCLUSION In addition to APOE, the p-PRSs can predict age-dependent changes in amyloid-β, tau, and cognition. Once validated, they could be used to identify individuals with an elevated genetic risk of accumulating amyloid-β and tau, long before the onset of clinical symptoms.
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Affiliation(s)
- Yuexuan Xu
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | - Eva Vasiljevic
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Center for Demography of Health and Aging, University of Wisconsin-Madison, WI, USA
| | - Yuetiva K. Deming
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
| | - Rebecca L. Koscik
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Carol A. Van Hulle
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
| | | | | | | | - Cynthia M. Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sterling C. Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Corinne D. Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, WI, USA
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21
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Bouges S, Fischer B, Norton DL, Wyman MF, Lambrou N, Zuelsdorff M, Van Hulle CA, Ennis GE, James TT, Johnson AL, Chin N, Carlsson CM, Gleason CE. Effect of Metabolic Syndrome Risk Factors on Processing Speed and Executive Function in Three Racialized Groups. J Alzheimers Dis 2023; 92:285-294. [PMID: 36744341 PMCID: PMC10211459 DOI: 10.3233/jad-220920] [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] [Indexed: 02/05/2023]
Abstract
BACKGROUND Metabolic syndrome (MetS) has been associated with increased risk for Alzheimer's disease and related dementias (ADRD). Understanding the association of MetS risk factors to processing speed and executive function in the pre-clinical stages of ADRD in under-represented groups would offer insight on potential mechanisms through which MetS associates with ADRD risk. OBJECTIVE Examine association of MetS features and processing speed and executive function across three racial groups. METHODS Cognitively unimpaired adults from the Wisconsin Alzheimer's Disease Research Center and the Wisconsin Registry for Alzheimer's Disease Prevention completed blood-draws and neuropsychological testing. Six cognitive outcomes were assessed in association to MetS risk factors: Trailmaking Tests A and B, Animal Fluency, Digit Symbol, and composite scores for Processing Speed and Executive Function. Linear mixed effect models were used to assess the relationship between MetS risk factor count and longitudinal cognitive performance across three racialized groups. RESULTS Participant sample sizes varied by outcome analyzed (N = 714-1,088). African American and Native American groups exhibited higher rates of MetS than non-Hispanic Whites. MetS was associated with processing speed and executive function across all racialized groups. Three-way interaction by racialized group was limited to one cognitive outcome: Trailmaking Test A. CONCLUSION Metabolic dysfunction incrementally affects cognitive trajectory, with generally similar associations across racial groups. Since racialized groups exhibit higher levels of both MetS and ADRD, MetS may represent a driving factor for increased ADRD risk experience by racialized group and an important and modifiable target through which to reduce risk of ADRD.
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Affiliation(s)
- Shenikqua Bouges
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Barbara Fischer
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Neurology, Department of Medicine, University of Wisconsin School of Medicine & Public Health, Madison, WI, USA
| | - Derek L. Norton
- Department of Biostatistics and Medical Informatics, University of Wisconsin, Madison, WI, USA
| | - Mary F. Wyman
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- University of Wisconsin School of Medicine & Public Health, Department of Psychiatry, Madison, WI, USA
| | - Nickolas Lambrou
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
- University of Wisconsin – Madison School of Nursing
| | - Carol A. Van Hulle
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Gilda E. Ennis
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Taryn T. James
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
| | - Adrienne L. Johnson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- University of Wisconsin School of Medicine & Public Health, Center for Tobacco Research and Intervention, Madison, WI, USA
| | - Nathaniel Chin
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
| | - Cynthia M. Carlsson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, UW School of Medicine & Public Health, Madison, WI, USA
| | - Carey E. Gleason
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin (UW) School of Medicine & Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health, Madison, WI, USA
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22
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Driscoll I, Ma Y, Lose SR, Gallagher CL, Johnson SC, Asthana S, Hermann BP, Sager MA, Blennow K, Zetterberg H, Carlsson CM, Engelman CD, Dubal DB, Okonkwo OC. AD-associated CSF biomolecular changes are attenuated in KL-VS heterozygotes. Alzheimers Dement (Amst) 2022; 14:e12383. [PMID: 36505396 PMCID: PMC9728548 DOI: 10.1002/dad2.12383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 12/12/2022]
Abstract
Introduction Dementia as an inevitable aging consequence has been challenged and underscores the need for investigations of the factors that confer resilience. We examine whether the functionally advantageous KL-VS variant of the putative aging suppressor KLOTHO gene attenuates age-related cognitive decline and deleterious biomolecular changes. Methods Trajectories of change in memory and executive function (N = 360; 2-12 visits) and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers-amyloid beta (Aβ)42, total tau (t-tau), phosphorylated tau (p-tau) (N = 112; 2-4 samplings)-were compared between KL-VS non-carriers and heterozygotes in middle-aged and older adults from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center studies. Results Memory and executive function declined (p's ≤ 0.001) and CSF t-tau, p-tau, t-tau/Aβ42, and p-tau/Aβ42 levels increased (all p's ≤ 0.004) with age. The rate of p-tau accumulation was attenuated for KL-VS heterozygotes (p = 0.03). Discussion KL-VS heterozygosity may confer resilience to AD-associated biomolecular changes.
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Affiliation(s)
- Ira Driscoll
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Department of PsychologyUniversity of Wisconsin‐MilwaukeeMilwaukeeWisconsinUSA
| | - Yue Ma
- Wisconsin Alzheimer's InstituteMadisonWisconsinUSA
| | - Sarah R. Lose
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA
| | - Catherine L. Gallagher
- Geriatric Research Education and Clinical CenterWilliam S. Middleton VA HospitalMadisonWisconsinUSA,Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton VA HospitalMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton VA HospitalMadisonWisconsinUSA
| | - Bruce P. Hermann
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Mark A. Sager
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska Academy at the University of GothenburgGöteborgSweden,Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska Academy at the University of GothenburgGöteborgSweden,Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden,Department of Neurodegenerative DiseaseUCL Institute of NeurologyQueen SquareLondonUK,UK Dementia Research Institute at UCLLondonUK
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton VA HospitalMadisonWisconsinUSA
| | - Corinne D. Engelman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Departments of Population Health SciencesUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Dena B. Dubal
- Department of Neurology and Weill Institute for NeurosciencesUniversity of CaliforniaCaliforniaSan FranciscoUSA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton VA HospitalMadisonWisconsinUSA
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23
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Moody JF, Dean DC, Kecskemeti SR, Blennow K, Zetterberg H, Kollmorgen G, Suridjan I, Wild N, Carlsson CM, Johnson SC, Alexander AL, Bendlin BB. Associations between diffusion MRI microstructure and cerebrospinal fluid markers of Alzheimer's disease pathology and neurodegeneration along the Alzheimer's disease continuum. Alzheimers Dement (Amst) 2022; 14:e12381. [PMID: 36479018 PMCID: PMC9720004 DOI: 10.1002/dad2.12381] [Citation(s) in RCA: 2] [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: 03/30/2022] [Revised: 09/14/2022] [Accepted: 10/29/2022] [Indexed: 12/07/2022]
Abstract
Introduction White matter (WM) degeneration is a critical component of early Alzheimer's disease (AD) pathophysiology. Diffusion-weighted imaging (DWI) models, including diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI), and mean apparent propagator MRI (MAP-MRI), have the potential to identify early neurodegenerative WM changes associated with AD. Methods We imaged 213 (198 cognitively unimpaired) aging adults with DWI and used tract-based spatial statistics to compare 15 DWI metrics of WM microstructure to 9 cerebrospinal fluid (CSF) markers of AD pathology and neurodegeneration treated as continuous variables. Results We found widespread WM injury in AD, as indexed by robust associations between DWI metrics and CSF biomarkers. MAP-MRI had more spatially diffuse relationships with Aβ42/40 and pTau, compared with NODDI and DTI. Discussion Our results suggest that WM degeneration may be more pervasive in AD than is commonly appreciated and that innovative DWI models such as MAP-MRI may provide clinically viable biomarkers of AD-related neurodegeneration in the earliest stages of AD progression.
