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Greil W, de Bardeci M, Müller-Oerlinghausen B, Nievergelt N, Stassen H, Hasler G, Erfurth A, Cattapan K, Rüther E, Seifert J, Toto S, Bleich S, Schoretsanitis G. Controversies regarding lithium-associated weight gain: case-control study of real-world drug safety data. Int J Bipolar Disord 2023; 11:34. [PMID: 37840048 PMCID: PMC10577117 DOI: 10.1186/s40345-023-00313-8] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/27/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs). METHODS We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: "Arzneimittelsicherheit in der Psychiatrie"; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports. RESULTS We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI 0.9-5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI 4.7-28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI 1.3-8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI 1.1-5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium. CONCLUSIONS Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.
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Affiliation(s)
- Waldemar Greil
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331, Munich, Germany.
- Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland.
| | - Mateo de Bardeci
- Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
| | - Bruno Müller-Oerlinghausen
- Charité Universitätsmedizin-Berlin, Berlin, Germany
- Medical Faculty Brandenburg Theodor Fontane, Neuruppin, Germany
- Drug Commission of the German Medical Association, Berlin, Germany
| | - Nadja Nievergelt
- Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland
| | - Hans Stassen
- Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- IFMA Preventive Health Management Inc., 80 Pine Street, 24th Floor, New York, NY, 10005, USA
| | - Gregor Hasler
- Psychiatry Research Unit, University of Fribourg, Fribourg, Switzerland
| | - Andreas Erfurth
- Klinik Hietzing, 1st Department of Psychiatry and Psychotherapeutic Medicine, Vienna, Austria
| | - Katja Cattapan
- Psychiatric Private Hospital, Sanatorium Kilchberg, Zurich, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331, Munich, Germany
| | - Johanna Seifert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Georgios Schoretsanitis
- Department of Psychiatry, Psychotherapy and Psychosomatics, Hospital of Psychiatry, University of Zurich, Zurich, Switzerland
- The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry at the Donald and Barbara Zucker School of Medicine at Northwell/Hofstra, Hempstead, NY, USA
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2
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de Bardeci M, Greil W, Stassen H, Willms J, Köberle U, Bridler R, Hasler G, Kasper S, Rüther E, Bleich S, Toto S, Grohmann R, Seifert J. Dear Doctor Letters regarding citalopram and escitalopram: guidelines vs real-world data. Eur Arch Psychiatry Clin Neurosci 2023; 273:65-74. [PMID: 35217913 PMCID: PMC9957836 DOI: 10.1007/s00406-022-01392-x] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/04/2022] [Indexed: 12/14/2022]
Abstract
Dear Doctor Letters (DDLs, Direct Healthcare Professional Communications) from 2011 provided guidance regarding QTc-prolonging effects with risk of torsade de pointes during treatment with citalopram and escitalopram. This study examines the DDLs' effects on prescription behavior. Data from 8842 inpatients treated with citalopram or escitalopram with a primary diagnosis of major depressive disorder (MDD) were derived from a European pharmacovigilance study (Arzneimittelsicherheit in der Psychiatrie, AMSP) from 2001 to 2017. It was examined to what extent new maximum doses were adhered to and newly contraindicated combinations with QTc-prolonging drugs were avoided. In addition, the prescriptions of psychotropic drugs before and after DDLs were compared in all 43,480 inpatients with MDD in the data set. The proportion of patients dosed above the new limit decreased from 8 to 1% in patients ≤ 65 years and from 46 to 23% in patients > 65 years old for citalopram versus 14-5% and 47-31% for escitalopram. Combinations of es-/citalopram with other QTc-prolonging psychotropic drugs reduced only insignificantly (from 35.9 to 30.9%). However, the proportion of patients with doses of quetiapine > 150 mg/day substantially decreased within the combinations of quetiapine and es-/citalopram (from 53 to 35%). After the DDLs, prescription of citalopram decreased and of sertraline increased. The DDLs' recommendations were not entirely adhered to, particularly in the elderly and concerning combination treatments. This might partly be due to therapeutic requirements of the included population. Official warnings should consider clinical needs.
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Affiliation(s)
- Mateo de Bardeci
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331 Munich, Germany ,grid.492890.e0000 0004 0627 5312Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
| | - Waldemar Greil
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331, Munich, Germany. .,Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland.
| | - Hans Stassen
- grid.492890.e0000 0004 0627 5312Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland ,grid.412004.30000 0004 0478 9977Institute for Response-Genetics, Psychiatric University Hospital (KPPP), Zurich, Switzerland
| | - Jamila Willms
- grid.492890.e0000 0004 0627 5312Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
| | - Ursula Köberle
- Arzneimittelkommission der Deutschen Ärzteschaft, Berlin, Germany
| | - René Bridler
- grid.492890.e0000 0004 0627 5312Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg-Zurich, Switzerland
| | - Gregor Hasler
- grid.8534.a0000 0004 0478 1713Psychiatry Research Unit, University of Fribourg, Fribourg, Switzerland
| | - Siegfried Kasper
- grid.22937.3d0000 0000 9259 8492Department of Molecular Neuroscience, Medical University of Vienna, Vienna, Austria
| | - Eckart Rüther
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331 Munich, Germany
| | - Stefan Bleich
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Sermin Toto
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Renate Grohmann
- grid.5252.00000 0004 1936 973XDepartment of Psychiatry and Psychotherapy, Ludwig Maximilian University, Nussbaumstr. 7, 80331 Munich, Germany
| | - Johanna Seifert
- grid.10423.340000 0000 9529 9877Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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3
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Polcher A, Wolfsgruber S, Peters O, Frölich L, Wiltfang J, Kornhuber J, Hüll M, Rüther E, Lewczuk P, Maier W, Jessen F, Wagner M. A Comparison of Operational Definitions for Mild Cognitive Impairment. J Alzheimers Dis 2022; 88:1663-1678. [PMID: 35811516 PMCID: PMC9484125 DOI: 10.3233/jad-215548] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Consideration of many tests from different cognitive domains in defining mild cognitive impairment (MCI) is clinical routine, but guidelines for a neuropsychological operationalization of MCI are lacking. Objective: Among different operational MCI criteria, to identify those which are best in predicting either conversion to dementia, or a biomarker profile indicative for Alzheimer’s disease (AD). Methods: Memory-clinic patients without dementia (N = 558; mean age = 66; up to 3 years of follow-up; n = 360 with baseline CSF biomarkers) were included in an observational study using most liberal criteria of cognitive impairment. Four operational definitions of MCI were retrospectively applied: 1) amnestic MCI (word list delayed recall), 2) CERAD total score, 3) comprehensive criteria and 4) base rate corrected CERAD. We compared their accuracy in predicting incident all-cause dementia or AD dementia within three years, or a concurrent CSF Aβ42/tau-ratio indicative of AD. Results: The four definitions overlapped considerably, classified 35–58% of the original sample as impaired and were associated with markedly increased PPVs regarding incident all-cause dementia (39–46% versus 26% of the original sample), AD dementia and AD biomarker positivity. The base-rate corrected MCI definition had the highest prognostic accuracy. Conclusion: he operational criteria examined seem suitable to specify MCI in memory clinic settings, as they identify subjects at high risk of clinical progression. Depending on the neuropsychological battery in use, one or several of these criteria could help to calibrate the clinical judgment of test results, reduce false-positive decisions, and define risk-enriched groups for clinical trials.
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Affiliation(s)
- Alexandra Polcher
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité, Campus Benjamin Franklin, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), University of Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Science Department, University of Aveiro, Aveiro, Portugal
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, and Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Hüll
- Center for Geriatric Medicine and Gerontology, University of Freiburg, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), University of Göttingen, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, and Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Biasłystok, and Department of Biochemical Diagnostics, University Hospital of Bialystok, Bialystok, Poland
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany
- Department of Psychiatry and Psychotherapy, University Hospital Cologne, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
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4
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Jansen WJ, Janssen O, Tijms BM, Vos SJB, Ossenkoppele R, Visser PJ, Aarsland D, Alcolea D, Altomare D, von Arnim C, Baiardi S, Baldeiras I, Barthel H, Bateman RJ, Van Berckel B, Binette AP, Blennow K, Boada M, Boecker H, Bottlaender M, den Braber A, Brooks DJ, Van Buchem MA, Camus V, Carill JM, Cerman J, Chen K, Chételat G, Chipi E, Cohen AD, Daniels A, Delarue M, Didic M, Drzezga A, Dubois B, Eckerström M, Ekblad LL, Engelborghs S, Epelbaum S, Fagan AM, Fan Y, Fladby T, Fleisher AS, Van der Flier WM, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Frings L, Frisoni GB, Fröhlich L, Gabryelewicz T, Gertz HJ, Gill KD, Gkatzima O, Gómez-Tortosa E, Grimmer T, Guedj E, Habeck CG, Hampel H, Handels R, Hansson O, Hausner L, Hellwig S, Heneka MT, Herukka SK, Hildebrandt H, Hodges J, Hort J, Huang CC, Iriondo AJ, Itoh Y, Ivanoiu A, Jagust WJ, Jessen F, Johannsen P, Johnson KA, Kandimalla R, Kapaki EN, Kern S, Kilander L, Klimkowicz-Mrowiec A, Klunk WE, Koglin N, Kornhuber J, Kramberger MG, Kuo HC, Van Laere K, Landau SM, Landeau B, Lee DY, de Leon M, Leyton CE, Lin KJ, Lleó A, Löwenmark M, Madsen K, Maier W, Marcusson J, Marquié M, Martinez-Lage P, Maserejian N, Mattsson N, de Mendonça A, Meyer PT, Miller BL, Minatani S, Mintun MA, Mok VCT, Molinuevo JL, Morbelli SD, Morris JC, Mroczko B, Na DL, Newberg A, Nobili F, Nordberg A, Olde Rikkert MGM, de Oliveira CR, Olivieri P, Orellana A, Paraskevas G, Parchi P, Pardini M, Parnetti L, Peters O, Poirier J, Popp J, Prabhakar S, Rabinovici GD, Ramakers IH, Rami L, Reiman EM, Rinne JO, Rodrigue KM, Rodríguez-Rodriguez E, Roe CM, Rosa-Neto P, Rosen HJ, Rot U, Rowe CC, Rüther E, Ruiz A, Sabri O, Sakhardande J, Sánchez-Juan P, Sando SB, Santana I, Sarazin M, Scheltens P, Schröder J, Selnes P, Seo SW, Silva D, Skoog I, Snyder PJ, Soininen H, Sollberger M, Sperling RA, Spiru L, Stern Y, Stomrud E, Takeda A, Teichmann M, Teunissen CE, Thompson LI, Tomassen J, Tsolaki M, Vandenberghe R, Verbeek MM, Verhey FRJ, Villemagne V, Villeneuve S, Vogelgsang J, Waldemar G, Wallin A, Wallin ÅK, Wiltfang J, Wolk DA, Yen TC, Zboch M, Zetterberg H. Prevalence Estimates of Amyloid Abnormality Across the Alzheimer Disease Clinical Spectrum. JAMA Neurol 2022; 79:228-243. [PMID: 35099509 DOI: 10.1001/jamaneurol.2021.5216] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE One characteristic histopathological event in Alzheimer disease (AD) is cerebral amyloid aggregation, which can be detected by biomarkers in cerebrospinal fluid (CSF) and on positron emission tomography (PET) scans. Prevalence estimates of amyloid pathology are important for health care planning and clinical trial design. OBJECTIVE To estimate the prevalence of amyloid abnormality in persons with normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia and to examine the potential implications of cutoff methods, biomarker modality (CSF or PET), age, sex, APOE genotype, educational level, geographical region, and dementia severity for these estimates. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional, individual-participant pooled study included participants from 85 Amyloid Biomarker Study cohorts. Data collection was performed from January 1, 2013, to December 31, 2020. Participants had normal cognition, subjective cognitive decline, mild cognitive impairment, or clinical AD dementia. Normal cognition and subjective cognitive decline were defined by normal scores on cognitive tests, with the presence of cognitive complaints defining subjective cognitive decline. Mild cognitive impairment and clinical AD dementia were diagnosed according to published criteria. EXPOSURES Alzheimer disease biomarkers detected on PET or in CSF. MAIN OUTCOMES AND MEASURES Amyloid measurements were dichotomized as normal or abnormal using cohort-provided cutoffs for CSF or PET or by visual reading for PET. Adjusted data-driven cutoffs for abnormal amyloid were calculated using gaussian mixture modeling. Prevalence of amyloid abnormality was estimated according to age, sex, cognitive status, biomarker modality, APOE carrier status, educational level, geographical location, and dementia severity using generalized estimating equations. RESULTS Among the 19 097 participants (mean [SD] age, 69.1 [9.8] years; 10 148 women [53.1%]) included, 10 139 (53.1%) underwent an amyloid PET scan and 8958 (46.9%) had an amyloid CSF measurement. Using cohort-provided cutoffs, amyloid abnormality prevalences were similar to 2015 estimates for individuals without dementia and were similar across PET- and CSF-based estimates (24%; 95% CI, 21%-28%) in participants with normal cognition, 27% (95% CI, 21%-33%) in participants with subjective cognitive decline, and 51% (95% CI, 46%-56%) in participants with mild cognitive impairment, whereas for clinical AD dementia the estimates were higher for PET than CSF (87% vs 79%; mean difference, 8%; 95% CI, 0%-16%; P = .04). Gaussian mixture modeling-based cutoffs for amyloid measures on PET scans were similar to cohort-provided cutoffs and were not adjusted. Adjusted CSF cutoffs resulted in a 10% higher amyloid abnormality prevalence than PET-based estimates in persons with normal cognition (mean difference, 9%; 95% CI, 3%-15%; P = .004), subjective cognitive decline (9%; 95% CI, 3%-15%; P = .005), and mild cognitive impairment (10%; 95% CI, 3%-17%; P = .004), whereas the estimates were comparable in persons with clinical AD dementia (mean difference, 4%; 95% CI, -2% to 9%; P = .18). CONCLUSIONS AND RELEVANCE This study found that CSF-based estimates using adjusted data-driven cutoffs were up to 10% higher than PET-based estimates in people without dementia, whereas the results were similar among people with dementia. This finding suggests that preclinical and prodromal AD may be more prevalent than previously estimated, which has important implications for clinical trial recruitment strategies and health care planning policies.