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Affiliation(s)
- Jason F. Moody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Douglas C. Dean
- Waisman CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of Medical PhysicsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of PediatricsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | | | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research InstituteUCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | | | | | | | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterMiddleton Memorial VA HospitalMadisonWisconsinUSA
| | - Andrew L. Alexander
- Waisman CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of Medical PhysicsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
- Department of PsychiatryUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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24
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Ennis GE, Bouges S, Zuelsdorff M, Van Hulle CA, Jonaitis EM, Koscik RL, Lambrou NH, Salazar H, Carter FP, James TT, Johnson AL, Fischer BL, Kirmess K, Holubasch MS, Meyer MR, Venkatesh V, West T, Verghese PB, Yarasheski KE, Chin NA, Asthana S, Carlsson CM, Johnson SC, Bendlin BB, Gleason CE. Diabetes is related to cognition but not plasma amyloid‐β 42/40 in an African American cohort. Alzheimers Dement 2022. [DOI: 10.1002/alz.067925] [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: 12/24/2022]
Affiliation(s)
- Gilda E. Ennis
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Shenikqua Bouges
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | - Megan Zuelsdorff
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison School of Nursing Madison WI USA
| | - Carol A. Van Hulle
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Nickolas H. Lambrou
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Hector Salazar
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Fabu P Carter
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Taryn T. James
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Adrienne L. Johnson
- University of Wisconsin ‐ Center for Tobacco Research and Intervention Madison WI USA
| | - Barbara L. Fischer
- 5. Madison VA GRECC, William S. Middleton Memorial Hospital Madison WI USA
- 6. Department of Neurology University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | | | | | | | - Tim West
- C2N Diagnostics, LLC Saint Louis MO USA
| | | | | | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Medicine, Geriatrics Division, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- 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, William S. Middleton Veterans Hospital Madison WI USA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Carey E. Gleason
- Geriatric Research, Education, and Clinical Center (GRECC), Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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25
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Bouges S, Noell D, Osman F, Benton SF, Clipps AD, Fischer BL, Gooding DC, Anthony RL, Carter FP, Salazar H, Simó CAF, Ennis GE, Van Hulle CA, Zuelsdorff M, Wyman MF, Johnson AL, Lambrou NH, James TT, Carlsson CM, Asthana S. Assessing trust and research attitudes in Blacks/African Americans following a personalized vs less personalized community approach. Alzheimers Dement 2022. [DOI: 10.1002/alz.068033] [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: 12/24/2022]
Affiliation(s)
- Shenikqua Bouges
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, UW School of Medicine & Public Health Madison WI USA
| | - Debra Noell
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | - Fauzia Osman
- University of Wisconsin ‐ Madison Madison WI USA
| | | | - Antwon D Clipps
- School of Nursing, University of Wisconsin‐ Madison Madison WI USA
| | - Barbara L. Fischer
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- 6. Department of Neurology University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Diane C. Gooding
- Department of Psychology, University of Wisconsin, Madison Madison WI USA
| | | | - Fabu P Carter
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Hector Salazar
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison Madison WI USA
| | - Carola A. Ferrer Simó
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Gilda E. Ennis
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin ‐ Madison School of Medicine and Public Health Madison WI USA
| | - Carol A. Van Hulle
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Megan Zuelsdorff
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
| | - Mary F. Wyman
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin School of Medicine and Public Health, Department of Psychiatry Madison WI USA
| | - Adrienne L. Johnson
- University of Wisconsin ‐ Center for Tobacco Research and Intervention Madison WI USA
| | - Nickolas H. Lambrou
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐ Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Taryn T. James
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sanjay Asthana
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health Madison WI USA
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26
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Gleason CE, Koscik RL, Zuelsdorff M, Norton DL, Fischer BL, Van Hulle CA, Gooding DC, Yarasheski KE, Wyman MF, Johnson AL, Lambrou NH, James TT, Bouges S, Carter FP, Salazar H, Norris N, Chin NA, Ennis GE, Jonaitis EM, Simó CAF, Kirmess K, Meyer MR, Holubasch MS, Venkatesh V, West T, Verghese PB, Carlsson CM, Asthana S, Johnson SC. An examination of baseline plasma Aβ42/40 and intra‐individual cognitive variability (IICV) associations with longitudinal cognitive change in a Black Cohort: Data from the African Americans Fighting Alzheimer’s in Midlife (AA‐FAIM) study. Alzheimers Dement 2022. [DOI: 10.1002/alz.061055] [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: 12/24/2022]
Affiliation(s)
- Carey E. Gleason
- Geriatric Research, Education, and Clinical Center (GRECC), Middleton Memorial Veterans Hospital Madison WI USA
- University of Wisconsin School of Medicine and Public Health Alzheimer's Disease Research Center Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Megan Zuelsdorff
- University of Wisconsin School of Nursing Madison WI USA
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Alzheimer's Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Derek L. Norton
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Biostatistics and Medical Informatics, University of Wisconsin Madison WI USA
| | - Barbara L. Fischer
- Madison VA GRECC, William S. Middleton Memorial Hospital Madison WI USA
- Department of Neurology University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Carol A. Van Hulle
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Diane C. Gooding
- Department of Psychology, University of Wisconsin, Madison Madison WI USA
| | - Kevin E. Yarasheski
- Washington University School of Medicine St. Louis MO USA
- C2N Diagnostics, LLC Saint Louis MO USA
| | - Mary F. Wyman
- Geriatric Research, Education, and Clinical Center (GRECC), Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin School of Medicine and Public Health, Department of Psychiatry Madison WI USA
| | - Adrienne L. Johnson
- University of Wisconsin ‐ Center for Tobacco Research and Intervention Madison WI USA
| | - Nickolas H. Lambrou
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin, Division of Geriatrics Madison WI USA
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Taryn T. James
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison Madison WI USA
| | - Shenikqua Bouges
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | - Fabu P Carter
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Hector Salazar
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | - Nia Norris
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Gilda E. Ennis
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Carola A. Ferrer Simó
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
| | | | | | | | | | - Tim West
- C2N Diagnostics, LLC Saint Louis MO USA
| | | | - Cynthia M. Carlsson
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
| | - Sanjay Asthana
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
| | - Sterling C. Johnson
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital Madison WI USA
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27
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Zuelsdorff M, Van Hulle CA, McLester‐Davis LWY, Chin NA, Livingston S, Logan J, Carlsson CM, Okonkwo OC, Gleason CE, Bendlin BB, Asthana S, Johnson SC, Betthauser TJ. Relationships between psychosocial stress, cerebrospinal fluid markers of Alzheimer’s disease, and cognitive function in middle‐aged and older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.069307] [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: 12/24/2022]
Affiliation(s)
- Megan Zuelsdorff
- University of Wisconsin‐Madison School of Nursing Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Carol A. Van Hulle
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | | | - Nathaniel A. Chin
- Department of Medicine, Geriatrics Division, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Julianne Logan
- University of Wisconsin‐Madison School of Nursing Madison WI USA
| | - Cynthia M. Carlsson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin, University of Wisconsin, Madison, WI, USA Madison WI USA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Carey E. Gleason
- William S. Middleton Veterans Hospital Geriatric Research Education and Clinical Center Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health, Madison WI USA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Tobey J Betthauser
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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28
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Pewowaruk RJ, Hein AJ, Carlsson CM, Korcarz CE, Gepner AD. Effects of nitroglycerin-induced vasodilation on elastic and muscular artery stiffness in older Veterans. Hypertens Res 2022; 45:1997-2007. [PMID: 35840750 PMCID: PMC10896453 DOI: 10.1038/s41440-022-00981-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/01/2022] [Accepted: 06/05/2022] [Indexed: 11/09/2022]
Abstract
Vascular smooth muscle tone may play an important role in the physiology of increased arterial stiffness that occurs with aging. This study evaluated the impact of smooth muscle tone on arterial stiffness in older individuals following nitroglycerin-induced vasodilation in elastic and muscular arteries. Forty older Veterans (≥60 years old) without known cardiovascular disease were included in this study. Twenty Veterans were included as hypertensive participants (70.8 ± 6.6 years, 10 females), and 20 were included as normotensive controls (72.0 ± 9.3 years, 8 females). Nitroglycerin (NTG)-induced changes in arterial stiffness were measured locally with vascular ultrasound in the carotid and brachial arteries and regionally by carotid-femoral pulse wave velocity (cfPWV) with tonometry. With NTG treatment, both hypertensive participants and normotensive controls Veterans showed increased carotid PWV (6.4 ± 1.3 m/s to 7.2 ± 1.4 m/s, Δ 0.8 ± 1.1 m/s, p = 0.007) and cfPWV (8.6 ± 1.9 m/s to 9.5 ± 2.4 m/s, Δ 0.9 ± 2.3 m/s, p = 0.020) but did not show changes in brachial PWV (11.2 ± 2.4 m/s to 11.1 ± 2.2 m/s, Δ -0.2 ± 2.5 m/s, p = 0.72). The carotid artery was dilated more in control participants than hypertensive Veterans (Δ 0.54 ± 0.19 mm vs. 0.42 ± 0.12 mm, p = 0.022). Brachial artery dilation was similar between the two groups (Δ 0.55 ± 0.26 mm vs. 0.51 ± 0.20 mm, p = 0.46). In older Veterans without known cardiovascular disease, NTG-induced vasodilation increased elastic artery stiffness but did not change muscular artery stiffness. Increased central arterial stiffness and a decrease in the arterial stiffness gradient could offset some of the benefits of lowering blood pressure in older patients who are prescribed vasodilators as an antihypertensive therapy. Elastic artery stiffening with vasodilation warrants further investigation, as it may be important for antihypertensive medication selection and influence CVD development.