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Affiliation(s)
- Willemijn J Jansen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Banner Alzheimer's Institute, Phoenix, Arizona
| | - Olin Janssen
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Betty M Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands
| | - Stephanie J B Vos
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Pieter Jelle Visser
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.,Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (UMC), Amsterdam, the Netherlands.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Daniele Altomare
- Laboratory Alzheimer's Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Christine von Arnim
- Division of Geriatrics, University of Goettingen Medical School, Goettingen, Germany.,Clinic for Neurogeriatrics and Neurological Rehabilitation, University and Rehabilitation Hospital Ulm, Ulm, Germany
| | - Simone Baiardi
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Spain
| | - Ines Baldeiras
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Randall J Bateman
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Bart Van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Neuroscience and Physiology, Sahlgren's University Hospital, Mölndal, Sweden
| | - Merce Boada
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Henning Boecker
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany
| | - Michel Bottlaender
- Université Paris-Saclay, Service Hospitalier Frédéric Joliot (CEA), French National Centre for Scientific Research (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM), BioMaps, Service Hospitalier Frederic Joliot, Orsay, France
| | - Anouk den Braber
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David J Brooks
- Translational and Clinical Research Institute, University of Newcastle upon Tyne, United Kingdom.,Department of Nuclear Medicine, Positron Emission Tomography Centre, Aarhus University, Aarhus, Denmark.,Department of Brain Sciences, Imperial College London, London, United Kingdom
| | - Mark A Van Buchem
- Department of Neurology, University Hospital Leiden, Leiden, the Netherlands
| | - Vincent Camus
- Unite Mixte de Recherche, INSERM U930, French National Centre for Scientific Research (CNRS) ERL, Tours, France
| | - Jose Manuel Carill
- Nuclear Medicine Department, University Hospital Marqués de Valdecilla, Molecular Imaging, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), University of Cantabria, Santander, Spain
| | - Jiri Cerman
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Gaël Chételat
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Elena Chipi
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Alisha Daniels
- Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Marion Delarue
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Mira Didic
- Assistance Publique Hôpitaux de Marseille (AP-HM), Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France.,Aix Marseille Univ, INSERM, Institut de Neurosciences des Systèmes (INS), Marseille, France
| | - Alexander Drzezga
- Deutsches Zentrum für Neurodegenerative Erkrankungen e.V. (DZNE), Bonn, Germany.,Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - Bruno Dubois
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Marie Eckerström
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | | | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium.,Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stéphane Epelbaum
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Anne M Fagan
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Yong Fan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | | | - Wiesje M Van der Flier
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Stefan Förster
- Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.,Department of Nuclear Medicine, Klinikum Bayreuth, Bayreuth, Germany
| | - Juan Fortea
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Kristian Steen Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Lars Frings
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Giovanni B Frisoni
- Memory Clinic, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Lutz Fröhlich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, Warsaw, Poland
| | - Hermann-Josef Gertz
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Kiran Dip Gill
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Olymbia Gkatzima
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Eric Guedj
- Aix Marseille University, AP-HM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, Centre Européen de Recherche en Imagerie Médicale (CERIMED), Nuclear Medicine Department, Marseille, France
| | - Christian G Habeck
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, New York
| | - Harald Hampel
- Sorbonne University, Clinical Research Group no. 21, Alzheimer Precision Medicine, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Ron Handels
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Lucrezia Hausner
- Universität Heidelberg, Abteilung Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit Mannheim, Mannheim, Germany
| | - Sabine Hellwig
- Department of Psychiatry and Psychotherapy Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital of Bonn, Bonn, Germany.,Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine-Neurology, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Helmut Hildebrandt
- Klinikum Bremen-Ost, University of Oldenburg, Institute of Psychology, Oldenburg, Germany
| | - John Hodges
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Jakub Hort
- Department of Neurology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Ane Juaristi Iriondo
- Center for Research and Advanced Therapies, Centro de Investigación y Ciencias Avanzadas-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | - Yoshiaki Itoh
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Adrian Ivanoiu
- Department of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley.,Division of Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, California
| | - Frank Jessen
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.,DZNE, Bonn, Germany
| | - Peter Johannsen
- Memory Disorder Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Boston
| | - Ramesh Kandimalla
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India.,Department of Radiation Oncology, Emory University, Atlanta, Georgia.,Applied Biology, Council of Scientific and Industrial Research (CSIR)-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, Telangana State, India.,Department of Biochemistry, Kakatiya Medical College/Mahatma Gandhi Memorial Hospital, Warangal, Telangana State, India
| | - Elisabeth N Kapaki
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Silke Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Aleksandra Klimkowicz-Mrowiec
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - William E Klunk
- Department of Psychiatry, Massachusetts General Hospital, Boston.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Milica G Kramberger
- Department of Neurology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Hung-Chou Kuo
- Department of Neurology, Chang Gung Memorial Hospital at Linkou Medical Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Koen Van Laere
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley
| | - Brigitte Landeau
- Normandie University, University of Caen Normandie (UNICAEN), INSERM, U1237, Physiopathology and Imaging of Neurological Disorders (PhIND), Institut Blood and Brain at Caen-Normandie, Cyceron, Caen, France
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Mony de Leon
- Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Cristian E Leyton
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Kun-Ju Lin
- Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan
| | - Alberto Lleó
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.,Memory Unit, Neurology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Malin Löwenmark
- Memory Clinic, Department of Geriatrics, Uppsala University Hospital, Uppsala, Sweden
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Jan Marcusson
- Acute Internal Medicine and Geriatrics, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marta Marquié
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Pablo Martinez-Lage
- Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, Donostia-San Sebastian, Spain
| | | | - Niklas Mattsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | | | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Shinobu Minatani
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Vincent C T Mok
- Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.,Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong, China.,BrainNow Research Institute, Guangdong Province, Shenzhen, China
| | - Jose Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Clinic University Hospital, Barcelona, Spain
| | - Silvia Daniela Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - John C Morris
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland.,Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Neuroscience Center, Samsung Medical Center, Seoul, South Korea
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Flavio Nobili
- Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DINOGMI), University of Genoa, Genoa, Italy.,Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division for Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden.,Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | | | | | - Pauline Olivieri
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Adela Orellana
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - George Paraskevas
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Piero Parchi
- Istituto delle Scienze Neurologiche di Bologna, IRCCS, Bologna, Italy.,DIMES, University of Bologna, Bologna, Italy
| | | | - Lucilla Parnetti
- Centro Disturbi della Memoria, Laboratorio di Neurochimica Clinica, Clinica Neurologica, Università di Perugia, Perugia, Italy
| | - Oliver Peters
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin-CBF, Berlin, Deutschland
| | - Judes Poirier
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Julius Popp
- Department of Geriatric Psychiatry, University Hospital of Psychiatry Zürich and University of Zürich, Zürich, Switzerland.,Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne and University of Lausanne, Lausanne, Switzerland
| | - Sudesh Prabhakar
- Department of Neurology, Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Inez H Ramakers
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas
| | | | - Catherine M Roe
- Department of Neurology and the Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Pedro Rosa-Neto
- Studies on Prevention of Alzheimer's Disease (StOP-AD) Centre, Montreal, Quebec, Canada
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Uros Rot
- Department of Neurology, Medical Center, Zaloska 7, Ljubljana, Slovenia
| | - Christopher C Rowe
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Florey Department of Neuroscience, University of Melbourne, Melbourne, Victoria, Australia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Agustín Ruiz
- Research Center and Memory Clinic of Fundació Alzheimer Centre Educacional, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, Barcelona, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, National Institute of Health Carlos III, Madrid, Spain
| | - Osama Sabri
- Department of Nuclear Medicine, University Hospital of Leipzig, Leipzig, Germany
| | - Jayant Sakhardande
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Pascual Sánchez-Juan
- Service of Neurology, University Hospital Marqués de Valdecilla-IDIVAL, CIBERNED, Santander, Spain
| | - Sigrid Botne Sando
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, University Hospital of Trondheim, Trondheim, Norway
| | - Isabel Santana
- Center for Neuroscience and Cell Biology (CIBB), University of Coimbra, Coimbra, Portugal.,Neurology Department and Laboratory of Neurochemistry, Centro Hospitalar e Universitário de Coimbra, Praceta Professor Mota Pinto, Coimbra, Portugal.,Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, Coimbra, Portugal
| | - Marie Sarazin
- Department of Neurology of Memory and Language, Groupe Hospitalier Universitaire Paris Psychiatry and Neurosciences, Hôpital Sainte Anne, F-75014, Paris, France.,Université de Paris, Paris, Université Paris-Saclay, BioMaps, CEA, CNRS, INSERM, Orsay, France
| | - Philip Scheltens
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Johannes Schröder
- Section for Geriatric Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Sang Won Seo
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Dina Silva
- Faculty of Medicine, University of Lisboa, Lisboa, Portugal
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Peter J Snyder
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, The University of Rhode Island, Kingston
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurocenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Marc Sollberger
- Memory Clinic, University Department of Geriatric Medicine, Felix Platter-Hospital, Basel, Switzerland.,Department of Neurology, University Hospital Basel, Basel, Switzerland
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard Aging Brain Study, Department of Neurology, Harvard Medical School, Boston, Massachusetts
| | - Luisa Spiru
- Geriatrics, Gerontology and Old Age Psychiatry Clinical Department, Carol Davila University of Medicine and Pharmacy-Elias, Emergency Clinical Hospital, Bucharest, Romania.,Memory Clinic and Longevity Medicine, Ana Aslan International Foundation, Bucharest, Romania
| | - Yaakov Stern
- Cognitive Neuroscience Division, Department of Neurology and the Taub Institute, Columbia University, New York, New York
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Akitoshi Takeda
- Department of Neurology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Marc Teichmann
- Department of Neurology, Institut de la Mémoire et de la Maladie d'Alzheimer, Centre de Référence Démences Rares, Hôpital de la Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Centre de Référence Démences Rares, Pitié-Salpêtrière University Hospital, AP-HP, Paris, France
| | - Charlotte E Teunissen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Louisa I Thompson
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jori Tomassen
- Department of Neurology, Alzheimer Centre Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, George Papanicolau General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, University of Leuven, Leuven, Belgium.,Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Centre, Nijmegen, the Netherlands
| | - Frans R J Verhey
- Alzheimer Centre Limburg, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Victor Villemagne
- Department of Molecular Imaging, Austin Health, Melbourne, Victoria, Australia.,Molecular Biomarkers in Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada.,Douglas Mental Health University Institute, Montreal, Quebec, Canada.,McConnell Brain Imaging Centre, Montreal Neurological Institute, Montreal, Quebec, Canada
| | - Jonathan Vogelgsang
- Translational Neuroscience Laboratory, McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anders Wallin
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Åsa K Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany.,Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Tzu-Chen Yen
- Department of Nuclear Medicine and Molecular Imaging Center, Linkou Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan.,Healthy Aging Research Center and Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Marzena Zboch
- Research-Scientific-Didactic Centre of Dementia-Related Diseases in Scinawa, Medical University of Wroclaw, Wroclaw, Poland
| | - Henrik Zetterberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, University College London (UCL) Queen Square Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute, London, United Kingdom.,Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
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5
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Baumgärtner J, Grohmann R, Bleich S, Glocker C, Seifert J, Toto S, Rüther E, Engel RR, Stübner S. Atypical dyskinesias under treatment with antipsychotic drugs: Report from the AMSP multicenter drug safety project. World J Biol Psychiatry 2022; 23:151-164. [PMID: 34096837 DOI: 10.1080/15622975.2021.1938213] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aim of this study was to describe atypical dyskinesias (AtypDs) occurring during treatment with antipsychotic drugs (APDs). AtypDs are dyskinesias showing either an unusual temporal relationship between onset of treatment and start of the adverse drug reaction (ADR) or an unusual presentation of clinical symptoms. METHODS Data on the utilisation of APDs and reports of severe APD-induced AtypDs were collected using data from the observational pharmacovigilance programme - 'Arzneimittelsicherheit in der Psychiatrie (English: drug safety in psychiatry)' (AMSP) - from 1993 to 2016. RESULTS A total of 495,615 patients were monitored, of which 333,175 were treated with APDs. Sixty-seven cases (0.020%) of severe AtypDs under treatment with APDs were registered. The diagnoses of schizophrenic disorders as well as organic mental disorders were related to significantly higher rates of AtypDs. Second-generation antipsychotic drugs (SGAs) showed slightly higher rates of AtypDs (0.024%) than high-potency (0.011%) or low-potency first-generation antipsychotic drugs (FGAs; 0.006%). In 41 cases (61.2%), two or more drugs were found to cause AtypDs. CONCLUSIONS Our study indicates that AtypDs are rare ADRs. SGAs may have a higher risk for the occurrence of AtypDs than FGAs. Clinicians should be aware of this ADR and patients should be monitored and examined carefully.
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Affiliation(s)
- Jessica Baumgärtner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Renate Grohmann
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - Catherine Glocker
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Johanna Seifert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover, Germany
| | - Eckart Rüther
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.,Prosomno, Clinic for Sleep Medicine, Munich, Germany
| | - Rolf R Engel
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Susanne Stübner
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.,Department of Forensic Psychiatry, Bezirksklinikum Ansbach, Ansbach, Germany
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6
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Martino Adami PV, Orellana A, García P, Kleineidam L, Alarcón-Martín E, Montrreal L, Aguilera N, Espinosa A, Abdelnour C, Rosende-Roca M, Tartari JP, Vargas L, Mauleón A, Esteban-De Antonio E, López-Cuevas R, Dalmasso MC, Martin RC, Parveen K, Andrade Fuentes VM, Amin N, Ahmad S, Ikram MA, Lewczuk P, Kornhuber J, Peters O, Frölich L, Rüther E, Wiltfang J, Tarraga L, Boada M, Maier W, de Rojas I, Cano A, Sanabria A, Alegret M, Hernández I, Marquié M, Valero S, van Duijn CM, Wagner M, Jessen F, Schneider A, Sáez Goñi ME, Pérez AG, Ruiz A, Ramírez A. Matrix metalloproteinase 10 is linked to the risk of progression to dementia of the Alzheimer's type. Brain 2022; 145:2507-2517. [PMID: 35088840 DOI: 10.1093/brain/awac024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 12/10/2021] [Accepted: 12/16/2021] [Indexed: 11/12/2022] Open
Abstract
Alzheimer's disease has a long asymptomatic phase that offers a substantial time window for intervention. Utilizing this window of opportunity will require early diagnostic and prognostic biomarkers to detect Alzheimer's disease pathology at pre-dementia stages, thus allowing identification of patients who will most probably progress to dementia of the Alzheimer's type and benefit from specific disease-modifying therapies. Consequently, we searched for CSF proteins associated with disease progression along with the clinical disease staging. We measured the levels of 184 proteins in CSF samples from 556 subjective cognitive decline and mild cognitive impairment patients from three independent memory clinic longitudinal studies (Spanish ACE, n = 410; German DCN, n = 93; German Mannheim, n = 53). We evaluated the association between protein levels and clinical stage, and the effect of protein levels on the progression from mild cognitive impairment to dementia of the Alzheimer's type. Mild cognitive impairment subjects with increased CSF level of matrix metalloproteinase 10 showed a higher probability of progressing to dementia of the Alzheimer's type and a faster cognitive decline. CSF matrix metalloproteinase 10 increased the prediction accuracy of CSF Aβ42, P-tau181, and T-tau for conversion to dementia of the Alzheimer's type. Including matrix metalloproteinase 10 to the [A/T/(N)] scheme improved considerably the prognostic value in mild cognitive impairment patients with abnormal Aβ42, but normal P-tau181 and T-tau, and in mild cognitive impairment patients with abnormal Aβ42, P-tau181, and T-tau. Matrix metalloproteinase 10 was correlated with age in subjects with normal Aβ42, P-tau181, and T-tau levels. Our findings support the use of CSF matrix metalloproteinase 10 as a prognostic marker for dementia of the Alzheimer's type and its inclusion to the [A/T/(N)] scheme to incorporate pathologic aspects beyond amyloid and tau. CSF level of matrix metalloproteinase 10 may reflect ageing and neuroinflammation.