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Affiliation(s)
- Ryan J Pewowaruk
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
| | - Amy J Hein
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Cynthia M Carlsson
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Medicine - Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Claudia E Korcarz
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Adam D Gepner
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
- Department of Medicine - Division of Cardiovascular Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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29
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Rivera‐Rivera LA, Cody KA, Betthauser TJ, Koscik RL, Jonaitis EM, Cadman RV, Hermann BP, Rowley HA, Carlsson CM, Chin NA, Eisenmenger L, Johnson SC, Johnson KM. Examining cerebrovascular burden across the cognitive continuum in older adults with and without evidence of amyloidosis. Alzheimers Dement 2022. [DOI: 10.1002/alz.063350] [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: 12/24/2022]
Affiliation(s)
| | - Karly Alex Cody
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Tobey J Betthauser
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | - Erin M. Jonaitis
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Robert V. Cadman
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Bruce P Hermann
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Howard A. Rowley
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Nathaniel A. Chin
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Laura Eisenmenger
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Sterling C. Johnson
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Kevin M Johnson
- University of Wisconsin School of Medicine and Public Health Madison WI USA
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Rowley HA, Rowley PA, Field AS, Johnson SC, Carlsson CM, Asthana S, Chin NA, Bendlin BB, Okonkwo OC. Unexpected Findings from 8,205 Brain Magnetic Resonance Imaging Examinations of Research Volunteers ≥ 40 years old. Alzheimers Dement 2022. [DOI: 10.1002/alz.065845] [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: 12/24/2022]
Affiliation(s)
- Howard A. Rowley
- Wisconsin Alzheimer's Disease Research Center Madison WI USA
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Paul A Rowley
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Aaron S Field
- University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison Madison WI USA
| | - Sterling C. Johnson
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Alzheimer's Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
| | - Barbara B. Bendlin
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Medicine, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Ozioma C. Okonkwo
- Alzheimer's Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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Hale MR, Koscik RL, Du L, Hermann BP, Van Hulle CA, Suridjan I, Kollmorgen G, Basche KE, Bruno D, Sanson‐Miles L, Jonaitis EM, Chin NA, Okonkwo OC, Bendlin BB, Carlsson CM, Zetterberg H, Blennow K, Betthauser TJ, Johnson SC, Mueller KD. Associations between semantic memory for proper names in story recall and CSF amyloid and tau in a cognitively unimpaired sample. Alzheimers Dement 2022. [DOI: 10.1002/alz.059439] [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: 12/24/2022]
Affiliation(s)
- Madeline R Hale
- University of Wisconsin‐Madison Madison WI USA
- Department of Communication Sciences and Disorders, University of Wisconsin‐Madison Madison WI USA
| | - Rebecca Langhough Koscik
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Lianlian Du
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Bruce P Hermann
- University of Wisconsin‐Madison Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Department of Neurology, School of Medicine and Public Health, Univeristy of Wisconsin‐Madison Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Carol A. Van Hulle
- University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin‐Madison, School of Medicine & Public Health Madison WI USA
| | | | | | - Kristin E Basche
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Davide Bruno
- Liverpool John Moores University Liverpool United Kingdom
| | - Leah Sanson‐Miles
- Department of Communication Sciences and Disorders, University of Wisconsin‐Madison Madison WI USA
| | - Erin M. Jonaitis
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Nathaniel A. Chin
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Ozioma C. Okonkwo
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Barbara B. Bendlin
- University of Wisconsin‐Madison Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- University of Wisconsin‐Madison Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Henrik Zetterberg
- University of Gothenburg Mölndal Sweden
- Hong Kong Center for Neurodegenerative Diseases Clear Water Bay Hong Kong
- The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- UK Dementia Research Institute at UCL London United Kingdom
- UCL Queen Square Institute of Neurology London United Kingdom
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Universitat Pompeu Fabra Barcelona Spain
- Institute of Neuroscience & Physiology, Department of Psychiatry & Neurochemistry, The Sahlgrenska Academy, University of Gothenburg Mölndal Sweden
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg Gothenburg Sweden
| | - Tobey J Betthauser
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
| | - Sterling C. Johnson
- University of Wisconsin‐Madison Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Kimberly D Mueller
- University of Wisconsin‐Madison Madison WI USA
- Department of Communication Sciences and Disorders, University of Wisconsin‐Madison Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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Albrecht T, Schroeder M, LeCaire T, Endicott S, Marschall K, Felten K, Sayavedra N, Russmann S, Kern V, Blazek MC, Kales HC, Carlsson CM, Mahoney J, Walaszek A. Training dementia care professionals to help caregivers improve the management of behavioral and psychological symptoms of dementia using the DICE Approach: A pilot study. Geriatr Nurs 2022; 48:74-79. [PMID: 36155312 DOI: 10.1016/j.gerinurse.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022]
Abstract
Most persons living with dementia (PLWD) exhibit behavioral or psychological symptoms of dementia (BPSD) over the course of the illness. The DICE Approach (DICE) is a framework that enables caregivers to identify, evaluate, and manage BPSD. This pilot pre-post test study examined the effects of DICE training on dementia care professionals' self-efficacy, knowledge, and attitudes regarding care of patients with BPSD. Participants underwent either in-person DICE training or, during the pandemic, online training. Case consultations were offered as additional learning opportunities in challenging situations. Of 134 participants in the trainings, 122 (91.0%) provided survey data for one or more instruments before and after training. Participants experienced significant improvement in knowledge and attitudes with respect to BPSD and improvement in self-efficacy with respect to helping caregivers respond to BPSD. Training dementia care professionals in DICE can improve their capacity to support caregivers in the management of BPSD.
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Affiliation(s)
- Tammi Albrecht
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA
| | - Molly Schroeder
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA
| | - Tamara LeCaire
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA
| | - Sarah Endicott
- University of Wisconsin School of Nursing, 701 Highland Ave, Madison, WI 53705, USA
| | - Katelyn Marschall
- Wisconsin Department of Health Services, 1 W Wilson St, Madison, WI 53703, USA
| | - Kristen Felten
- Wisconsin Department of Health Services, 1 W Wilson St, Madison, WI 53703, USA
| | - Noelia Sayavedra
- University of Wisconsin Population Health Institute, WARF Office Bldg, 610 Walnut St, Rm 575, Madison, WI 53726, USA
| | - Sydney Russmann
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA
| | - Vince Kern
- University of California, Department of Psychiatry and Behavioral Sciences, 2230 Stockton Blvd, Sacramento, Davis, CA 95817, USA
| | - Mary C Blazek
- University of Michigan School of Medicine, 4250 Plymouth Road, Ann Arbor, MI 48109, USA
| | - Helen C Kales
- University of California, Department of Psychiatry and Behavioral Sciences, 2230 Stockton Blvd, Sacramento, Davis, CA 95817, USA
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA; University of Wisconsin School of Medicine and Public Health, 750 Highland Ave, Madison, WI 53726, USA
| | - Jane Mahoney
- University of Wisconsin School of Medicine and Public Health, 750 Highland Ave, Madison, WI 53726, USA
| | - Art Walaszek
- Wisconsin Alzheimer's Institute, WARF Office Bldg, 610 Walnut St, Suite 957, Madison, WI 53726, USA; University of Wisconsin School of Medicine and Public Health, 750 Highland Ave, Madison, WI 53726, USA.
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Birdsill AC, Koscik RL, Cody KA, Jonaitis EM, Cadman RV, Erickson CM, Chin NA, Przybelski RJ, Carlsson CM, Asthana S, Christian BT, Eisenmenger LB, Betthauser TJ, Johnson SC. Trajectory of clinical symptoms in relation to amyloid chronicity. Alzheimers Dement (Amst) 2022; 14:e12360. [PMID: 36187195 PMCID: PMC9489232 DOI: 10.1002/dad2.12360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/27/2022] [Accepted: 08/29/2022] [Indexed: 01/25/2023]
Abstract
Introduction While it is generally appreciated that amyloid precedes symptomatic Alzheimer's disease (AD) by decades, a greater understanding of this timeline may increase prognostic accuracy, planning, and care of persons who are on the AD continuum. Methods We examined trajectories of Clinical Dementia Rating-Sum of Boxes (CDR-SB) relative to estimated years of amyloid positivity (A+) in n = 123 participants who were all A+ based on [C-11]Pittsburgh compound B positron emission tomography. Results The average amyloid chronicity at CDR-SB of 2.5 was 20.1 years. The average trajectory of CDR-SB accelerated after 10 years of elevated amyloid and varied greatly between 10 and 30 years. Exploratory analyses suggested that older age and higher volume of white matter hyperintensities shortened the interval between amyloid onset and cognitive impairment. Discussion The recontextualization of amyloid burden into the time domain will facilitate studies of disease progression, the influence of co-pathology, and factors that hasten or slow cognitive impairment.
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Affiliation(s)
- Alex C. Birdsill
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA
| | - Rebecca L. Koscik
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Karly A. Cody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Robert V. Cadman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Claire M. Erickson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Robert J. Przybelski
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Bradley T. Christian
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Waisman Laboratory for Brain Imaging and BehaviorUniversity of Wisconsin‐MadisonMadisonWisconsinUSA,Department of Medical PhysicsUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Laura B. Eisenmenger
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of RadiologyUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Geriatric Research Education and Clinical CenterWilliam S. Middleton Veterans HospitalMadisonWisconsinUSA,Wisconsin Alzheimer's InstituteUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,Department of MedicineUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
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Mander BA, Dave A, Lui KK, Sprecher KE, Berisha D, Chappel-Farley MG, Chen IY, Riedner BA, Heston M, Suridjan I, Kollmorgen G, Zetterberg H, Blennow K, Carlsson CM, Okonkwo OC, Asthana S, Johnson SC, Bendlin BB, Benca RM. Inflammation, tau pathology, and synaptic integrity associated with sleep spindles and memory prior to β-amyloid positivity. Sleep 2022; 45:6603598. [PMID: 35670275 PMCID: PMC9758508 DOI: 10.1093/sleep/zsac135] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 05/17/2022] [Indexed: 01/25/2023] Open
Abstract
STUDY OBJECTIVES Fast frequency sleep spindles are reduced in aging and Alzheimer's disease (AD), but the mechanisms and functional relevance of these deficits remain unclear. The study objective was to identify AD biomarkers associated with fast sleep spindle deficits in cognitively unimpaired older adults at risk for AD. METHODS Fifty-eight cognitively unimpaired, β-amyloid-negative, older adults (mean ± SD; 61.4 ± 6.3 years, 38 female) enriched with parental history of AD (77.6%) and apolipoprotein E (APOE) ε4 positivity (25.9%) completed the study. Cerebrospinal fluid (CSF) biomarkers of central nervous system inflammation, β-amyloid and tau proteins, and neurodegeneration were combined with polysomnography (PSG) using high-density electroencephalography and assessment of overnight memory retention. Parallelized serial mediation models were used to assess indirect effects of age on fast frequency (13 to <16Hz) sleep spindle measures through these AD biomarkers. RESULTS Glial activation was associated with prefrontal fast frequency sleep spindle expression deficits. While adjusting for sex, APOE ε4 genotype, apnea-hypopnea index, and time between CSF sampling and sleep study, serial mediation models detected indirect effects of age on fast sleep spindle expression through microglial activation markers and then tau phosphorylation and synaptic degeneration markers. Sleep spindle expression at these electrodes was also associated with overnight memory retention in multiple regression models adjusting for covariates. CONCLUSIONS These findings point toward microglia dysfunction as associated with tau phosphorylation, synaptic loss, sleep spindle deficits, and memory impairment even prior to β-amyloid positivity, thus offering a promising candidate therapeutic target to arrest cognitive decline associated with aging and AD.
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Affiliation(s)
- Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.,Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.,Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Kitty K Lui
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.,San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Katherine E Sprecher
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA.,Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Destiny Berisha
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Miranda G Chappel-Farley
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.,Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Margo Heston
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, 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
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital , Mölndal, Sweden
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.,Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA.,Department of Neurobiology and Behavior, University of California, Irvine, CA, USA.,Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA.,Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
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35
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Dong R, Denier-Fields DN, Lu Q, Suridjan I, Kollmorgen G, Wild N, Betthauser TJ, Carlsson CM, Asthana S, Johnson SC, Zetterberg H, Blennow K, Engelman CD. Principal components from untargeted cerebrospinal fluid metabolomics associated with Alzheimer's disease biomarkers. Neurobiol Aging 2022; 117:12-23. [PMID: 35640460 PMCID: PMC9737218 DOI: 10.1016/j.neurobiolaging.2022.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 08/26/2021] [Revised: 01/20/2022] [Accepted: 04/12/2022] [Indexed: 01/13/2023]
Abstract
Studying the correlation between cerebrospinal fluid (CSF) metabolites and the Alzheimer's Disease (AD) biomarkers may offer a window to the alterations of the brain metabolome and unveil potential biological mechanisms underlying AD. In this analysis, 308 CSF metabolites from 338 individuals of Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center were included in a principal component analysis (PCA). The resulted principal components (PCs) were tested for association with CSF total tau (t-tau), phosphorylated tau (p-tau), amyloid β 42 (Aβ42), and Aβ42/40 ratio using linear regression models. Significant PCs were further tested with other CSF NeuroToolKit (NTK) and imaging biomarkers. Using a Bonferroni corrected p < 0.05, 5 PCs were significantly associated with CSF p-tau and t-tau and 3 PCs were significantly associated with CSF Aβ42. Pathway analysis suggested that these PCS were enriched in 6 pathways, including metabolism of caffeine and nicotinate and nicotinamide. This study provides evidence that CSF metabolites are associated with AD pathology through core AD biomarkers and other NTK markers and suggests potential pathways to follow up in future studies.
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Affiliation(s)
- Ruocheng Dong
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Diandra N Denier-Fields
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Department Nutrition Science, University of Wisconsin-Madison, Madison, WI, USA
| | - Qiongshi Lu
- Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | - Tobey James Betthauser
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial VA Hospital, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, UK; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Corinne D Engelman
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA; Wisconsin Alzheimer's Institute, University of Wisconsin-Madison, School of Medicine and Public Health, Madison, WI, USA.
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Mora Pinzon M, Krainer J, LeCaire T, Houston S, Green‐Harris G, Norris N, Barnes S, Clark LR, Gleason CE, Hermann BP, Ramon H, Buckingham W, Chin NA, Asthana S, Johnson SC, Walaszek A, Carlsson CM. The Wisconsin Alzheimer's Institute Dementia Diagnostic Clinic Network: A community of practice to improve dementia care. J Am Geriatr Soc 2022; 70:2121-2133. [PMID: 35362093 PMCID: PMC9542133 DOI: 10.1111/jgs.17768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/05/2022] [Accepted: 03/02/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND The Wisconsin Alzheimer's Institute (WAI) Dementia Diagnostic Clinic Network is a community of practice formed in 1998 as a collaboration of community-based clinics from various healthcare systems throughout the state. Its purpose is to promote the use of evidence-based strategies to provide high quality care throughout Wisconsin for people with dementia. The purpose of this study is to describe the use of a community of practice to facilitate education of healthcare providers on best practices in dementia care, and the implementation of an interprofessional approach to diagnose and manage dementia and related disorders. METHODS Cross-sectional study of the members of the WAI's Dementia Diagnosis Clinic Network. Characteristics of clinics and healthcare teams, learners' participation in educational events and educational outcomes were collected from evaluation forms. Number and characteristics of patients seen in the memory clinics were collected from de-identified data forms submitted by members to a centralized location for data analysis. RESULTS The clinic network currently has 38 clinics affiliated with 26 different healthcare systems or independent medical groups in 21 of 72 Wisconsin counties. Most (56%) are based in primary care, 15% in psychiatry, and 29% in neurology. Between 2018 and 2021, we received data on 4710 patients; 92% were ≥65 years old, 60% were female, and 92% were white. Network members meet in-person twice a year to learn about innovations in the field of dementia care and to share best practices. Educational events associated with the network are shown to be relevant, useful, and improve knowledge and skills of participants. CONCLUSION Communities of practice provide added value via shared best practices and educational resources, continuing education of the health workforce, continuous quality improvement of clinical practices, and adoption of new diagnostic and management approaches in dementia care.