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Affiliation(s)
- Pamela V Martino Adami
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Adelina Orellana
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Pablo García
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Emilio Alarcón-Martín
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Laura Montrreal
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Nuria Aguilera
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Ana Espinosa
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Carla Abdelnour
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Maitee Rosende-Roca
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Juan Pablo Tartari
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Liliana Vargas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Ana Mauleón
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Ester Esteban-De Antonio
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Rogelio López-Cuevas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Maria Carolina Dalmasso
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Rafael Campos Martin
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Kayenat Parveen
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Victor M Andrade Fuentes
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Najaf Amin
- Nuffield Department of Population Health, University of Oxford, University of Oxford Richard Doll Building, Old Road Campus, Headington, Oxford OX3 7LF, UK
| | - Shahzad Ahmad
- Department of Epidemiology, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, 3015 GD Rotterdam, The Netherlands
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Białystok, 15-269 Białystok, Poland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander-Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Oliver Peters
- Department of Biochemical Diagnostics, University Hospital of Białystok, 15-269 Białystok, Poland.,Department of Psychiatry, Charité University Medicine, Campus Benjamin Franklin, 12200 Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen. von-Siebold-Str. 5, 37075 Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen. von-Siebold-Str. 5, 37075 Göttingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), 37075 Göttingen, Germany.,iBiMED, Medical Sciences Department, University of Aveiro. Aradas 3810-193, Aveiro, Portugal
| | - Lluis Tarraga
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Merce Boada
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Itziar de Rojas
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Amanda Cano
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Angela Sanabria
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain
| | - Montserrat Alegret
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Marta Marquié
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Sergi Valero
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | | | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany
| | | | | | - Agustín Ruiz
- Research Center and Memory Clinic, Ace Alzheimer Center Barcelona, International University of Catalonia, 8029 Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28031 Madrid, Spain
| | - Alfredo Ramírez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Medical Faculty, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, 78229 San Antonio, Texas, USA.,Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne. Joseph-Stelzmann-Straße 26, 50931 Cologne, Germany
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7
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Druschky K, Toto S, Bleich S, Baumgärtner J, Engel RR, Grohmann R, Maier HB, Neyazi A, Rudolph YJ, Rüther E, Schwörer H, Seifert J, Stübner S, Degner D. Severe drug-induced liver injury in patients under treatment with antipsychotic drugs: Data from the AMSP study. World J Biol Psychiatry 2021; 22:373-386. [PMID: 32892689 DOI: 10.1080/15622975.2020.1819565] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Drug-induced liver injury (DILI) has been associated with various antipsychotic drugs (APDs). Comparative studies between individual APDs are largely not available. METHODS Antipsychotic drug utilisation data and reports of severe antipsychotic DILI were assessed by using data from an observational pharmacovigilance programme-Arzneimittelsicherheit in der Psychiatrie (AMSP)-during the period 1993-2016. RESULTS Of the 333,175 patients treated with APDs, a total of 246 (0.07%) events of severe DILI were identified. Phenothiazines were associated with significantly higher rates of severe DILI (0.03%, 95% CI = 0.02-0.04) than thioxanthenes (0.01%, 95% CI = 0.00-0.02) or butyrophenones (0.01%, 95% CI = 0.00-0.01). Among individual drugs, olanzapine (0.12%, 95% CI = 0.10-0.16), perazine (0.09%, 95% CI = 0.05-0.15) and clozapine (0.09%, 95% CI = 0.10-0.12 ranked highest. In 78 cases (31.7%), combination therapies with antipsychotic and antidepressant drugs or with two or more APDs were considered responsible. Male sex and a diagnosis of mania were associated with significantly higher rates of severe DILI while older patients (≥65 years old) were significantly less often affected. CONCLUSIONS In the present analysis of a representative psychiatric inpatient cohort, olanzapine, perazine, and clozapine were the most common individual APDs associated with severe DILI.
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Affiliation(s)
- Katrin Druschky
- Department of Neurology, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Jessica Baumgärtner
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Augsburg, Germany
| | - Rolf R Engel
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Renate Grohmann
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Hannah B Maier
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Alexandra Neyazi
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Yannick J Rudolph
- Department of Psychiatry and Psychotherapy, Georg-August University of Goettingen, Goettingen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Harald Schwörer
- Department of Gastroenterology and Gastrointestinal Oncology, Liver Center Goettingen, University Medical Center Goettingen, Georg-August University of Goettingen, Göttingen, Germany
| | - Johanna Seifert
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Susanne Stübner
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany.,Department of Forensic Psychiatry, Kbo-IAK, Academic Teaching Hospital of the Ludwig-Maximilian University, Munich, Germany
| | - Detlef Degner
- Department of Psychiatry and Psychotherapy, Georg-August University of Goettingen, Goettingen, Germany
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8
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Seifert J, Führmann F, Reinhard MA, Engel RR, Bernegger X, Bleich S, Stübner S, Rüther E, Toto S, Grohmann R, Sieberer M, Greil W. Sex differences in pharmacological treatment of major depressive disorder: results from the AMSP pharmacovigilance program from 2001 to 2017. J Neural Transm (Vienna) 2021; 128:827-843. [PMID: 33977402 PMCID: PMC8205885 DOI: 10.1007/s00702-021-02349-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/02/2021] [Indexed: 12/25/2022]
Abstract
Data on drug prescription for outpatients with major depressive disorder (MDD) suggest women are more likely to be treated with psychotropic drugs, while data on sex differences regarding pharmacological treatment of psychiatric inpatients are currently not available. Drug utilization data from the program "Drug Safety in Psychiatry" (German: Arzneimittelsicherheit in der Psychiatrie, AMSP) of 44,418 psychiatric inpatients with MDD were analyzed for sex differences between 2001 and 2017. Sex differences were analyzed using relative risks (RR) and 95% confidence intervals (95% CI). Time trends were analyzed by comparing the first (2001-2003) with the last time period (2015-2017). In general, men and women were equally likely to use psychotropic drugs. Monotherapy was more common in men. Women were more likely to utilize ≥ 4 psychotropic drugs. Antidepressant drugs (ADDs) were the most prescribed drug class. Men had a higher utilization of noradrenergic and specific serotonergic antidepressants (RR 1.15; 95% CI 1.12-1.19), especially mirtazapine (RR 1.16; 95% CI 1.12-1.19), but also of other ADDs such as bupropion (RR 1.50; 95% CI 1.35-1.68). Males had a slightly higher utilization of second-generation antipsychotic drugs (RR 1.06; 95% CI 1.03-1.09) and were less often treated with low-potency first-generation antipsychotic drugs (RR 0.86; 95% CI 0.83-0.90). Tranquilizing (e.g., benzodiazepines; RR 0.89; 95% CI 0.86-0.92) and hypnotic drugs (e.g., Z-drugs; RR 0.85; 95% CI 0.81-0.89) were less utilized in the treatment of male patients. Not all sex differences were stable over time. More sex differences were detectable in 2015-2017 than in 2001-2003. Findings suggest that certain psychotropic drugs are preferred in the treatment of men vs. women, however, sex differences found in this study are not as large as in ambulatory settings. To make evidence-based sex-specific recommendations in the treatment of MDD, differences in drug response and tolerability need to be further researched.
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Affiliation(s)
- Johanna Seifert
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
| | - Fabienne Führmann
- Department of Psychiatry and Psychotherapy, KRH Psychiatrie GmbH, Wunstorf, Germany
| | - Matthias A Reinhard
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Rolf R Engel
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Xueqiong Bernegger
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Stefan Bleich
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Susanne Stübner
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Department of Forensic Psychiatry, Bezirksklinikum Ansbach, Ansbach, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Prosomno, Clinic for Sleep Medicine, Munich, Germany
| | - Sermin Toto
- Department of Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Renate Grohmann
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany
| | - Marcel Sieberer
- Department of Psychiatry, Psychotherapy, and Psychosomatics, St. Marien-Hospital Hamm gGmbH, Hamm, Germany.,Department of Psychiatry and Psychotherapy, University Witten/Herdecke, Witten, Germany
| | - Waldemar Greil
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Munich, Germany.,Psychiatric Private Hospital, Sanatorium Kilchberg, Kilchberg, Switzerland
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9
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Heck J, Seifert J, Stichtenoth DO, Schroeder C, Groh A, Szycik GR, Degner D, Adamovic I, Schneider M, Glocker C, Rüther E, Bleich S, Grohmann R, Toto S. A case series of serious and unexpected adverse drug reactions under treatment with cariprazine. Clin Case Rep 2021; 9:e04084. [PMID: 34084502 PMCID: PMC8142394 DOI: 10.1002/ccr3.4084] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 01/18/2021] [Revised: 02/15/2021] [Accepted: 03/14/2021] [Indexed: 01/20/2023] Open
Abstract
Reporting of new or unexpected adverse drug reactions of medicines that are subject to additional monitoring ("black triangle" label), such as the antipsychotic drug cariprazine, is of paramount importance to improve pharmacotherapy safety.
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Affiliation(s)
- Johannes Heck
- Institute for Clinical PharmacologyHannover Medical SchoolHannoverGermany
| | - Johanna Seifert
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Dirk O. Stichtenoth
- Institute for Clinical PharmacologyHannover Medical SchoolHannoverGermany
- Drug Commissioner of Hannover Medical SchoolHannoverGermany
| | - Christoph Schroeder
- Institute for Clinical PharmacologyHannover Medical SchoolHannoverGermany
- Head of Pharmacovigilance of Hannover Medical SchoolHannoverGermany
| | - Adrian Groh
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Gregor R. Szycik
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Detlef Degner
- Department of Psychiatry and PsychotherapyGeorg August University of GöttingenGöttingenGermany
| | - Ivana Adamovic
- Department of Psychiatry and PsychotherapyGeorg August University of GöttingenGöttingenGermany
| | - Michael Schneider
- University Clinic for Psychiatry and PsychotherapyBrandenburg Medical SchoolImmanuel KlinikRüdersdorfGermany
| | - Catherine Glocker
- Department of Psychiatry and PsychotherapyLudwig Maximilian University of MunichMunichGermany
| | - Eckart Rüther
- Department of Psychiatry and PsychotherapyLudwig Maximilian University of MunichMunichGermany
- Prosomno Klinik und Poliklinik für SchlafmedizinMunichGermany
| | - Stefan Bleich
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
| | - Renate Grohmann
- Department of Psychiatry and PsychotherapyLudwig Maximilian University of MunichMunichGermany
| | - Sermin Toto
- Department of PsychiatrySocial Psychiatry and PsychotherapyHannover Medical SchoolHannoverGermany
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10
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Rüther E, Hajak G, Huber L, Zech K, Trojan A. Die Bedeutung der Ethik bei der Nutzung Künstlicher emotionaler Intelligenz in der Psychiatrie – ein ethischer Diskurs. Psychiatr Prax 2021; 48:S58-S64. [PMID: 33652490 DOI: 10.1055/a-1364-8382] [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] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The ethical discourse addresses the following aspects: What do we need ethics for? Man's disposition to morality, natural ethics. Morality as a social norm. Morality to maintain an inhuman, superhuman power structure. Morality as an artifact of the brain, as a hindrance to new developments. Unity of ethics and aesthetics. "Zoon politikon", "Robinson Crusoe". Does Artificial Intelligence (AI) need new ethics? Characteristics of an AI, developed for loneliness, as a servant or with Christian software, group ability, own emotions, awareness and own ethics, as a supplement. Should AI be expected to have human emotions? Emotional intelligence, language as a mediator of emotions and empathy, the ability to mentalize, artificial (general) emotional intelligence, "Terminator", "L'Eve future".
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Affiliation(s)
- Eckart Rüther
- Prosomno Klinik für Schlafmedizin, München, Abt. für Schlafmedizin LMU München, Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Kompetenzzentrum für Klinische Studien Bremen/Biometrie, Universität Bremen
| | - Göran Hajak
- Klinik für Psychiatrie und Psychotherapie, Sozialstiftung Bamberg
| | - Lukas Huber
- Psychologische Fakultät, Universität Groningen
| | | | - Andreas Trojan
- Fakultät für Sprach- und Literaturwissenschaften, Komparatistik, LMU München
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11
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Kleineidam L, Chouraki V, Próchnicki T, van der Lee SJ, Madrid-Márquez L, Wagner-Thelen H, Karaca I, Weinhold L, Wolfsgruber S, Boland A, Martino Adami PV, Lewczuk P, Popp J, Brosseron F, Jansen IE, Hulsman M, Kornhuber J, Peters O, Berr C, Heun R, Frölich L, Tzourio C, Dartigues JF, Hüll M, Espinosa A, Hernández I, de Rojas I, Orellana A, Valero S, Stringa N, van Schoor NM, Huisman M, Scheltens P, Rüther E, Deleuze JF, Wiltfang J, Tarraga L, Schmid M, Scherer M, Riedel-Heller S, Heneka MT, Amouyel P, Jessen F, Boada M, Maier W, Schneider A, González-Pérez A, van der Flier WM, Wagner M, Lambert JC, Holstege H, Sáez ME, Latz E, Ruiz A, Ramirez A. PLCG2 protective variant p.P522R modulates tau pathology and disease progression in patients with mild cognitive impairment. Acta Neuropathol 2020; 139:1025-1044. [PMID: 32166339 PMCID: PMC7244617 DOI: 10.1007/s00401-020-02138-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 02/07/2023]
Abstract
A rare coding variant (rs72824905, p.P522R) conferring protection against Alzheimer’s disease (AD) was identified in the gene encoding the enzyme phospholipase-C-γ2 (PLCG2) that is highly expressed in microglia. To explore the protective nature of this variant, we employed latent process linear mixed models to examine the association of p.P522R with longitudinal cognitive decline in 3595 MCI patients, and in 10,097 individuals from population-based studies. Furthermore, association with CSF levels of pTau181, total tau, and Aβ1-42 was assessed in 1261 MCI patients. We found that MCI patients who carried the p.P522R variant showed a slower rate of cognitive decline compared to non-carriers and that this effect was mediated by lower pTau181 levels in CSF. The effect size of the association of p.P522R with the cognitive decline and pTau181 was similar to that of APOE-ε4, the strongest genetic risk factor for AD. Interestingly, the protective effect of p.P522R was more pronounced in MCI patients with low Aβ1-42 levels suggesting a role of PLCG2 in the response to amyloid pathology. In line with this hypothesis, we observed no protective effect of the PLCG2 variant on the cognitive decline in population-based studies probably due to the lower prevalence of amyloid positivity in these samples compared to MCI patients. Concerning the potential biological underpinnings, we identified a network of co-expressed proteins connecting PLCG2 to APOE and TREM2 using unsupervised co-regulatory network analysis. The network was highly enriched for the complement cascade and genes differentially expressed in disease-associated microglia. Our data show that p.P522R in PLCG2 reduces AD disease progression by mitigating tau pathology in the presence of amyloid pathology and, as a consequence, maintains cognitive function. Targeting the enzyme PLCG2 might provide a new therapeutic approach for treating AD.