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Affiliation(s)
- Maria Mora Pinzon
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA,Department of Family Medicine and Community HealthUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Jody Krainer
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Tamara LeCaire
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Stephanie Houston
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Gina Green‐Harris
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Nia Norris
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA
| | - Stacy Barnes
- College of NursingMarquette UniversityMilwaukeeWisconsinUSA
| | - Lindsay R. Clark
- Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,VA Geriatric Research, Education and Clinical Center (GRECC)William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Carey E. Gleason
- Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,VA Geriatric Research, Education and Clinical Center (GRECC)William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Bruce P. Hermann
- Department of NeurologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | | | - Will Buckingham
- Center for Health Disparities Research (CHDR), School of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA,Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sanjay Asthana
- Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,VA Geriatric Research, Education and Clinical Center (GRECC)William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA,Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,VA Geriatric Research, Education and Clinical Center (GRECC)William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Art Walaszek
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA,Department of PsychiatryUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's InstituteUniversity of Wisconsin, School of Medicine and Public HealthMadisonWisconsinUSA,Department of Medicine, Division of Geriatrics and GerontologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA,VA Geriatric Research, Education and Clinical Center (GRECC)William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
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Carlsson CM. Management of Dementia. Continuum (Minneap Minn) 2022; 28:885-900. [PMID: 35678408 DOI: 10.1212/con.0000000000001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article describes an approach to managing patients following a diagnosis of dementia, including medical management, nonpharmacologic strategies, safety interventions, caregiver support, mobilization of community resources, and advanced care planning. RECENT FINDINGS Dementia clinical syndromes are frequently caused by mixed pathologies, leading to varied clinical presentations that include memory loss, behavioral changes, communication challenges, safety concerns, and loss of independent function. Medications for treating dementia currently target cognitive and behavioral symptoms, although disease-modifying therapies for Alzheimer disease may be making their way into widespread clinical practice soon. Identification and treatment of co-occurring medical problems, such as obstructive sleep apnea, adverse medication effects, mood disorders, hearing loss, pain, alcohol misuse, and vascular risk factors, may mitigate the impact of these conditions on cognitive decline. Mobilization of clinical and community-based interprofessional teams will ensure that people with dementia and their care partners have the expertise, support, and access to resources they need. Addressing goals of care early in the disease course will allow people with dementia to contribute to their care plan by expressing their wishes. SUMMARY Developing a structured approach to treating common causes of dementia and related comorbid medical conditions, identifying a local network of interprofessional clinical and community-based referrals, and providing readily available educational resources will help clinicians provide quality dementia care management that extends beyond the clinic visit. Encouraging patients and families to engage in clinical research will advance the identification of effective therapies, preventive strategies, and quality care models for the future.
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Jonaitis EM, Zetterberg H, Koscik RL, Betthauser TJ, Van Hulle CA, Hogan K, Hegge L, Kollmorgen G, Suridjan I, Gleason CE, Engelman CD, Okonkwo OC, Asthana S, Bendlin BB, Carlsson CM, Johnson SC, Blennow K. Crosswalk study on blood collection-tube types for Alzheimer's disease biomarkers. Alzheimers Dement (Amst) 2022; 14:e12266. [PMID: 35155728 PMCID: PMC8828996 DOI: 10.1002/dad2.12266] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/25/2021] [Revised: 09/09/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Blood-based Alzheimer's disease (AD) biomarkers show promise, but pre-analytical protocol differences may pose problems. We examined seven AD blood biomarkers (amyloid beta [A β ] 42 ,A β 40 ,phosphorylated tau [ p - ta u 181 , total tau [t-tau], neurofilament light chain [NfL],A β 42 40 , andp - ta u 181 A β 42 ) in three collection tube types (ethylenediaminetetraacetic acid [EDTA] plasma, heparin plasma, serum). METHODS Plasma and serum were obtained from cerebrospinal fluid or amyloid positron emission tomography-positive and -negative participants (N = 38) in the Wisconsin Registry for Alzheimer's Prevention. We modeled AD biomarker values observed in EDTA plasma versus heparin plasma and serum, and assessed correspondence with brain amyloidosis. RESULTS Results suggested bias due to tube type, but crosswalks are possible for some analytes, with excellent model fit for NfL (R 2 = 0.94), adequate for amyloid (R 2 = 0.40-0.69), and weaker for t-tau (R 2 = 0.04-0.42) andp - ta u 181 (R 2 = 0.22-0.29). Brain amyloidosis differentiated several measures, especially EDTA plasmapTa u 181 A β 42 (d = 1.29). DISCUSSION AD biomarker concentrations vary by tube type. However, correlations for some biomarkers support harmonization across types, suggesting cautious optimism for use in banked blood.
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Affiliation(s)
- Erin M. Jonaitis
- School of Medicine and Public HealthWisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyUniversity of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratoryInstitute of Neuroscience and PhysiologySahlgrenska University HospitalMölndalSweden
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- UK Dementia Research Institute at UCLLondonUK
- Hong Kong Center for Neurodegenerative DiseasesHong KongChina
| | - Rebecca Langhough Koscik
- School of Medicine and Public HealthWisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Carol A. Van Hulle
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Kirk Hogan
- Department of AnesthesiologySchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Laura Hegge
- School of Medicine and Public HealthWisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | | | | | - Carey E. Gleason
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Corinne D. Engelman
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Department of Population Health SciencesUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Barbara B. Bendlin
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
| | - Cynthia M. Carlsson
- School of Medicine and Public HealthWisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Sterling C. Johnson
- School of Medicine and Public HealthWisconsin Alzheimer's InstituteUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Wisconsin Alzheimer's Disease Research CenterSchool of Medicine and Public HealthUniversity of Wisconsin–MadisonMadisonWisconsinUSA
- Geriatric Research Education and Clinical Center of the Wm. S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologyUniversity of GothenburgMölndalSweden
- Clinical Neurochemistry LaboratoryInstitute of Neuroscience and PhysiologySahlgrenska University HospitalMölndalSweden
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Morrow A, Panyard DJ, Deming YK, Jonaitis E, Dong R, Vasiljevic E, Betthauser TJ, Kollmorgen G, Suridjan I, Bayfield A, Van Hulle CA, Zetterberg H, Blennow K, Carlsson CM, Asthana S, Johnson SC, Engelman CD. Cerebrospinal Fluid Sphingomyelins in Alzheimer's Disease, Neurodegeneration, and Neuroinflammation. J Alzheimers Dis 2022; 90:667-680. [PMID: 36155504 PMCID: PMC9809197 DOI: 10.3233/jad-220349] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Sphingomyelin (SM) levels have been associated with Alzheimer's disease (AD), but the association direction has been inconsistent and research on cerebrospinal fluid (CSF) SMs has been limited by sample size, breadth of SMs examined, and diversity of biomarkers available. OBJECTIVE Here, we seek to build on our understanding of the role of SM metabolites in AD by studying a broad range of CSF SMs and biomarkers of AD, neurodegeneration, and neuroinflammation. METHODS Leveraging two longitudinal AD cohorts with metabolome-wide CSF metabolomics data (n = 502), we analyzed the relationship between the levels of 12 CSF SMs, and AD diagnosis and biomarkers of pathology, neurodegeneration, and neuroinflammation using logistic, linear, and linear mixed effects models. RESULTS No SMs were significantly associated with AD diagnosis, mild cognitive impairment, or amyloid biomarkers. Phosphorylated tau, neurofilament light, α-synuclein, neurogranin, soluble triggering receptor expressed on myeloid cells 2, and chitinase-3-like-protein 1 were each significantly, positively associated with at least 5 of the SMs. CONCLUSION The associations between SMs and biomarkers of neurodegeneration and neuroinflammation, but not biomarkers of amyloid or diagnosis of AD, point to SMs as potential biomarkers for neurodegeneration and neuroinflammation that may not be AD-specific.
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Affiliation(s)
- Autumn Morrow
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Daniel J. Panyard
- Department of Genetics, School of Medicine, Stanford University, 291 Campus Drive, Stanford, CA 94305, United States of America
| | - Yuetiva K. Deming
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - Erin Jonaitis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Wisconsin Alzheimer’s Institute, UW School of Medicine and Public Health, 610 Walnut Street, 9th Floor, Madison, WI 53726
| | - Ruocheng Dong
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
| | - Eva Vasiljevic
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
- Center for Demography of Health and Aging, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI 53706
| | - Tobey J Betthauser
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | | | - Ivonne Suridjan
- Roche Diagnostics International Ltd, Forrenstrasse 2, 6343 Rotkreuz, Switzerland
| | - Anna Bayfield
- Roche Diagnostics GmbH, Nonnenwald 2, 82377 Penzberg, Germany
| | - Carol A. Van Hulle
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, 43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 43180 Mölndal, Sweden
- United Kingdom Dementia Research Institute at UCL, London, WC1E6BT, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1H0AL, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at University of Gothenburg, 43180 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 43180 Mölndal, Sweden
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, 600 Highland Avenue, J5/1 Mezzanine, Madison, WI 53792, United States of America
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 1685 Highland Avenue, 5158 Medical Foundation Centennial Building, Madison, WI 53705, United States of America
- William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, United States of America
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut Street, 707 WARF Building, Madison, WI 53726, United States of America
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Walaszek A, Schroeder M, Albrecht T, LeCaire T, Carlsson CM. Using academic detailing to enhance the knowledge, skills and attitudes of clinicians caring for patients with behavioral and psychological symptoms of dementia. Alzheimers Dement 2022. [PMID: 34971253 DOI: 10.1002/alz.051961] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Approximately 90% of persons with dementia experience behavioral and psychological symptoms of dementia (BPSD) over the course of their illness. Primary care clinicians often provide care as specialty geriatric-medicine or -psychiatry consultation may be difficult to obtain. Academic detailing (AD) is an evidence-based educational approach for engaging and persuading healthcare professionals to make changes in their practice (Avorn 2017). We sought to enhance the knowledge, skills and attitudes of providers' care of patients with BPSD using the AD model in primary care. METHODS We implemented AD in an urban clinic serving a largely Black community and a rural clinic serving a large, White community. Each AD visit included didactic content, case discussion, and consultation regarding patients with BPSD. Eleven visits over 18 months are planned for each site. Outcome measures include a 10-item multiple-choice assessment of knowledge and an adaptation of the General Practitioners Attitude and Confidence Scale for Dementia (GPACS-D) (Mason et al. 2019) at baseline before training, and 6 and 18 months, and Likert-scale measurement of acceptability at 6 and 18 months, all self-report. RESULTS We present interim data. Five urban and 14 rural providers completed baseline assessments. Providers were mostly White (95%) and Non-Hispanic (100%); 47% were female. Urban and rural providers had similar baseline BPSD knowledge (mean (SD) of correct answers, 5.4 (1.7) for rural, and 5.0 (2.6) for urban). The adapted GPACS-D, where higher score indicates more confidence, showed less confidence (mean score 11.4 versus 16.6, p=0.01) in urban versus rural providers. The overall attitudes score indicate there may be more confidence in treating BPSD at baseline among the slightly older rural providers as compared to their urban colleagues. Thus far, eight of 22 planned AD visits have been completed; 6-month assessments are forthcoming and will be presented. DISCUSSION Academic detailing may be a feasible and effective way of increasing self-reported knowledge and skills and improving self-reported attitude of primary care providers responsible for the care of patients with BPSD. The pilot data collected in this study will inform the design of a larger study to measure the impact of AD on patient outcomes.
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Affiliation(s)
- Art Walaszek
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Wisconsin Alzheimer's Institute, Madison, WI, USA.,University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | | | | | - Cynthia M Carlsson
- Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, USA.,School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
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Vogt NM, Hunt JFV, Adluru N, Ma Y, Van Hulle CA, Dean DC, Kecskemeti SR, Chin NA, Carlsson CM, Asthana S, Johnson SC, Kollmorgen G, Batrla R, Wild N, Buck K, Zetterberg H, Alexander AL, Blennow K, Bendlin BB. Interaction of amyloid and tau on cortical microstructure in cognitively unimpaired adults. Alzheimers Dement 2022; 18:65-76. [PMID: 33984184 PMCID: PMC8589921 DOI: 10.1002/alz.12364] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 03/31/2021] [Accepted: 04/12/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Neurite orientation dispersion and density imaging (NODDI), a multi-compartment diffusion-weighted imaging (DWI) model, may be useful for detecting early cortical microstructural alterations in Alzheimer's disease prior to cognitive impairment. METHODS Using neuroimaging (NODDI and T1-weighted magnetic resonance imaging [MRI]) and cerebrospinal fluid (CSF) biomarker data (measured using Elecsys® CSF immunoassays) from 219 cognitively unimpaired participants, we tested the main and interactive effects of CSF amyloid beta (Aβ)42 /Aβ40 and phosphorylated tau (p-tau) on cortical NODDI metrics and cortical thickness, controlling for age, sex, and apolipoprotein E ε4. RESULTS We observed a significant CSF Aβ42 /Aβ40 × p-tau interaction on cortical neurite density index (NDI), but not orientation dispersion index or cortical thickness. The directionality of these interactive effects indicated: (1) among individuals with lower CSF p-tau, greater amyloid burden was associated with higher cortical NDI; and (2) individuals with greater amyloid and p-tau burden had lower cortical NDI, consistent with cortical neurodegenerative changes. DISCUSSION NDI is a particularly sensitive marker for early cortical changes that occur prior to gross atrophy or development of cognitive impairment.
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Affiliation(s)
- Nicholas M. Vogt
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jack F. V. Hunt
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Nagesh Adluru
- Waisman Laboratory for Brain Imaging and Behavior, Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Yue Ma
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Carol A. Van Hulle
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Douglas C. Dean
- Waisman Laboratory for Brain Imaging and Behavior, Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Steven R. Kecskemeti
- Waisman Laboratory for Brain Imaging and Behavior, Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | | | - Richard Batrla
- Roche Diagnostics International AG, Rotkreuz, Switzerland
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at University College London, London, UK
| | - Andrew L. Alexander
- Waisman Laboratory for Brain Imaging and Behavior, Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Barbara B. Bendlin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Walaszek A, Schroeder M, Albrecht T, Endicott S, Marschall K, Felten K, Sayavedra N, LeCaire T, Russmann S, Kern VJ, Blazek MC, Kales HC, Carlsson CM, Mahoney J. Effectively training dementia care specialists and other dementia professionals on using the DICE Approach TM with caregivers to improve the management of behavioral and psychological symptoms of dementia. Alzheimers Dement 2022. [PMID: 34971262 DOI: 10.1002/alz.049782] [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] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Most persons living with dementia will exhibit at least one behavioral or psychological symptom of dementia (BPSD) (Kales, et al., 2015). As brain pathology progresses, challenging behaviors can increase in frequency and severity, causing an increase in caregiver stress and burden. Furthermore, BPSD can result in unplanned hospitalizations and unnecessary use of psychotropic medications. Non-pharmacological management of BPSD should be the first line of treatment. The DICE (Describe, Investigate, Create, Evaluate) ApproachTM was developed by experts from the University of Michigan and John Hopkins University, to help caregivers learn how to identify and manage BPSD. This project describes a statewide implementation of the DICE approach with community-based dementia care providers. METHODS From September 2017 to April 2020, we held four DICE trainings (three in-person trainings, one web-based training) for Dementia Care Specialists (DCSs) and other dementia care professionals who work directly with family caregivers of people with dementia in Wisconsin. We assessed trainees' knowledge and attitudes from the Dementia Attitudes Scale (DAS) and the Knowledge about Memory Loss and Care test (KAML-C) at baseline of training, immediately after training, and six months after training. Consultations were provided to address challenging cases. RESULTS Participants (N=136) in both in-person and online DICE trainings experienced significant changes in knowledge, self-efficacy and attitudes from baseline to post-training (immediately after training) assessments (p<.01) (see Table 2 for details). Narrative feedback from trainees was generally very positive. Trainees used DICE with 165 caregivers who were primarily non-Hispanic white (92%) females (74.4%) from an urban location (68.1%), caring for their spouse (52.7%) (Table 1). DISCUSSION By using the DICE approach with caregivers of persons with dementia, Wisconsin's DCSs and other dementia professionals are uniquely positioned to help reduce risks associated with BPSD, including the use of psychotropic medications. Training satisfaction was high, knowledge about BPSD increased, and attitudes improved. The DICE trainings prepared trainees to implement this intervention with 165 family caregivers. A follow-up survey will explore the real-world application of DICE, including barriers to its use and modifications made in communities across the state.