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Affiliation(s)
- Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Vincent Chouraki
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
- Epidemiology and Public Health Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Tomasz Próchnicki
- Institute of Innate Immunity, University Hospitals Bonn, Bonn, Germany
| | - Sven J van der Lee
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Holger Wagner-Thelen
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Ilker Karaca
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Leonie Weinhold
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Évry, France
| | - Pamela V Martino Adami
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Białystok, Białystok, Poland
- Department of Biochemical Diagnostics, University Hospital of Białystok, Białystok, Poland
| | - Julius Popp
- Department of Psychiatry, Lausanne University Hospital, Prilly, Switzerland
- Department of Geriatric Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Frederic Brosseron
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Iris E Jansen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marc Hulsman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- DZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Claudine Berr
- INSERM, University Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
| | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, 53127, Bonn, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Christophe Tzourio
- Inserm, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, Bordeaux, France
| | - Jean-François Dartigues
- Inserm, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, Bordeaux, France
| | - Michael Hüll
- Department of Psychiatry and Psychotherapy, Center for Psychiatry, Clinic for Geriatric Psychiatry and Psychotherapy Emmendingen, University of Freiburg, Freiburg, Germany
| | - Ana Espinosa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Isabel Hernández
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar de Rojas
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Adelina Orellana
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
| | - Sergi Valero
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Najada Stringa
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC-Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Jean-Francois Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de Biologie François Jacob, CEA, Université Paris-Saclay, Évry, France
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Lluis Tarraga
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Matthias Schmid
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital of Bonn, Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Philippe Amouyel
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Merce Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anja Schneider
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jean-Charles Lambert
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE-Facteurs de risque Et déterminants moléculaires des maladies liées au vieillissement, Lille, France
| | - Henne Holstege
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mª Eugenia Sáez
- Andalusian Bioinformatics Research Centre (CAEBi), Seville, Spain
| | - Eicke Latz
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Institute of Innate Immunity, University Hospitals Bonn, Bonn, Germany
- Division of Infectious Diseases and Immunology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
- Centre for Molecular Inflammation Research (CEMIR), Norwegian University of Science and Technology, Trondheim, Norway
| | - Agustin Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades-Universitat Internacional de Catalunya-Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Alfredo Ramirez
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.
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Abstract
AbstractBackground– Earlier studies on the influence of pregnancy and postpartum period on the course of panic disorder have been inconsistent. The present study aims to quantify panic manifestations in these periods in large sample of women.Method– Panic manifestations, including exacerbations and new manifestations of panic disorder, were assessed retrospectively in a sample of 128 women with panic disorder with or without agoraphobia, 93 of whom had had 195 pregnancies.Results– Panic manifestations were fewer during pregnancy and more frequent in the postpartum period when compared with the control period. Women who had never been pregnant had significantly more panic manifestations than women with prior pregnancies. Breastfeeding and miscarriages did not have a significant effect. Women with postpartum panic reported more psychosocial stress events during this period.Conclusions– Possible reasons for postpartum panic and the protective effects of pregnancy are discussed, including psychosocial or hormonal factors and other neurobiological changes. Postpartum panic coincides with a sudden drop of hormones after delivery.
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Affiliation(s)
- Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany.
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13
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Hajak G, Clarenbach P, Fischer W, Haase W, Bandelow B, Adler L, Rüther E. Effects of hypnotics on sleep quality and daytime well-being. Data from a comparative multicentre study in outpatients with insomnia. Eur Psychiatry 2020; 10 Suppl 3:173s-9s. [DOI: 10.1016/0924-9338(96)80100-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
SummaryThe effect of treatment (28 days) with zopiclone, triazolam, flunitrazepam and placebo on sleep quality and daytime well-being was proven in a randomised, double-blind, parallel group, multicentre study in private practice. Results of an exploratory statistic of treatment efficacy in a subgroup of 1,291 patients suffering from insomnia are presented. Patients met the following criteria: insomnia lasting at least four weeks and the presence of at least two of the following: 1) sleep latency ≥ 45 minutes, 2) total sleep time ≤ 6 hours, and 3) nocturnal awakening ≥3 times. Treatment efficacy was assessed according to the following factors: either a shortening of sleep latency by at least 15 minutes, or prolongation of total sleep time by at least 20%, or reduction of the number of nocturnal awakenings to three or less and a refreshed feeling in the morning as well as no impairment in daytime well-being due to tiredness or anxiety. The total response rate was markedly higher with zopiclone (42.3%; p = 0.0003) than with placebo (29.0%). Triazolam (36.6%; p = 0.0905) and flunitrazepam (33.1%; p = 0.3401) were also more effective than the placebo, but they both tended to have a lower response rate than with zopiclone (p = 0.1199 and 0.0151, respectively). Total response was found to be essentially a reflection of the response of the socially important parameter of daytime well-being. These results suggest that zopiclone is more effective in the treatment of insomnia than either triazolam or flunitrazepam. Since the response of daytime well-being to therapy was generally poor, this parameter embodies the next main therapeutic challenge in the treatment of patients with insomnia.
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14
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Schennach R, Riedel M, Obermeier M, Seemüller F, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt L, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke M, Rüther E, Klingberg S, Gastpar M, Möller HJ. What are depressive symptoms in acutely ill patients with schizophrenia spectrum disorder? Eur Psychiatry 2020; 30:43-50. [DOI: 10.1016/j.eurpsy.2014.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 11/01/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022] Open
Abstract
AbstractBackground:Aim was to examine depressive symptoms in acutely ill schizophrenia patients on a single symptom basis and to evaluate their relationship with positive, negative and general psychopathological symptoms.Methods:Two hundred and seventy-eight patients suffering from a schizophrenia spectrum disorder were analysed within a naturalistic study by the German Research Network on Schizophrenia. Using the Calgary Depression Scale for Schizophrenia (CDSS) depressive symptoms were examined and the Positive and Negative Syndrome Scale (PANSS) was applied to assess positive, negative and general symptoms. Correlation and factor analyses were calculated to detect the underlying structure and relationship of the patient’s symptoms.Results:The most prevalent depressive symptoms identified were depressed mood (80%), observed depression (62%) and hopelessness (54%). Thirty-nine percent of the patients suffered from depressive symptoms when applying the recommended cut-off of a CDSS total score of > 6 points at admission. Negligible correlations were found between depressive and positive symptoms as well as most PANSS negative and global symptoms despite items on depression, guilt and social withdrawal. The factor analysis revealed that the factor loading with the PANSS negative items accounted for most of the data variance followed by a factor with positive symptoms and three depression-associated factors.Limitations:The naturalistic study design does not allow a sufficient control of study results for the effect of different pharmacological treatments possibly influencing the appearance of depressive symptoms.Conclusion:Results suggest that depressive symptoms measured with the CDSS are a discrete symptom domain with only partial overlap with positive or negative symptoms.
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15
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van Maurik IS, Vos SJ, Bos I, Bouwman FH, Teunissen CE, Scheltens P, Barkhof F, Frolich L, Kornhuber J, Wiltfang J, Maier W, Peters O, Rüther E, Nobili F, Frisoni GB, Spiru L, Freund-Levi Y, Wallin AK, Hampel H, Soininen H, Tsolaki M, Verhey F, Kłoszewska I, Mecocci P, Vellas B, Lovestone S, Galluzzi S, Herukka SK, Santana I, Baldeiras I, de Mendonça A, Silva D, Chetelat G, Egret S, Palmqvist S, Hansson O, Visser PJ, Berkhof J, van der Flier WM. Biomarker-based prognosis for people with mild cognitive impairment (ABIDE): a modelling study. Lancet Neurol 2019; 18:1034-1044. [PMID: 31526625 DOI: 10.1016/s1474-4422(19)30283-2] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Biomarker-based risk predictions of dementia in people with mild cognitive impairment are highly relevant for care planning and to select patients for treatment when disease-modifying drugs become available. We aimed to establish robust prediction models of disease progression in people at risk of dementia. METHODS In this modelling study, we included people with mild cognitive impairment (MCI) from single-centre and multicentre cohorts in Europe and North America: the European Medical Information Framework for Alzheimer's Disease (EMIF-AD; n=883), Alzheimer's Disease Neuroimaging Initiative (ADNI; n=829), Amsterdam Dementia Cohort (ADC; n=666), and the Swedish BioFINDER study (n=233). Inclusion criteria were a baseline diagnosis of MCI, at least 6 months of follow-up, and availability of a baseline Mini-Mental State Examination (MMSE) and MRI or CSF biomarker assessment. The primary endpoint was clinical progression to any type of dementia. We evaluated performance of previously developed risk prediction models-a demographics model, a hippocampal volume model, and a CSF biomarkers model-by evaluating them across cohorts, incorporating different biomarker measurement methods, and determining prognostic performance with Harrell's C statistic. We then updated the models by re-estimating parameters with and without centre-specific effects and evaluated model calibration by comparing observed and expected survival. Finally, we constructed a model combining markers for amyloid deposition, tauopathy, and neurodegeneration (ATN), in accordance with the National Institute on Aging and Alzheimer's Association research framework. FINDINGS We included all 2611 individuals with MCI in the four cohorts, 1007 (39%) of whom progressed to dementia. The validated demographics model (Harrell's C 0·62, 95% CI 0·59-0·65), validated hippocampal volume model (0·67, 0·62-0·72), and updated CSF biomarkers model (0·72, 0·68-0·74) had adequate prognostic performance across cohorts and were well calibrated. The newly constructed ATN model had the highest performance (0·74, 0·71-0·76). INTERPRETATION We generated risk models that are robust across cohorts, which adds to their potential clinical applicability. The models could aid clinicians in the interpretation of CSF biomarker and hippocampal volume results in individuals with MCI, and help research and clinical settings to prepare for a future of precision medicine in Alzheimer's disease. Future research should focus on the clinical utility of the models, particularly if their use affects participants' understanding, emotional wellbeing, and behaviour. FUNDING ZonMW-Memorabel.
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Affiliation(s)
- Ingrid S van Maurik
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.
| | - Stephanie J Vos
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Isabelle Bos
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Femke H Bouwman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Lutz Frolich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, Medical Faculty Mannheim University of Heidelberg, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Erlangen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August-University, Göttingen, Germany; German Center for Neurodegenerative Diseases, Göttingen, Germany; iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Gerotopsychiatry, University of Bonn, German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Flavio Nobili
- Clinical Neurology, Department of Neurosciences, University of Genoa, Genoa, Italy; Neurology Department, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni B Frisoni
- Memory Clinic, University Hospital and University of Geneva, Geneva, Switzerland
| | - Luiza Spiru
- Geriatrics, Gerontology and Old Age Psychiatry Clinical Department, Carol Davila University of Medicine and Pharmacy-"Elias" Emergency Clinical Hospital, Bucharest, Romania; Memory Clinic and Longevity Medicine, Ana Aslan International Foundation, Romania
| | - Yvonne Freund-Levi
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden; Department of Old Age Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Asa K Wallin
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden
| | - Harald Hampel
- Alzheimer Precision Medicine, GRC 21, Sorbonne University, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Eisai, Neurology Business Group, Woodcliff Lake, NJ, USA
| | - Hilkka Soininen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Magda Tsolaki
- 1st Department of Neurology, Aristotle University of Thessaloniki, Memory and Dementia Center, "AHEPA" General Hospital, Thessaloniki, Greece
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Iwona Kłoszewska
- Department of Geriatric Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland
| | - Patrizia Mecocci
- Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Perugia, Italy
| | | | | | - Samantha Galluzzi
- Lab Alzheimer's Neuroimaging and Epidemiology, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Ines Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Department of Neurology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - Dina Silva
- Institute of Molecular Medicine, University of Lisbon, Lisbon, Portugal; Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Centre for Biomedical Research, Universidade do Algarve, Faro, Portugal
| | - Gael Chetelat
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | - Stephanie Egret
- Université Normandie, Inserm, Université de Caen-Normandie, Inserm UMR-S U1237, GIP Cyceron, Caen, France
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, Netherlands
| | - Johannes Berkhof
- Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
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Schennach R, Obermeier M, Spellmann I, Seemüller F, Musil R, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Bauer M, Adli M, Zeiler J, Bender W, Kronmüller KT, Ising M, Brieger P, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Möller HJ, Riedel M. Remission in schizophrenia - What are we measuring? Comparing the consensus remission criteria to a CGI-based definition of remission and to remission in major depression. Schizophr Res 2019; 209:185-192. [PMID: 31138482 DOI: 10.1016/j.schres.2019.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 03/03/2019] [Accepted: 04/26/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite being recommended for use in clinical trials, the consensus remission criteria were found to leave patients with persisting symptoms, relevant areas of functional impairment and a decreased sense of wellbeing. Therefore, to evaluate the appropriateness of the schizophrenia consensus criteria, a definition of remission based on the Clinical Global Impression Scale (CGI) was developed and remitter subgroups were compared. METHODS 239 patients with a schizophrenia spectrum disorder were evaluated regarding their remission status after inpatient treatment. Remission in schizophrenia was defined according to the symptom-severity component of the consensus criteria by Andreasen et al. and a CGI based definition was calculated using sensitivity and specificity using receiver operating curves (asymptomatic remitter). Both remitter groups (schizophrenia consensus versus asymptomatic remitters) were compared regarding different clinical variables at discharge as well as the likelihood to relapse within a 1-year follow-up period. Both schizophrenia remitter subgroups were compared to remitters in major depression as a reference value. RESULTS Following the consensus criteria, 63% of the schizophrenia patients were in remission compared to only 18% following the asymptomatic criterion. The schizophrenia consensus remitters were less likely to be concurrent treatment responders (p < 0.0001), had a significantly greater illness severity (p < 0.0001) and less functioning (p = 0.0358) as well as a significantly greater risk to relapse (p = 0.0174) compared to the schizophrenia asymptomatic remitters as well as the depressed remitters. CONCLUSION It should be critically re-evaluated if the currently proposed consensus criteria are adequate to measure what is traditionally understood to be remission.