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Affiliation(s)
- Art Walaszek
- Wisconsin Alzheimer's Institute, Madison, WI, USA.,University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | | | - Sarah Endicott
- University of Wisconsin School of Nursing, Madison, WI, USA
| | | | - Kristen Felten
- Wisconsin Department of Health Services, Madison, WI, USA
| | - Noelia Sayavedra
- University of Wisconsin-Madison Population Health Institute, Madison, WI, USA
| | | | | | | | | | - Helen C Kales
- University of California, Davis, Sacramento, CA, USA
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, USA.,School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jane Mahoney
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Pinzon MCM, Krainer J, Houston S, LeCaire T, Green-Harris G, Norris N, Walaszek A, Johnson SC, Carlsson CM. Quality measures in dementia care across a network of memory clinics: An implementation study. Alzheimers Dement 2022. [PMID: 34971261 DOI: 10.1002/alz.056350] [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] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND In 2015 the American Academy of Neurology and American Psychiatric Association updated the Dementia Management Measurement Set from 2009. Out of the nine measures proposed, four have been included by the Centers for Medicare and Medicaid Services (CMS) in their Merit-Based Incentive Payment System, which is used to determine payment adjustments in pay-for-reporting program. In 2018, the Wisconsin Alzheimer's Institute (WAI) developed a process to track the performance of these measures across the WAI Dementia Diagnostic Clinic Network, which consists of 44 statewide clinics across 24 healthcare systems. METHOD In September 2018, WAI launched the following implementation strategies to improve adoption of the quality measures: audit and feedback, new de-identified forms, and development of a codebook with definitions and examples on how to fill the new forms. Clinics submit de-identified forms containing demographics, diagnosis and process measures that are used to calculate performance on the quality measures. Descriptive analyses were performed, and performance was calculated according to criteria set by CMS. RESULT Over 24 months, 23 clinics have submitted information on 3,247 patients. Early adopters demonstrated a high performance on the measures, but as more clinics participate, the distribution has shown regression to the mean (Table 1). When comparing clinic performance between Oct 2019 - Oct 2020 with CMS benchmarks for 2020, the percentage of clinics performing above the CMS average were: 68% for measure #2; 91% for measure #3; 48% for measure #4; and 86% for measure #5 (Figure). Variations in performances have been attributed to unique characteristics of each clinic, for example, some do not follow-up individuals and only provide recommendations to primary care providers; this lowers their metrics in measures that require management of behaviors or conditions. CONCLUSION Implementation of the quality measures across the WAI network has been facilitated by the use of clinical care models that promote interdisciplinary care. Further research is required to explore additional mechanisms that increase participation of clinics, and to develop new data collection methods that can explore the impact of these measures on health outcomes.
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Affiliation(s)
- Maria C Mora Pinzon
- Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.,Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, USA
| | - Jody Krainer
- Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Stephanie Houston
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Gina Green-Harris
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Nia Norris
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Art Walaszek
- Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
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Gaitán JM, Asthana S, Carlsson CM, Engelman CD, Johnson SC, Sager MA, Wang D, Dubal DB, Okonkwo OC. Circulating Klotho Is Higher in Cerebrospinal Fluid than Serum and Elevated Among KLOTHO Heterozygotes in a Cohort with Risk for Alzheimer's Disease. J Alzheimers Dis 2022; 90:1557-1569. [PMID: 36314202 PMCID: PMC10139824 DOI: 10.3233/jad-220571] [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] [Indexed: 12/12/2022]
Abstract
BACKGROUND Klotho is a longevity and neuroprotective hormone encoded by the KLOTHO gene, and heterozygosity for the KL-VS variant confers a protective effect against neurodegenerative disease. OBJECTIVE Test whether klotho concentrations in serum or cerebrospinal fluid (CSF) vary as a function of KLOTHO KL-VS genotype, determine whether circulating klotho concentrations from serum and CSF differ from one another, and evaluate whether klotho levels are associated with Alzheimer's disease risk factors. METHODS Circulating klotho was measured in serum (n = 1,116) and CSF (n = 183) of cognitively intact participants (aged 62.4 ± 6.5 years; 69.5% female). KLOTHO KL-VS zygosity (non-carrier; heterozygote; homozygote) was also determined. Linear regression was used to test whether klotho hormone concentration varied as a function of KL-VS genotype, specimen source, and demographic and clinical characteristics. RESULTS Serum and CSF klotho were higher in KL-VS carriers than non-carriers. Klotho concentration was higher in CSF than in serum. Females had higher serum and CSF klotho, while younger age was associated with higher klotho in CSF. CONCLUSION In a cohort enriched for risk for Alzheimer's disease, heterozygotic and homozygotic carriers of the KL-VS allele, females, and younger individuals have higher circulating klotho. Fluid source, KL-VS genotype, age, and sex should be considered in analyses of circulating klotho on brain health.
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Affiliation(s)
- Julian M. Gaitán
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
| | - Corinne D. Engelman
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 707, Madison, WI 53726, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
| | - Mark A. Sager
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
| | - Dan Wang
- Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158, USA
| | - Dena B. Dubal
- Department of Neurology and Weill Institute for Neurosciences, University of California, San Francisco, 675 Nelson Rising Lane, San Francisco, CA 94158, USA
| | - Ozioma C. Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Ave., Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut St. Suite 957, Madison, WI 53726, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, 2500 Overlook Terrace, Madison, WI 53705, USA
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Walaszek A, Albrecht T, LeCaire T, Sayavedra N, Schroeder M, Krainer J, Prichett G, Wilcenski M, Endicott S, Russmann S, Carlsson CM, Mahoney J. Training professional caregivers to screen for report of cognitive changes in persons with intellectual disability. A&D Transl Res & Clin Interv 2022; 8:e12345. [PMID: 36016831 PMCID: PMC9398220 DOI: 10.1002/trc2.12345] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 04/13/2022] [Accepted: 06/01/2022] [Indexed: 11/19/2022]
Abstract
Introduction By age 60, 60% of adults with Down syndrome (DS) have dementia. Detecting dementia in persons with intellectual disability (ID) can be challenging because their underlying cognitive impairment can confound presentation of dementia symptoms and because adults with ID may have difficulty reporting symptoms. The National Task Group Early Detection Screen for Dementia (NTG‐EDSD) was developed to aid detection of report of cognitive impairment in adults with ID. We implemented an educational curriculum using the NTG‐EDSD and evaluated the impact of the intervention on professional caregivers’ self‐assessed capacity to identify persons with ID and dementia. Methods We held five in‐person training sessions for professional caregivers of persons with ID, partnering with various managed care organizations and social services agencies. We assessed knowledge and attitudes at baseline; immediately after training; and 1 week, 1 month, and 6 months after training. Results A total of 154 direct care workers, case managers, health‐care providers, and other social services staff attended the trainings. Satisfaction with the NTG‐EDSD training was high; 94% of attendees agreed or strongly agreed that they could use the NTG‐EDSD with their clients. After training, attendees reported a marked increase in confidence in their ability to track various health circumstances and detect functional decline in their clients, although some gains were not sustained over time. As a result of the training, one managed care organization made the NTG‐EDSD a standard part of its assessment of adults with DS starting at age 40. Discussion Social services and health‐care professionals can learn to document signs of cognitive decline in adults with ID using the NTG‐EDSD. Attendees were highly satisfied with the training, experienced an increase in confidence in their care of persons with ID, and found the NTG‐ EDSD feasible to use. Because not all gains were sustained over time, booster trainings may be necessary.