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Affiliation(s)
- Rebecca Schennach
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Schön Clinic Roseneck, Germany.
| | - Michael Obermeier
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Ilja Spellmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Department of Special Psychiatry, Social Psychiatry and Psychotherapy, Klinikum Stuttgart, Germany
| | - Florian Seemüller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Jäger
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Department of Psychiatry, Psychosomatic and Psychotherapy, Bezirkskrankenhaus Kempten, Germany
| | - Max Schmauss
- Psychiatric Clinic, District Hospital Augsburg, Germany
| | - Gerd Laux
- Psychiatric Clinic, Inn-Salzach Hospital Wasserburg/Inn, Germany
| | - Herbert Pfeiffer
- Department of Psychiatry and Psychotherapy Munich East, kbo-Isar-Amper-Klinikum Haar, Germany
| | - Dieter Naber
- Department of Psychiatry and Psychotherapy, University of Hamburg, Germany
| | - Lutz G Schmidt
- Department of Psychiatry and Psychotherapy, University of Mainz, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Dusseldorf, Germany
| | | | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charite Berlin, Campus Benjamin Franklin, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - Joachim Zeiler
- Department of Psychiatry and Psychotherapy, Auguste-Viktoria-Krankenhaus Berlin, Germany
| | - Wolfram Bender
- Department of Psychiatry and Psychotherapy Munich East, kbo-Isar-Amper-Klinikum Haar, Germany
| | | | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Peter Brieger
- Department of Psychiatry and Psychotherapy Munich East, kbo-Isar-Amper-Klinikum Haar, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
| | | | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Markus Gastpar
- Department of Psychiatry and Psychotherapy, University of Essen, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Riedel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany; Psychiatric Clinic Rodewisch, Rodewisch, Germany
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17
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Veselinović T, Scharpenberg M, Heinze M, Cordes J, Mühlbauer B, Juckel G, Habel U, Rüther E, Timm J, Gründer G. Disparate effects of first and second generation antipsychotics on cognition in schizophrenia - Findings from the randomized NeSSy trial. Eur Neuropsychopharmacol 2019; 29:720-739. [PMID: 30981585 DOI: 10.1016/j.euroneuro.2019.03.014] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 01/25/2019] [Accepted: 03/27/2019] [Indexed: 12/15/2022]
Abstract
Cognitive impairment represents a core feature of schizophrenia. Uncertainty about demonstrable benefits of available antipsychotics on cognition remains an important clinical question relevant to patients' quality of life. The aim of our multi-center, randomized, double-blind "Neuroleptic Strategy Study" (NeSSy) was to compare the effectiveness of selected antipsychotics, conventionally classified as second- (SGAs) (haloperidol, flupentixol) and first generation antipsychotics (FGAs) (aripiprazole, olanzapine, quetiapine), on quality of life in schizophrenia. The effects on cognitive deficits represented a secondary outcome. We used an innovative double randomization for assignment of treatment group, and followed the patients with a neurocognitive test-battery upon six and 24 weeks of treatment. Psychopathology and quality of life were assessed using CGI, PANSS and SF-36. Assessment of cognitive performance was conducted in 114 of the 136 randomized patients. The SGA group (N = 62) showed beneficial effects of small to moderate effect size on cognition during the initial six weeks of treatment (executive functions, verbal fluency) and at 24 weeks (executive functions, working memory). In contrast, the FGA group (N = 52) showed moderately improved executive function, but a decline in verbal fluency at six weeks, with significant declines of moderate to large effect size in executive function, verbal learning and memory, and verbal fluency at 24 weeks. Our study indicates that SGAs present an advantage over FGAs regarding cognitive function during a medium-term treatment for schizophrenia. The results further emphasize a distinction between progression to detrimental effects of FGAs with prolonged treatment in contrast to more persistent cognitive benefits with SGA treatment.
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Affiliation(s)
- Tanja Veselinović
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany.
| | - Martin Scharpenberg
- Competence Center for Clinical Trials - Biometry, University of Bremen, Bremen, Germany
| | - Martin Heinze
- Department of Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik, Rüdersdorf, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bernd Mühlbauer
- Competence Center for Clinical Trials - Biometry, University of Bremen, Bremen, Germany; Department of Pharmacology, Klinikum Bremen Mitte, Bremen, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Jürgen Timm
- Competence Center for Clinical Trials - Biometry, University of Bremen, Bremen, Germany
| | - Gerhard Gründer
- Department of Molecular Neuroimaging, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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18
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Bibl M, Gallus M, Welge V, Esselmann H, Wolf S, Rüther E, Wiltfang J. Correction to: Cerebrospinal fluid amyloid-β 2-42 is decreased in Alzheimer's, but not in frontotemporal dementia. J Neural Transm (Vienna) 2018; 125:1515-1516. [PMID: 30159607 DOI: 10.1007/s00702-018-1914-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The respective first and last authors of this article, Mirko Bibl and Jens Wiltfang, would like to clarify the issue of the seeming duplicate publication of a figure in two articles.
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Affiliation(s)
- Mirko Bibl
- Department of Psychiatry, University of Goettingen, von-Siebold-Str. 5, 37075, Goettingen, Germany. .,Praxis für ärztliche Psychotherapie, Gartenstrasse 2, 40822, Mettmann, Germany.
| | - Marion Gallus
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Henricistrasse 92, 45136, Essen, Germany
| | - Volker Welge
- Department of Psychiatry, Psychotherapy and Addiction Medicine, Kliniken Essen-Mitte, University of Duisburg-Essen, Henricistrasse 92, 45136, Essen, Germany
| | - Hermann Esselmann
- Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, 45147, Essen, Germany
| | - Stefanie Wolf
- Department of Psychiatry, University of Goettingen, von-Siebold-Str. 5, 37075, Goettingen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Geschwister-Scholl-Platz 1, 80539, Munich, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Duisburg-Essen, 45147, Essen, Germany.,Clinic of Psychiatry and Psychotherapy, University Medical Center, Von-Siebold-Strasse 5, 37075, Göttingen, Germany
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19
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Joachim LK, Frölich L, Rüther E, Wiltfang J, Maier W, Kornhuber J, Bauer C, Heuser I, Peters O. Correlation of CSF- and MRI-Biomarkers and Progression of Cognitive Decline in an Open Label MCI Trial. J Prev Alzheimers Dis 2018; 5:202-206. [PMID: 29972214 DOI: 10.14283/jpad.2018.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND In several randomized controlled trials (RCT) acetylcholinesterase-inhibitors (AChE-I) were tested in patients with mild cognitive impairment (MCI) but were ineffective in delaying disease progression as determined by neuropsychological testing only. Here we present data from an open label observational extension of a multicenter RCT in order to assess if biomarkers are providing useful additional information about a drug's efficacy. We followed 83 amnestic MCI patients and performed correlational analyses of Aβ 1-42 and total-Tau in the cerebrospinal fluid (CSF), hippocampal and amygdala volume at baseline, the total duration of blinded and open label AChE-I treatment and the outcome 24 months after inclusion into the RCT. Twelve out of 83 amnestic MCI (14%) had progressed to Alzheimer's disease (AD). Overall, worsening and disease progression as measured by the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog), Alzheimer's Disease Cooperative Study - Activities of Daily Living (ADCS-ADL) and Clinical Dementia Rating (CDR) did not correlate with the duration of AChE-I treatment. However, a specific multidimensional biomarker profile at baseline indicated more reliably than cognitive testing alone progression to AD. We conclude that pharmacological RCTs testing symptomatic treatment effects in MCI should include biomarker assessment.
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Affiliation(s)
- L K Joachim
- Oliver Peters, Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203 Berlin, Germany, Tel.: +49-30-450-517628, Fax.: +49-30-450-517942,
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20
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Stübner S, Grohmann R, Greil W, Zhang X, Müller-Oerlinghausen B, Bleich S, Rüther E, Möller HJ, Engel R, Falkai P, Toto S, Kasper S, Neyazi A. Suicidal Ideation and Suicidal Behavior as Rare Adverse Events of Antidepressant Medication: Current Report from the AMSP Multicenter Drug Safety Surveillance Project. Int J Neuropsychopharmacol 2018; 21:814-821. [PMID: 29939264 PMCID: PMC6119288 DOI: 10.1093/ijnp/pyy048] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/15/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Suicidal ideations, suicide attempts, and fatal suicides are rare adverse drug reactions to antidepressant drugs, but they essentially are clinically relevant. Drawing on a larger dataset of the European drug surveillance program, the present naturalistic study updates a previous contribution (Stübner et al., 2010). METHODS First an analysis of the comprehensive data collected in 81 psychiatric hospitals from 1993 to 2014 by the European drug surveillance program Arzneimittelsicherheit in der Psychiatrie was made. All documented single cases of suicidal ideations or behavior judged as adverse drug reactions to antidepressant drugs were carefully assessed as to their clinical features and drug prescriptions. RESULTS Among 219,635 adult hospitalized patients taking antidepressant drugs under surveillance, 83 cases of suicidal adverse drug reactions occurred (0.04%): 44 cases of suicidal ideation, 34 attempted suicides, and 5 committed suicides were documented. Restlessness was present in 42 patients, ego-dystonic intrusive suicidal thoughts or urges in 39 patients, impulsiveness in 22 patients, and psychosis in 7 patients. Almost all adverse drug reactions occurred shortly after beginning antidepressant drug medication or increasing the dosage. Selective serotonin reuptake inhibitors caused a higher incidence of suicidal ideation and suicidal behavior as adverse drug reactions than noradrenergic and specific serotonergic antidepressants or tricyclic antidepressants, as did monotherapy consisting of one antidepressant drug, compared to combination treatments. CONCLUSIONS The study supports the view that antidepressant drug-triggered suicidal ideation and suicidal behavior (primarily with selective serotonin reuptake inhibitors) are rare. Special clinical features (restlessness, ego-dystonic thoughts or urges, impulsiveness) may be considered as possible warning signs. A combination therapy might be preferable to antidepressant drug monotherapy when beginning treatment.
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Affiliation(s)
- Susanne Stübner
- Department of Psychiatry, Kbo-IAK, Academic Teaching Hospital of the Ludwig-Maximilian University, Haar/ Munich, Germany,Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany,Correspondence: Susanne Stübner, PD Dr, Department of Psychiatry, Kbo-IAK, Academic teaching hospital of the Ludwig-Maximilian, University, School of Medicine, Vockestraße 72, 85540 Haar/ Munich ()
| | - Renate Grohmann
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany
| | - Waldemar Greil
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany,Psychiatric Hospital Kilchberg /Zurich, Switzerland
| | - Xueqiong Zhang
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany,Psychiatric Hospital Kilchberg /Zurich, Switzerland
| | | | - Stefan Bleich
- Department of Psychiatry, Hannover Medical School, Hannover, Germany
| | - Eckart Rüther
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany,Department of Psychiatry, Georg August University, Göttingen, Germany
| | | | - Rolf Engel
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry, Ludwig-Maximilian University, Munich, Germany
| | - Sermin Toto
- Department of Psychiatry, Hannover Medical School, Hannover, Germany
| | | | - Alexandra Neyazi
- Department of Psychiatry, Hannover Medical School, Hannover, Germany
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21
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Mattsson N, Groot C, Jansen WJ, Landau SM, Villemagne VL, Engelborghs S, Mintun MM, Lleo A, Molinuevo JL, Jagust WJ, Frisoni GB, Ivanoiu A, Chételat G, Resende de Oliveira C, Rodrigue KM, Kornhuber J, Wallin A, Klimkowicz-Mrowiec A, Kandimalla R, Popp J, Aalten PP, Aarsland D, Alcolea D, Almdahl IS, Baldeiras I, van Buchem MA, Cavedo E, Chen K, Cohen AD, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Gill KD, Gkatzima O, Grimmer T, Hampel H, Herukka SK, Johannsen P, van Laere K, de Leon MJ, Maier W, Marcusson J, Meulenbroek O, Møllergård HM, Morris JC, Mroczko B, Nordlund A, Prabhakar S, Peters O, Rami L, Rodríguez-Rodríguez E, Roe CM, Rüther E, Santana I, Schröder J, Seo SW, Soininen H, Spiru L, Stomrud E, Struyfs H, Teunissen CE, Verhey FRJ, Vos SJB, van Waalwijk van Doorn LJC, Waldemar G, Wallin ÅK, Wiltfang J, Vandenberghe R, Brooks DJ, Fladby T, Rowe CC, Drzezga A, Verbeek MM, Sarazin M, Wolk DA, Fleisher AS, Klunk WE, Na DL, Sánchez-Juan P, Lee DY, Nordberg A, Tsolaki M, Camus V, Rinne JO, Fagan AM, Zetterberg H, Blennow K, Rabinovici GD, Hansson O, van Berckel BNM, van der Flier WM, Scheltens P, Visser PJ, Ossenkoppele R. Prevalence of the apolipoprotein E ε4 allele in amyloid β positive subjects across the spectrum of Alzheimer's disease. Alzheimers Dement 2018; 14:913-924. [PMID: 29601787 DOI: 10.1016/j.jalz.2018.02.009] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 12/28/2017] [Accepted: 02/07/2018] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Apolipoprotein E (APOE) ε4 is the major genetic risk factor for Alzheimer's disease (AD), but its prevalence is unclear because earlier studies did not require biomarker evidence of amyloid β (Aβ) pathology. METHODS We included 3451 Aβ+ subjects (853 AD-type dementia, 1810 mild cognitive impairment, and 788 cognitively normal). Generalized estimating equation models were used to assess APOE ε4 prevalence in relation to age, sex, education, and geographical location. RESULTS The APOE ε4 prevalence was 66% in AD-type dementia, 64% in mild cognitive impairment, and 51% in cognitively normal, and it decreased with advancing age in Aβ+ cognitively normal and Aβ+ mild cognitive impairment (P < .05) but not in Aβ+ AD dementia (P = .66). The prevalence was highest in Northern Europe but did not vary by sex or education. DISCUSSION The APOE ε4 prevalence in AD was higher than that in previous studies, which did not require presence of Aβ pathology. Furthermore, our results highlight disease heterogeneity related to age and geographical location.
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Affiliation(s)
- Niklas Mattsson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden.
| | - Colin Groot
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Willemijn J Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | | | - Alberto Lleo
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Giovanni B Frisoni
- Memory Clinic and LANVIE- Laboratory of Neuroimaging of Aging, University Hospitals, and University of Geneva, Geneva, Switzerland; Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Adrian Ivanoiu
- Memory Clinic and Neurochemistry Laboratory, Saint Luc University Hospital, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Gaël Chételat
- Inserm, Inserm UMR-S U1237, Université de Caen-Normandie, GIP Cyceron, Caen, France
| | - Catarina Resende de Oliveira
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, USA
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen- Nuremberg, Erlangen, Germany
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | | | - Ramesh Kandimalla
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Julius Popp
- Department of Psychiatry, Service of Old Age Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Pauline P Aalten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Ina S Almdahl
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Enrica Cavedo
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Paris, France
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Ann D Cohen
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Stefan Förster
- Department of Nuclear Medicine, Technische Universitaet München, Munich, Germany
| | - Juan Fortea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Department of Geriatrics, Karolinska University Hospital Huddinge, Section of Clinical Geriatrics, Institution of NVS, Karolinska Institutet, Stockholm, Sweden
| | - Kiran Dip Gill
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Olymbia Gkatzima
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universitaet München, Munich, Germany
| | - Harald Hampel
- AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie (UPMC) Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière (ICM), Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Salpêtrière, Paris, France; Department of Psychiatry, Alzheimer Memorial Center and Geriatric Psychiatry Branch, Ludwig-Maximilian University, Munich, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Peter Johannsen
- Memory Clinic, Danish Dementia Research Center, Rigshospitalet, Copenhagen, Denmark
| | - Koen van Laere
- Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - Mony J de Leon
- School of Medicine, Center for Brain Health, New York University, New York, NY, USA
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Marcusson
- Geriatric Medicine, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanne M Møllergård
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Leading National Research Centre in Białystok (KNOW), Medical University of Białystok, Białystok, Poland
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Sudesh Prabhakar
- Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - Eloy Rodríguez-Rodríguez
- Neurology Service, Universitary Hospital Marqués de Valdecilla, CIBERNED, IDIVAL, Santander, Spain
| | - Catherine M Roe
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Johannes Schröder
- Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany
| | - Sang W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Luiza Spiru
- Department of Geriatrics-Gerontology-Gerontopsychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Erik Stomrud
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Linda J C van Waalwijk van Doorn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Åsa K Wallin
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer Research Centre KU Leuven, Catholic University Leuven, Leuven, Belgium
| | - David J Brooks
- Division of Neuroscience, Medical Research Council Clinical Sciences Centre, Imperial College London, London, UK
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Marcel M Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Adam S Fleisher
- Banner Alzheimer's Institute, Phoenix, AZ, USA; Eli Lilly, Indianapolis, IN, USA; Department of Neurosciences, University of California, San Diego, CA, USA
| | - William E Klunk
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Pascual Sánchez-Juan
- Neurology Service, Universitary Hospital Marqués de Valdecilla, CIBERNED, IDIVAL, Santander, Spain
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Agneta Nordberg
- Department NVS, Center for Alzheimer Research, Translational Alzheimer Neurobiology, Karolinska Institutet and Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Magda Tsolaki
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vincent Camus
- CHRU de Tours, CIC INSERM 1415, INSERM U930, Université François Rabelais de Tours, Tours, France
| | - Juha O Rinne
- Turku PET Centre and Division of Clinical Neurosciences Turku, University of Turku and Turku University Hospital, Turku, Finland
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute, London, UK; Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Sweden and Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden; Sweden and Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, CA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden; Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands; Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands.