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Affiliation(s)
- Art Walaszek
- University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute Madison Wisconsin USA
| | | | | | - Noelia Sayavedra
- University of Wisconsin Population Health Institute Madison Wisconsin USA
| | | | - Jody Krainer
- Wisconsin Alzheimer's Institute Madison Wisconsin USA
| | | | | | - Sarah Endicott
- University of Wisconsin School of Nursing Madison Wisconsin USA
| | | | - Cynthia M. Carlsson
- University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
- Wisconsin Alzheimer's Institute Madison Wisconsin USA
| | - Jane Mahoney
- University of Wisconsin School of Medicine and Public Health Madison Wisconsin USA
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Rivera‐Rivera LA, Eisenmenger L, Cody KA, Reher T, Betthauser T, Cadman RV, Rowley HA, Carlsson CM, Chin NA, Johnson SC, Johnson KM. Cerebrovascular stiffness and flow dynamics in the presence of amyloid and tau biomarkers. Alzheimers Dement (Amst) 2021; 13:e12253. [PMID: 35005194 PMCID: PMC8719432 DOI: 10.1002/dad2.12253] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 09/30/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION This work investigated the relationship between cerebrovascular disease (CVD) markers and Alzheimer's disease (AD) biomarkers of amyloid beta deposition, and neurofibrillary tau tangles in subjects spanning the AD clinical spectrum. METHODS A total of 136 subjects participated in this study. Four groups were established based on AD biomarker positivity from positron emission tomography (amyloid [A] and tau [T]) and clinical diagnosis (cognitively normal [CN] and impaired [IM]). CVD markers were derived from structural and quantitative magnetic resonance imaging data. RESULTS Transcapillary pulse wave delay was significantly longer in controls compared to AT biomarker-confirmed groups (A+/T-/CN P < .001, A+/T+/CN P < .001, A+/T+/IM P = .003). Intracranial low-frequency oscillations were diminished in AT biomarker-confirmed groups both CN and impaired (A+/T-/CN P = .039, A+/T+/CN P = .007, A+/T+/IM P = .011). A significantly higher presence of microhemorrhages was measured in A+/T+/CN compared to controls (P = .006). DISCUSSION Cerebrovascular markers indicate increased vessel stiffness and reduced vasomotion in AT biomarker-positive subjects during preclinical AD.
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Affiliation(s)
- Leonardo A. Rivera‐Rivera
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of Medical PhysicsUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Laura Eisenmenger
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Karly A. Cody
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Thomas Reher
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Tobey Betthauser
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Robert V. Cadman
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Howard A. Rowley
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Cynthia M. Carlsson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Nathaniel A. Chin
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Sterling C. Johnson
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Geriatric Research Education and Clinical CenterWilliam S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
| | - Kevin M. Johnson
- Department of Medical PhysicsUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
- Department of RadiologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Van Hulle CA, Jonaitis EM, Betthauser TJ, Kollmorgen G, Suridjan I, Andreasson U, Carlsson CM, Asthana S, Johnson SC, Zetterberg H, Blennow K, Mueller KD. Amyloid status is associated with deficits in connected speech language. Alzheimers Dement 2021. [DOI: 10.1002/alz.057762] [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)
- Carol A. Van Hulle
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine & Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | | | - Ulf Andreasson
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
| | - Cynthia M. Carlsson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer's Institute, University of Wisconsin, Madison, WI, USA Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin‐Madison, School of Medicine and Public Health Madison WI USA
| | - Sanjay Asthana
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Department of Medicine, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - 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
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Department of Communication Sciences and Disorders, University of Wisconsin ‐ Madison Madison WI USA
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Morrow AR, Panyard DJ, Deming Y, Dong R, Vasiljevic E, Betthauser TJ, Jonaitis EM, Kollmorgen G, Suridjan I, Zetterberg H, Blennow K, Hulle CA, Carlsson CM, Asthana S, Johnson SC, Engelman CD. CSF sphingomyelin metabolites in Alzheimer’s disease, neurodegeneration, and neuroinflammation. Alzheimers Dement 2021. [DOI: 10.1002/alz.052290] [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: 11/09/2022]
Affiliation(s)
- Autumn Rose Morrow
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | | | - Yuetiva Deming
- School of Medicine and Public Health University of Wisconsin Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Ruocheng Dong
- Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Eva Vasiljevic
- University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Tobey J. Betthauser
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Erin M. Jonaitis
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- The Wisconsin Alzheimer's Institute, University of Wisconsin Madison WI USA
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- UCL Institute of Neurology London United Kingdom
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL London United Kingdom
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
| | - Carol A. Hulle
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Cynthia M. Carlsson
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin‐Madison, School of Medicine and Public Health Madison WI USA
- School of Medicine and Public Health, University of Wisconsin‐Madison Madison WI USA
| | - Sanjay Asthana
- University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- VA Geriatric Research, Education and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital Madison WI USA
- Geriatric Research, Education, and Clinical Center (GRECC), Middleton Memorial Veterans Hospital Madison WI USA
| | - Sterling C. Johnson
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health Madison WI USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital Madison WI USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital Madison WI USA
| | - Corinne D. Engelman
- Department of Population Health Sciences, University of Wisconsin Madison WI USA
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Thorstenson JC, Heston MB, Zarbock KR, Carlsson CM, Engelman CD, Deming Y, Johnson SC, Ulland TK, Asthana S, Kollmorgen G, Suridjan I, Blennow K, Zetterberg H, Chin NA, Rey FE, Bendlin BB. Diet and
APOE
as moderators of the relationship between trimethylamine N‐oxide and biomarkers of Alzheimer's disease and glial activation. Alzheimers Dement 2021. [DOI: 10.1002/alz.051827] [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)
- John C. Thorstenson
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Margo B. Heston
- Wisconsin School of Medicine and Public Health, Department of Pathology and Laboratory Medicine Madison WI USA
- Cellular and Molecular Pathology, University of Wisconsin‐Madison Madison WI USA
| | - Katie R Zarbock
- Wisconsin School of Medicine and Public Health, Department of Pathology and Laboratory Medicine Madison WI USA
| | - Cynthia M Carlsson
- Geriatric Research, Education and Clinical Center, Madison VA Hospital Madison WI USA
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | - Corinne D. Engelman
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
- Department of Population Health Sciences University of Wisconsin Madison WI USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Yuetiva Deming
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
- Wisconsin Alzheimer's Institute University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital Madison WI USA
- Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
| | - Tyler K. Ulland
- Wisconsin School of Medicine and Public Health, Department of Pathology and Laboratory Medicine Madison WI USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center University of Wisconsin School of Medicine and Public Health Madison WI USA
- Geriatric Research, Education, and Clinical Center (GRECC), Middleton Memorial Veterans Hospital Madison WI USA
| | | | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Institute of Physiology and Neuroscience, University of Gothenburg Mölndal Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Institute of Physiology and Neuroscience, University of Gothenburg Mölndal Sweden
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL London United Kingdom
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology London United Kingdom
| | - Nathaniel A Chin
- Wisconsin Alzheimer’s Disease Research Center University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
| | | | - Barbara B Bendlin
- Wisconsin Alzheimer’s Institute University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
- Division of Geriatrics and Gerontology Department of Medicine University of Wisconsin School of Medicine & Public Health Madison WI USA
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50
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Plante DT, Tran KM, Cook JD, Hagen EW, Peppard PE, Kollmorgen G, Suridjan I, Blennow K, Zetterberg H, Carlsson CM, Johnson SC, Bendlin BB. Associations between obstructive sleep apnea, Alzheimer’s disease pathology, and objective daytime sleepiness measured by the psychomotor vigilance task in cognitively unimpaired adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.054431] [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)
| | | | | | | | | | | | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg Mölndal Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital Mölndal Sweden
- UK Dementia Research Institute Fluid Biomarkers Laboratory, UK DRI at UCL London United Kingdom
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology London United Kingdom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg Mölndal Sweden
| | | | - Sterling C. Johnson
- University of Wisconsin‐Madison School of Medicine and Public Health Madison WI USA
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