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Wolfsgruber S, Polcher A, Koppara A, Kleineidam L, Frölich L, Peters O, Hüll M, Rüther E, Wiltfang J, Maier W, Kornhuber J, Lewczuk P, Jessen F, Wagner M. Cerebrospinal Fluid Biomarkers and Clinical Progression in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment. J Alzheimers Dis 2018; 58:939-950. [PMID: 28527210 DOI: 10.3233/jad-161252] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is very limited data on the prevalence of abnormal cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) and their predictive value for clinical progression in memory clinic patients with subjective cognitive decline (SCD). OBJECTIVE To assess the frequency of abnormal CSF biomarkers of AD and their predictive value for clinical progression in memory clinic patients with SCD in comparison to patients with mild cognitive impairment (MCI) from the same cohort. METHODS We analyzed prospective data from memory clinic patients of the German Competence Network Dementia cohort with a baseline diagnosis of SCD (n = 82) or MCI (n = 134), distinguished by actuarial neuropsychological MCI criteria ("Jak-Bondi criteria"). Risk of clinical progression during 3-year follow-up was evaluated with Cox-Proportional-Hazard models. RESULTS Prevalence of abnormal values in CSF markers of tau-mediated neurodegeneration (67.8% versus 46.3%) but not of amyloid deposition (40.3% versus 35.4%) was significantly higher in MCI compared to SCD. The rate of incident AD dementia (26.1% versus 12.2%) was also significantly higher in MCI. In SCD, additional 22% progressed to MCI during follow-up. Combined amyloid/tau abnormality was the strongest predictor of clinical progression in both groups. CONCLUSION High prevalence of biomarker abnormality and clinical progression, together with the predictive value of CSF biomarkers, in memory clinic patients with SCD support the validity and usefulness of this condition as a "pre-MCI" at risk stage of AD.
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Affiliation(s)
- Steffen Wolfsgruber
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Alexandra Polcher
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Alexander Koppara
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Luca Kleineidam
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Lutz Frölich
- Department of Gerontopsychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Michael Hüll
- Center for Geriatric Medicine and Gerontology, University of Freiburg, Germany
| | - Eckart Rüther
- Department ofPsychiatry and Psychotherapy, University of Göttingen, Germany
| | - Jens Wiltfang
- Department ofPsychiatry and Psychotherapy, University of Göttingen, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Biasłystok, and Departmentof Biochemical Diagnostics, University Hospital of Bialystok, Bialystok, Poland
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Bonn, Germany.,Department of Psychiatry, University of Cologne, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
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23
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Jansen WJ, Ossenkoppele R, Tijms BM, Fagan AM, Hansson O, Klunk WE, van der Flier WM, Villemagne VL, Frisoni GB, Fleisher AS, Lleó A, Mintun MA, Wallin A, Engelborghs S, Na DL, Chételat G, Molinuevo JL, Landau SM, Mattsson N, Kornhuber J, Sabri O, Rowe CC, Parnetti L, Popp J, Fladby T, Jagust WJ, Aalten P, Lee DY, Vandenberghe R, Resende de Oliveira C, Kapaki E, Froelich L, Ivanoiu A, Gabryelewicz T, Verbeek MM, Sanchez-Juan P, Hildebrandt H, Camus V, Zboch M, Brooks DJ, Drzezga A, Rinne JO, Newberg A, de Mendonça A, Sarazin M, Rabinovici GD, Madsen K, Kramberger MG, Nordberg A, Mok V, Mroczko B, Wolk DA, Meyer PT, Tsolaki M, Scheltens P, Verhey FRJ, Visser PJ, Aarsland D, Alcolea D, Alexander M, Almdahl IS, Arnold SE, Baldeiras I, Barthel H, van Berckel BNM, Blennow K, van Buchem MA, Cavedo E, Chen K, Chipi E, Cohen AD, Förster S, Fortea J, Frederiksen KS, Freund-Levi Y, Gkatzima O, Gordon MF, Grimmer T, Hampel H, Hausner L, Hellwig S, Herukka SK, Johannsen P, Klimkowicz-Mrowiec A, Köhler S, Koglin N, van Laere K, de Leon M, Lisetti V, Maier W, Marcusson J, Meulenbroek O, Møllergård HM, Morris JC, Nordlund A, Novak GP, Paraskevas GP, Perera G, Peters O, Ramakers IHGB, Rami L, Rodríguez-Rodríguez E, Roe CM, Rot U, Rüther E, Santana I, Schröder J, Seo SW, Soininen H, Spiru L, Stomrud E, Struyfs H, Teunissen CE, Vos SJB, van Waalwijk van Doorn LJC, Waldemar G, Wallin ÅK, Wiltfang J, Zetterberg H. Association of Cerebral Amyloid-β Aggregation With Cognitive Functioning in Persons Without Dementia. JAMA Psychiatry 2018; 75:84-95. [PMID: 29188296 PMCID: PMC5786156 DOI: 10.1001/jamapsychiatry.2017.3391] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Cerebral amyloid-β aggregation is an early event in Alzheimer disease (AD). Understanding the association between amyloid aggregation and cognitive manifestation in persons without dementia is important for a better understanding of the course of AD and for the design of prevention trials. OBJECTIVE To investigate whether amyloid-β aggregation is associated with cognitive functioning in persons without dementia. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 2908 participants with normal cognition and 4133 with mild cognitive impairment (MCI) from 53 studies in the multicenter Amyloid Biomarker Study. Normal cognition was defined as having no cognitive concerns for which medical help was sought and scores within the normal range on cognitive tests. Mild cognitive impairment was diagnosed according to published criteria. Study inclusion began in 2013 and is ongoing. Data analysis was performed in January 2017. MAIN OUTCOMES AND MEASURES Global cognitive performance as assessed by the Mini-Mental State Examination (MMSE) and episodic memory performance as assessed by a verbal word learning test. Amyloid aggregation was measured with positron emission tomography or cerebrospinal fluid biomarkers and dichotomized as negative (normal) or positive (abnormal) according to study-specific cutoffs. Generalized estimating equations were used to examine the association between amyloid aggregation and low cognitive scores (MMSE score ≤27 or memory z score≤-1.28) and to assess whether this association was moderated by age, sex, educational level, or apolipoprotein E genotype. RESULTS Among 2908 persons with normal cognition (mean [SD] age, 67.4 [12.8] years), amyloid positivity was associated with low memory scores after age 70 years (mean difference in amyloid positive vs negative, 4% [95% CI, 0%-7%] at 72 years and 21% [95% CI, 10%-33%] at 90 years) but was not associated with low MMSE scores (mean difference, 3% [95% CI, -1% to 6%], P = .16). Among 4133 patients with MCI (mean [SD] age, 70.2 [8.5] years), amyloid positivity was associated with low memory (mean difference, 16% [95% CI, 12%-20%], P < .001) and low MMSE (mean difference, 14% [95% CI, 12%-17%], P < .001) scores, and this association decreased with age. Low cognitive scores had limited utility for screening of amyloid positivity in persons with normal cognition and those with MCI. In persons with normal cognition, the age-related increase in low memory score paralleled the age-related increase in amyloid positivity with an intervening period of 10 to 15 years. CONCLUSIONS AND RELEVANCE Although low memory scores are an early marker of amyloid positivity, their value as a screening measure for early AD among persons without dementia is limited.
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Affiliation(s)
- Willemijn J. Jansen
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Radiology and Nuclear Medicine, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Neurology, Memory and Aging Center,
University of California, San Francisco,Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Betty M. Tijms
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center,
Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Oskar Hansson
- Clinical Memory Research Unit, Clinical Sciences
Malmö, Lund University, Lund, Sweden
| | - William E. Klunk
- Department of Psychiatry, University of Pittsburgh
School of Medicine, Pittsburgh, Pennsylvania
| | - Wiesje M. van der Flier
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands,Department of Epidemiology and Biostatistics, VU
University Medical Center, Amsterdam, the Netherlands
| | - Victor L. Villemagne
- Department of Nuclear Medicine and Centre for PET,
Austin Health, Melbourne, Australia
| | - Giovanni B. Frisoni
- Laboratory of Alzheimer's Neuroimaging and
Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy,Memory Clinic and LANVIE–Laboratory of
Neuroimaging of Aging, University Hospitals, and University of Geneva, Geneva, Switzerland
| | - Adam S. Fleisher
- Banner Alzheimer’s Institute, Phoenix,
Arizona,Eli Lilly and Company, Indianapolis, Indiana,Department of Neurosciences, University of
California, San Diego
| | - Alberto Lleó
- Neurology Department, Hospital de Sant Pau,
Barcelona, Spain
| | | | - Anders Wallin
- Institute of Neuroscience and Physiology,
Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia
(BIODEM), University of Antwerp, Antwerp, Belgium
| | - Duk L. Na
- Department of Neurology, Samsung Medical Center,
Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gäel Chételat
- Institut National de la Santé et de la
Recherche Médicale (INSERM), CHU de Caen, Caen, France
| | - José Luis Molinuevo
- Alzheimer’s Disease and Other Cognitive
Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - Susan M. Landau
- Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Niklas Mattsson
- Clinical Memory Research Unit, Clinical Sciences
Malmö, Lund University, Lund, Sweden
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy,
Friedrich-Alexander University of Erlangen–Nuremberg, Erlangen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of
Leipzig, Leipzig, Germany
| | - Christopher C. Rowe
- Knight Alzheimer’s Disease Research Center,
Department of Neurology, Washington University School of Medicine, St Louis, Missouri,Department of Nuclear Medicine and Centre for PET,
Austin Health, Melbourne, Australia
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory
Disturbances, University of Perugia, Perugia, Italy
| | - Julius Popp
- Department of Psychiatry, Service of Old Age
Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Tormod Fladby
- Department of Neurology, Akershus University
Hospital, Lørenskog, Norway
| | - William J. Jagust
- Helen Wills Neuroscience Institute, University of
California, Berkeley
| | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National
University, College of Medicine, Seoul, South Korea
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer
Research Centre KU Leuven, Catholic University Leuven, Leuven, Belgium
| | - Catarina Resende de Oliveira
- Center for Neuroscience and Cell Biology, Faculty of
Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Elisabeth Kapaki
- First Department of Neurology, Eginition Hospital,
Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central
Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim,
Germany
| | - Adrian Ivanoiu
- Memory Clinic and Neurochemistry Laboratory, Saint
Luc University Hospital, Institute of Neuroscience, Université catholique de Louvain,
Brussels, Belgium
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders,
Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Marcel M. Verbeek
- Departments of Neurology and Laboratory Medicine,
Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud
University Medical Center, Nijmegen, the Netherlands
| | - Páscual Sanchez-Juan
- Neurology Service, Universitary Hospital
Marqués de Valdecilla, IDIVAL, Santander, Spain
| | | | - Vincent Camus
- CHRU de Tours, CIC INSERM 1415, INSERM U930, and
Université François Rabelais de Tours, Tours, France
| | - Marzena Zboch
- Alzheimer Center, Wroclaw Medical University,
Scinawa, Poland
| | - David J. Brooks
- Division of Neuroscience, Medical Research Council
Clinical Sciences Centre, Imperial College London, London, England
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of
Cologne, Cologne, Germany
| | - Juha O. Rinne
- Turku PET Centre and Division of Clinical
Neurosciences Turku, University of Turku and Turku University Hospital, Turku, Finland
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas
Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Alexandre de Mendonça
- Institute of Molecular Medicine and Faculty of
Medicine, University of Lisbon, Lisbon, Portugal
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre
Hospitalier Sainte-Anne, Université Paris 5, Paris, France
| | - Gil D. Rabinovici
- Department of Neurology, Memory and Aging Center,
University of California, San Francisco
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University
Hospital, Copenhagen, Denmark
| | - Milica G. Kramberger
- Center for Cognitive Impairments, University Medical
Centre Ljubljana, Ljubljana, Slovenia
| | - Agneta Nordberg
- Department NVS, Center for Alzheimer Research,
Translational Alzheimer Neurobiology, Karolinska Institutet, and Geriatric Medicine,
Karolinska University Hospital, Stockholm, Sweden
| | - Vincent Mok
- Lui Che Woo Institute of Innovative Medicine,
Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Centre for
Prevention of Dementia, Hong Kong
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Leading
National Research Centre in Białystok (KNOW), Medical University of Białystok,
Białystok, Poland
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania,
Philadelphia
| | - Philipp T. Meyer
- Department of Nuclear Medicine, University Hospital
Freiburg, Freiburg, Germany
| | - Magda Tsolaki
- Third Department of Neurology, Aristotle University
of Thessaloniki, Thessaloniki, Greece
| | | | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frans R. J. Verhey
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School
for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University,
Maastricht, the Netherlands,Department of Neurology and Alzheimer Center, VU
University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Ina S Almdahl
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Steven E Arnold
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Enrica Cavedo
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Stijmsalpêtrière, Boulevard de l'hôpital, F-75013, Paris, France.,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière, Paris, France
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Elena Chipi
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Ann D Cohen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Stefan Förster
- Department of Nuclear Medicine, Technische Universitaet München, Munich, Germany
| | - Juan Fortea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Department of Geriatrics, Karolinska University Hospital Huddinge, Section of Clinical Geriatrics, Institution of NVS, Karolinska Institutet, Stockholm, Sweden
| | - Olymbia Gkatzima
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universitaet München, Munich, Germany
| | - Harald Hampel
- Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), Hôpital Pitié-Stijmsalpêtrière, Boulevard de l'hôpital, F-75013, Paris, France.,AXA Research Fund & UPMC Chair, Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Inserm, CNRS, Institut du Cerveau et de la Moelle Épinière, Paris, France.,Department of Psychiatry, Alzheimer Memorial Center and Geriatric Psychiatry Branch, Ludwig-Maximilian University, Munich, Germany
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sabine Hellwig
- Center of Geriatrics and Gerontology, University Hospital Freiburg, Freiburg, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Peter Johannsen
- Memory Clinic, Danish Dementia Research Center, Rigshospitalet, Copenhagen, Denmark
| | | | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | | | - Koen van Laere
- Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - Mony de Leon
- School of Medicine, Center for Brain Health, New York University, New York
| | - Viviana Lisetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Marcusson
- Geriatric Medicine, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanne M Møllergård
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Gerald P Novak
- Janssen Research and Development, Titusville, New Jersey
| | - George P Paraskevas
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gayan Perera
- Roche Products, Welwyn Garden City, United Kingdom.,Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, German Center for Neurodegenrative Diseases (DZNE), Berlin, Germany
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | | | - Catherine M Roe
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Uros Rot
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Centro Hospitalar e Universitário de Coimbra, Portugal
| | - Johannes Schröder
- Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany
| | - Sang W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Luiza Spiru
- Department of Geriatrics-Gerontology-Gerontopsychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Erik Stomrud
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Linda J C van Waalwijk van Doorn
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gunhild Waldemar
- Department of Nuclear Medicine, Technische Universitaet München, Munich, Germany
| | - Åsa K Wallin
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UCL Institute of Neurology, Queen Square, London, United Kingdom
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24
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Frölich L, Peters O, Lewczuk P, Gruber O, Teipel SJ, Gertz HJ, Jahn H, Jessen F, Kurz A, Luckhaus C, Hüll M, Pantel J, Reischies FM, Schröder J, Wagner M, Rienhoff O, Wolf S, Bauer C, Schuchhardt J, Heuser I, Rüther E, Henn F, Maier W, Wiltfang J, Kornhuber J. Incremental value of biomarker combinations to predict progression of mild cognitive impairment to Alzheimer's dementia. Alzheimers Res Ther 2017; 9:84. [PMID: 29017593 PMCID: PMC5634868 DOI: 10.1186/s13195-017-0301-7] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [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: 09/07/2016] [Accepted: 08/30/2017] [Indexed: 01/24/2023]
Abstract
Background The progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD) dementia can be predicted by cognitive, neuroimaging, and cerebrospinal fluid (CSF) markers. Since most biomarkers reveal complementary information, a combination of biomarkers may increase the predictive power. We investigated which combination of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR)-sum-of-boxes, the word list delayed free recall from the Consortium to Establish a Registry of Dementia (CERAD) test battery, hippocampal volume (HCV), amyloid-beta1–42 (Aβ42), amyloid-beta1–40 (Aβ40) levels, the ratio of Aβ42/Aβ40, phosphorylated tau, and total tau (t-Tau) levels in the CSF best predicted a short-term conversion from MCI to AD dementia. Methods We used 115 complete datasets from MCI patients of the “Dementia Competence Network”, a German multicenter cohort study with annual follow-up up to 3 years. MCI was broadly defined to include amnestic and nonamnestic syndromes. Variables known to predict progression in MCI patients were selected a priori. Nine individual predictors were compared by receiver operating characteristic (ROC) curve analysis. ROC curves of the five best two-, three-, and four-parameter combinations were analyzed for significant superiority by a bootstrapping wrapper around a support vector machine with linear kernel. The incremental value of combinations was tested for statistical significance by comparing the specificities of the different classifiers at a given sensitivity of 85%. Results Out of 115 subjects, 28 (24.3%) with MCI progressed to AD dementia within a mean follow-up period of 25.5 months. At baseline, MCI-AD patients were no different from stable MCI in age and gender distribution, but had lower educational attainment. All single biomarkers were significantly different between the two groups at baseline. ROC curves of the individual predictors gave areas under the curve (AUC) between 0.66 and 0.77, and all single predictors were statistically superior to Aβ40. The AUC of the two-parameter combinations ranged from 0.77 to 0.81. The three-parameter combinations ranged from AUC 0.80–0.83, and the four-parameter combination from AUC 0.81–0.82. None of the predictor combinations was significantly superior to the two best single predictors (HCV and t-Tau). When maximizing the AUC differences by fixing sensitivity at 85%, the two- to four-parameter combinations were superior to HCV alone. Conclusion A combination of two biomarkers of neurodegeneration (e.g., HCV and t-Tau) is not superior over the single parameters in identifying patients with MCI who are most likely to progress to AD dementia, although there is a gradual increase in the statistical measures across increasing biomarker combinations. This may have implications for clinical diagnosis and for selecting subjects for participation in clinical trials.
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Affiliation(s)
- Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Zentralinstitut für Seelische Gesundheit, Quadrat J5, D-68159, Mannheim, Germany.
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Nuremberg, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Oliver Gruber
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany.,Department of Psychosomatic Medicine, University Medicine Rostock, Rostock, Germany.,Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University of Munich, Munich, Germany
| | - Hermann J Gertz
- Department of Psychiatry, University of Leipzig, Leipzig, Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Cologne/Bonn, Germany.,Department of Psychiatry and Psychotherapy, Medical Faculty University of Cologne, Cologne, Germany
| | - Alexander Kurz
- Department of Psychiatry and Psychotherapy, Technical University of Munich, Munich, Germany
| | - Christian Luckhaus
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Düsseldorf, Germany
| | - Michael Hüll
- Center for Psychiatry, Clinic for Geriatric Psychiatry and Psychotherapy Emmendingen and Department of Psychiatry and Psychotherapy, University of Freiburg, Freiburg, Germany
| | - Johannes Pantel
- Institute of General Medicine University of Frankfurt, Frankfurt am Main, Germany
| | - Friedel M Reischies
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Johannes Schröder
- Section for Geriatric Psychiatry Research, Department for Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Göttingen, Germany
| | - Stefanie Wolf
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | | | | | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Berlin, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Fritz Henn
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Zentralinstitut für Seelische Gesundheit, Quadrat J5, D-68159, Mannheim, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, and German Center for Neurodegenerative Diseases (DZNE), Research Site Göttingen, Göttingen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University of Erlangen-Nuremberg, Nuremberg, Germany.,Department of Neurodegeneration Diagnostics, Medical University of Bialystok, Bialystok, Poland
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Karaca I, Walliser C, Wagner H, Rüther E, Frölich L, Peters O, Hüll M, Popp J, Lewczuk P, Kornhuber J, Wiltfang J, Heneka M, Walter J, Jessen F, Maier W, Gierschik P, Ramirez A. [P3–164]: FUNCTIONAL CHARACTERIZATION OF A RARE GENETIC VARIANT IN PHOSPHOLIPASE Cγ2 WHICH IS ASSOCIATED WITH A BENEFICIAL EFFECT ON THE PROGRESSION OF ALZHEIMER's DISEASE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1376] [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: 11/27/2022]
Affiliation(s)
| | - Claudia Walliser
- Universitätsklinikum Ulm, Institut für Pharmakologie und ToxikologieUlmGermany
| | | | - Eckart Rüther
- University of GöttingenDepartment of Psychiatry and PsychotherapyGoettingenGermany
| | - Lutz Frölich
- Heidelberg University, Central Institute of Mental HealthDepartment of Geriatric Psychiatry, Mannheim, GermanyMannheimGermany
| | - Oliver Peters
- Charité ‐ Universitätsmediz in BerlinBerlinGermany
- German Center for Neurodegenerative Diseases (DZNE)BerlinGermany
| | - Michael Hüll
- University of FreiburgFreiburgGermany
- Center for Psychiatry EmmendingenEmmendingenGermany
| | - Julius Popp
- University Hospital LausanneLausanneSwitzerland
| | - Piotr Lewczuk
- Universitätsklinikum ErlagenErlangenGermany
- Friedrich‐Alexander Universität Erlangen‐NürnbergErlangenGermany
| | - Johannes Kornhuber
- Universitätsklinikum ErlagenErlangenGermany
- University Hospital Erlangen, Friedrich‐Alexander‐University Erlangen NurembergErlangenGermany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE)GoettingenGermany
- Department of NeuropsychiatryCharité ‐ Universitätsmedizin Berlin and Berlin Institute of HealthBerlinGermany
- Department of Psychiatry and PsychotherapyUniversity Medical Center GöttingenGöttingenGermany
| | - Michael Heneka
- University Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | | | - Frank Jessen
- University Hospital CologneCologneGermany
- German Center for Neurodegenerative Diseases (DZNE)Bonn‐CologneGermany
| | - Wolfgang Maier
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
| | - Peter Gierschik
- Universitätsklinikum Ulm, Institut für Pharmakologie und ToxikologieUlmGermany
| | - Alfredo Ramirez
- University Hospital CologneCologneGermany
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
- Human GeneticUniversity of BonnBonnGermany
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26
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Polcher A, Wolfsgruber S, Frölich L, Peters O, Hüll M, Rüther E, Wiltfang J, Maier W, Kornhuber J, Lewczuk P, Jessen F, Wagner M. [P4–139]: APPLICATION OF THE ‘A/T/N’ BIOMARKER CLASSIFICATION SYSTEM IN PATIENTS WITH MILD COGNITIVE IMPAIRMENT: CONVERSION RATES TO AD AND OTHER DEMENTIAS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Alexandra Polcher
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Steffen Wolfsgruber
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Lutz Frölich
- Department of GerontopsychiatryCentral Institute of Mental HealthMannheimGermany
| | | | - Michael Hüll
- Center for Geriatric Medicine and GerontologyUniversity of FreiburgFreiburgGermany
| | - Eckart Rüther
- Department of Psychiatry and PsychotherapyUniversity of GöttingenGöttingenGermany
| | - Jens Wiltfang
- Department of Psychiatry and PsychotherapyUniversity of GöttingenGöttingenGermany
| | - Wolfgang Maier
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
| | - Johannes Kornhuber
- University Hospital Erlangen, Friedrich‐Alexander‐University Erlangen NurembergErlangenGermany
- Department of Psychiatry and PsychotherapyUniversity ErlangenErlangenGermany
| | - Piotr Lewczuk
- Department of Psychiatry and PsychotherapyUniversity ErlangenErlangenGermany
- Department of Biochemical DiagnosticsUniversity Hospital of BialystokBialystokPoland
- Friedrich‐Alexander University Erlangen‐NürnbergErlangenGermany
- Department of Neurodegeneration DiagnosticsMedical University of BiałystokBiałystokPoland
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE)CologneGermany
- Department of PsychiatryUniversity of CologneCologneGermany
| | - Michael Wagner
- Department of Psychiatry and PsychotherapyUniversity of BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
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27
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Schennach R, Obermeier M, Seemüller F, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Spellmann I, Musil R, Möller HJ, Riedel M. Add-on Antidepressants in the Naturalistic Treatment of Schizophrenia Spectrum Disorder - When, Who, and How? Pharmacopsychiatry 2017; 50:136-144. [PMID: 28505669 DOI: 10.1055/s-0043-106436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The aim of this study was to evaluate antidepressant add-on treatment within the acute treatment of schizophrenia spectrum disorder patients. Antidepressant add-on was evaluated in 365 patients within a naturalistic multicenter study. Patients with/without antidepressant add-on were compared regarding clinical and treatment-related variables, response and remission, and remission of depressive and negative symptoms. The efficacy of antidepressant add-on treatment was furthermore analyzed applying marginal structure models. Twenty-three percent of the patients received antidepressant add-on for a mean duration of 50.28 (33.42) days. Patients with the diagnosis of a schizoaffective disorder, multiple illness episodes, and a longer duration of their illness as well as those with significantly fewer baseline positive symptoms, more negative and depressive symptoms, more side effects, and less subjective well-being were augmented with antidepressants. At discharge no significant effect of antidepressant add-on treatment was observed in terms of a 25% improvement (p=0.2623), a 50% improvement (p=0.3946), remission (p=0.0552), or remission of depressive (p=0.6336) and negative symptoms (p=0.8756). Also, when analyzing marginal structure models considering the diagnostic subgroups, no significant effect was found. Add-on with antidepressants is common. A final recommendation in terms of this strategy's efficacy cannot be given.
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Affiliation(s)
- Rebecca Schennach
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Michael Obermeier
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Seemüller
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Jäger
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Max Schmauss
- Psychiatric Clinic, District Hospital Augsburg, Augsburg, Germany
| | - Gerd Laux
- Psychiatric Clinic, Inn-Salzach Hospital, Wasserburg/Inn, Germany
| | | | - Dieter Naber
- Department of Psychiatry, University of Hamburg, Hamburg, Germany
| | - Lutz G Schmidt
- Department of Psychiatry, Johannes Gutenberg-University of Mainz, Mainz, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Isabella Heuser
- Department of Psychiatry, Charite Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | | | - Eckart Rüther
- Department of Psychiatry, University of Göttingen, Göttingen, Germany
| | - Stefan Klingberg
- Department of Psychiatry, University of Tübingen, Tübingen, Germany
| | - Markus Gastpar
- Department of Psychiatry, University of Essen, Essen, Germany
| | - Ilja Spellmann
- Psychiatric Clinic, District Hospital Kaufbeuren, Kaufbeuren, Germany
| | - Richard Musil
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Riedel
- Department of Psychiatry, Ludwig-Maximilians-University, Munich, Germany.,Psychiatric Clinic Nordschwarzwald, Calw, Germany
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28
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Affiliation(s)
- Walter Pöllmann
- Department of Neurology, Klinikum Großhadern, University of Munich, FRG
| | | | - Eckart Rüther
- Psychiatric University Hospital, University of Munich, FRG
| | - Reimar Lund
- Psychiatric University Hospital, University of Munich, FRG
| | - Gören Hajak
- Department of Neurology, Klinikum Großhadern, University of Munich, FRG
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29
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Koppara A, Wolfsgruber S, Kleineidam L, Schmidtke K, Frölich L, Kurz A, Schulz S, Hampel H, Heuser I, Peters O, Reischies FM, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Rüther E, Henn F, Wiltfang J, Maier W, Jessen F, Kornhuber J, Wagner M. The Latent Dementia Phenotype δ is Associated with Cerebrospinal Fluid Biomarkers of Alzheimer's Disease and Predicts Conversion to Dementia in Subjects with Mild Cognitive Impairment. J Alzheimers Dis 2016; 49:547-60. [PMID: 26484902 DOI: 10.3233/jad-150257] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The recently proposed latent variable δ is a new tool for dementia case finding. It is built in a structural equation modeling framework of cognitive and functional data and constitutes a novel endophenotype for Alzheimer's disease (AD) research and clinical trials. OBJECTIVE To investigate the association of δ with AD biomarkers and to compare the prediction of δ with established scales for conversion to dementia in patients with mild cognitive impairment (MCI). METHODS Using data from a multicenter memory clinic study, we examined the external associations of the latent variable δ and compared δ with well-established cognitive and functional scales and cognitive-functional composite scores. For that purpose, logistic regressions with cerebrospinal fluid (CSF) biomarkers and conversion to dementia as dependent variables were performed with the investigated scores. The models were tested for significant differences. RESULTS In patients with MCI, δ based on a broad range of cognitive scales (including the ADAS-cog, the MMSE, and the CERAD neuropsychological battery) predicted an abnormal CSF Aβ42/tau ratio indicative of AD (n = 340, AUC = 0.78, p < 0.001), and predicted incident dementia within 1-3 years of follow-up (n = 525, AUC = 0.84, p < 0.001). These associations were generally stronger than for any other scale or cognitive-functional composite examined. Homologs of δ based on reduced test batteries yielded somewhat lower effects. CONCLUSION These findings support the interpretation of δ as a construct capturing the disease-related "essence" of cognitive and functional impairments in patients with MCI and dementia, and suggest that δ might become an analytical tool for dementia research.
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Affiliation(s)
- Alexander Koppara
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Luca Kleineidam
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Klaus Schmidtke
- Center for Geriatric Medicine, Ortenau Klinikum, Offenburg-Gengenbach, Germany
| | - Lutz Frölich
- Department of Gerontopsychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Alexander Kurz
- Department of Psychiatry, Technical University of Munich, Germany
| | | | - Harald Hampel
- Department of Neurology, Université Pierre et Marie Curie (Sorbonne), and AXA Research Fund & UPMC Chair, Paris, France
| | - Isabella Heuser
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Friedel M Reischies
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Holger Jahn
- Department of Psychiatry, University of Hamburg, Germany
| | | | - Michael Hüll
- Center for Psychiatry, Clinic for Geronto- and Neuropsychiatry Emmendingen and Dep. of Psychiatry, University of Freiburg, Germany
| | | | - Johannes Schröder
- Section for Geriatric Psychiatry/Institute of Gerontology, University of Heidelberg, Germany
| | - Johannes Pantel
- Institute of General Medicine University of Frankfurt, Frankfurt am Main, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Fritz Henn
- Ichan School of Medicine at Mt. Sinai, New York, USA
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany.,Department of Psychiatry, Medical Faculty University of Cologne, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Friedrich-Alexander-University Erlangen, Germany
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Germany.,German Center for Neurodegenerative Diseases, Bonn, Germany
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30
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Gründer G, Heinze M, Cordes J, Mühlbauer B, Juckel G, Schulz C, Rüther E, Timm J. Effects of first-generation antipsychotics versus second-generation antipsychotics on quality of life in schizophrenia: a double-blind, randomised study. Lancet Psychiatry 2016; 3:717-729. [PMID: 27265548 DOI: 10.1016/s2215-0366(16)00085-7] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 02/18/2016] [Accepted: 03/01/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Whether or not second-generation antipsychotics (SGAs) represent an advantage over first-generation antipsychotics (FGAs) in the treatment of schizophrenia is not certain. Effectiveness studies published in the past 10 years have not unequivocally confirmed the superiority of SGAs over FGAs. We aimed to compare quality of life in patients with schizophrenia on an FGA strategy with those on an SGA strategy. METHODS In the multicentre, randomised, double-blind Neuroleptic Strategy Study (NeSSy), we recruited participants (aged 18-65 years) with schizophrenia (ICD-10: F20.X) who required treatment initiation or a change in treatment, from 14 psychiatric university hospitals and state hospitals in Germany. Double randomisation allowed for restricted selection of a treatment within each antipsychotic drug group (FGA or SGA) for an individual patient: first, patients were assigned with a random number table to two of six possible drug pairs, each pair consisting of an FGA (haloperidol [3-6 mg] or flupentixol [6-12 mg]) given orally and an SGA (aripiprazole [10-20 mg], olanzapine [10-20 mg], or quetiapine [400-800 mg]) given orally, and the investigator then selected which pair was best suited to the patient; a second, double-blind random assignment allocated either the FGA or the SGA from the investigator-chosen pair to the patient. Treatment duration was 24 weeks. Primary outcomes were change from baseline to week 24 in quality of life (SF-36) and clinical global impression (CGI-I), analysed in all randomly assigned patients who received at least one dose of the study drug. Safety was assessed in a safety set, consisting of all randomly assigned patients who received at least one dose of the study drug, coinciding with the set of the efficacy analyses. The study is registered with ClinicalTrials.gov, number NCT01164059; German Clinical Trials Register, number DRKS00000304; WHO ICTRP, number U1111-1112-9727; and EudraCT, number 2009-010966-47. FINDINGS Between April 1, 2010, and May 31, 2013, 149 patients were randomly assigned, 69 to FGA treatment and 80 to SGA treatment. 136 patients received at least one dose of study drug (63 in the FGA group, 73 in the SGA group). Mean area under the curve (AUC) values of SF-36 were significantly higher in the SGA group than in the FGA group (85·1 [SD 14·7] vs 79·7 [17·3], p=0·0112). Mean AUC values for CGI-I scores decreased in both groups, but were not significantly different between the two groups (3·39 [SD 0·89] in the FGA group vs 3·26 [0·92] in the SGA group, p=0·3423). 30 (48%) of 63 patients given FGAs had at least one adverse event compared with 42 (57%) of 73 patients given an SGA (p=0·3019); the most common were nervous system disorders (18 [60%] of 30 in the FGA group vs 19 [45%] of 42 in the SGA group) and psychiatric disorders (ten [33%] vs 16 [38%]). One patient died after cessation of study drug (olanzapine), most likely as a result of an illicit drug overdose. The increase in body-mass index (BMI) was significantly higher in the SGA group than in the FGA group (p=0·0021 at week 6 and p=0·0041 at week 24). INTERPRETATION Improvement of patient-reported quality of life was significantly higher in patients with schizophrenia given SGAs than in those given FGAs, when treatment selection was individualised. This advantage, however, has to be weighed against the potential metabolic adverse effects of some SGAs. FUNDING German Federal Ministry of Education and Research.
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Affiliation(s)
- Gerhard Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany.
| | - Martin Heinze
- Department of Psychiatry, Psychotherapy and Psychosomatics, Immanuel Klinik, Brandenburg Medical School, Rüdersdorf, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Heinrich-Heine-University, Düsseldorf, Germany
| | - Bernd Mühlbauer
- Department of Pharmacology, Klinikum Bremen Mitte, Bremen, Germany; Biometry Section, Competence Center for Clinical Trials, University of Bremen, Bremen, Germany
| | - Georg Juckel
- Department of Psychiatry, LWL University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Constanze Schulz
- Biometry Section, Competence Center for Clinical Trials, University of Bremen, Bremen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Jürgen Timm
- Biometry Section, Competence Center for Clinical Trials, University of Bremen, Bremen, Germany
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Huether G, Schmidt S, Rüther E. Nutritional Effects on Central Serotonergic Activity: A Hypothesis on the Unconscious Self-manipulation of Mood by Food Intake and Dietary Selection. Nutr Neurosci 2016; 1:3-7. [DOI: 10.1080/1028415x.1998.11747208] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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32
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Schulz C, Timm J, Cordes J, Gründer G, Mühlbauer B, Rüther E, Heinze M. Response from the authors. Clin Trials 2016; 13:262-3. [DOI: 10.1177/1740774516639933] [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: 11/15/2022]
Affiliation(s)
- Constanze Schulz
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Jürgen Timm
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Gerhard Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bernd Mühlbauer
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
- Department of Pharmacology, Klinikum Bremen-Mitte, Bremen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Martin Heinze
- Department for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Rüdersdorf, Germany
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Adamovic I, Grohmann R, Rüther E, Degner D. Acute urinary retention after treatment with doxepin and duloxetine. Pharmacopsychiatry 2016. [DOI: 10.1055/s-0036-1582052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Bey K, Wolfsgruber S, Karaca I, Wagner H, Lardenoije R, Becker J, Milz E, Kornhuber J, Peters O, Frölich L, Hüll M, Rüther E, Wiltfang J, Riedel-Heller S, Scherer M, Jessen F, Maier W, van den Hove DL, Rutten BP, Wagner M, Ramirez A. No association of the variant rs11887120 in DNMT3A with cognitive decline in individuals with mild cognitive impairment. Epigenomics 2016; 8:593-8. [PMID: 27092400 DOI: 10.2217/epi-2015-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Alterations in DNA methylation have been associated with cognitive decline and Alzheimer's disease. A recent study of mild cognitive impairment (MCI) reported a significant association between annual decline in cognitive function and the rs11887120 SNP located in DNMT3A, a gene implicated in DNA methylation. Here, we aimed to replicate this finding in two independent MCI cohorts (n = 1024); however, no significant association was observed in either cohort or the pooled dataset. In stratified analyses for conversion to Alzheimer's disease status, no association between rs11887120 and cognitive decline was observed in either converters or nonconverters. In conclusion, our analyses provide no support for the hypothesis that genetic variants in DNMT3A are implicated in cognitive performance decline in individuals with MCI.
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Affiliation(s)
- Katharina Bey
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Steffen Wolfsgruber
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Ilker Karaca
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Holger Wagner
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Roy Lardenoije
- Department of Psychiatry & Neuropsychology, School for Mental Health & Neuroscience, European Graduate School of Neuroscience (EURON), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Julian Becker
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Esther Milz
- Department of Psychiatry & Psychotherapy, University of Cologne, 50937 Cologne, Germany
| | - Johannes Kornhuber
- Department of Psychiatry & Psychotherapy, Universitätsklinikum Erlangen, & Friedrich-Alexander Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité, 14050 Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Michael Hüll
- Centre for Geriatric Medicine & Section of Gerontopsychiatry & Neuropsychology, Medical School, University of Freiburg, 79106 Freiburg, Germany
| | - Eckart Rüther
- Department of Psychiatry & Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry & Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health & Public Health, University of Leipzig, 04103 Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Frank Jessen
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany.,Department of Psychiatry & Psychotherapy, University of Cologne, 50937 Cologne, Germany
| | - Wolfgang Maier
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Daniel L van den Hove
- Department of Psychiatry & Neuropsychology, School for Mental Health & Neuroscience, European Graduate School of Neuroscience (EURON), Maastricht University, 6229 ER Maastricht, The Netherlands.,Laboratory of Translational Neuroscience, Department of Psychiatry, Psychosomatics & Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
| | - Bart Pf Rutten
- Department of Psychiatry & Neuropsychology, School for Mental Health & Neuroscience, European Graduate School of Neuroscience (EURON), Maastricht University, 6229 ER Maastricht, The Netherlands
| | - Michael Wagner
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Alfredo Ramirez
- Department of Psychiatry & Psychotherapy, University of Bonn, 53127 Bonn, Germany.,Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany
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Schulz C, Timm J, Cordes J, Gründer G, Mühlbauer B, Rüther E, Heinze M. Patient-oriented randomisation: A new trial design applied in the Neuroleptic Strategy Study. Clin Trials 2016; 13:251-9. [DOI: 10.1177/1740774516639910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The ‘gold standard’ for clinical studies is a randomised controlled trial usually comparing specific treatments. If the scientific study expands to strategy comparison with each strategy including various treatments, the research problems are increasingly complicated. The strategy debate in the psychiatric community is the starting point for the development of our new design. It is widely accepted that second-generation antipsychotics are the therapy of choice in the treatment of schizophrenia. However, their general superiority over first-generation antipsychotics could not be demonstrated in recent randomised controlled trials. Furthermore, we are becoming increasingly aware that the experimental conditions of randomised controlled trials, as in the European First Episode Schizophrenia Trial and Clinical Antipsychotic Trials of Intervention Effectiveness Phase 1 studies, may be inappropriate for psychiatric treatments. The high heterogeneity in the patient population produces discrepancies between daily clinical perception and randomised controlled trials results. The patient-oriented approach in the Cost Utility of the Latest Antipsychotic drugs in Schizophrenia Study reflects everyday clinical practice. The results, however, are highly dependent on the physicians’ preferences. The goal of the design described here is to take an intermediate path between randomised controlled trials and clinical studies such as Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study, combining the advantages of both study types. Methods: The idea is to randomise two treatment pairs each consisting of one first-generation antipsychotic and one second-generation antipsychotic in a first step and subsequently, to involve the investigators in deciding for a pair most appropriate to the patients’ needs and then to randomise the allocation to one drug (first-generation antipsychotic or second-generation antipsychotic) of that chosen pair. This idea was first implemented in the clinical trial, the Neuroleptic Strategy Study, with a randomised design comparing efficacy and safety of two different strategies: either to use first-generation antipsychotics (haloperidol and flupentixol) or second-generation antipsychotics (olanzapine, aripiprazole and quetiapine) in patients suffering from schizophrenia. Results: In the course of the Neuroleptic Strategy Study, feasibility of this design was demonstrated. All aspects of the new design were implemented: randomisation process, documentation of responses from investigators as well as patients and drug logistic experience. In implementing the design, furthermore, we could investigate its theoretical properties. The physicians’ preferences for specific drugs used for the respective patients were analysed. Conclusion: The idea of patient-oriented randomisation can be generalised. In light of the heterogeneity and complexity of patient–drug interaction, this design should prove particularly useful.
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Affiliation(s)
- Constanze Schulz
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Jürgen Timm
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
| | - Joachim Cordes
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Gerhard Gründer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany
| | - Bernd Mühlbauer
- Competence Center for Clinical Trials Bremen, University of Bremen, Bremen, Germany
- Department of Pharmacology, Klinikum Bremen Mitte, Bremen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Martin Heinze
- Department for Psychiatry and Psychotherapy, Brandenburg Medical School, Immanuel Klinik Rüdersdorf, Berlin, Germany
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Peters O, Heuser I, Frölich L, Rüther E, Rienhoff O, Kornhuber J, Wiltfang J, Maier W. [Dementia Competence Network. Results and outlook]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:438-43. [PMID: 26979717 DOI: 10.1007/s00103-016-2314-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Dementia Competence Network (DCN) is represented by academic memory clinics and has three major aims: (1) To facilitate the development of diagnostic tools including neuropsychology, biomarkers, imaging and genetics. (2) To implement clinical trials in mild cognitive impairment and dementia and (3) to improve standard care for dementia in Germany. AIMS This article summarizes the achievements of the DCN so far and highlights future perspectives. METHODS The DCN has built up two multicentre cohorts. Within the first cohort, patients with mild cognitive impairment or mild dementia were examined longitudinally using multiple neuropsychological assessments and numerous different biomarkers. In a subgroup of the first cohort, patients were treated with antidementive drugs in two placebo-controlled clinical trials. The second cohort included cognitively healthy older people and examined repetitively clinical, neuropsychological and psychosocial parameters for ten years. RESULTS AND DISCUSSION The DCN has generated a large data and biomaterial bank. Numerous publications have helped to develop further diagnostic procedures and treatment of cognitive disorders and dementia. The DCN has contributed to end stigmatisation of dementia.
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Affiliation(s)
- Oliver Peters
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin - CBF, Berlin, Deutschland.
| | - Isabella Heuser
- Klinik für Psychiatrie und Psychotherapie, Charité Universitätsmedizin Berlin - CBF, Berlin, Deutschland
| | - Lutz Frölich
- Zentralinstitut für Seelische Gesundheit Mannheim, Mannheim, Deutschland
| | - Eckart Rüther
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Otto Rienhoff
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Johannes Kornhuber
- Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Jens Wiltfang
- Institut für Medizinische Informatik, Universitätsklinik Göttingen, Göttingen, Deutschland
| | - Wolfgang Maier
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Bonn, Bonn, Deutschland
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Schennach R, Möller HJ, Obermeier M, Seemüller F, Jäger M, Schmauss M, Laux G, Pfeiffer H, Naber D, Schmidt LG, Gaebel W, Klosterkötter J, Heuser I, Maier W, Lemke MR, Rüther E, Klingberg S, Gastpar M, Musil R, Spellmann I, Riedel M. Challenging the understanding of significant improvement and outcome in schizophrenia - the concept of reliable and clinically significant change methods. Int J Methods Psychiatr Res 2016; 25:3-11. [PMID: 26178421 PMCID: PMC6877263 DOI: 10.1002/mpr.1476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 03/08/2015] [Accepted: 03/23/2015] [Indexed: 11/10/2022] Open
Abstract
Significant changes of schizophrenia patients during inpatient treatment were evalutaed and compared to established outcome criteria. The concept of reliable and clinically significant change methods was applied to three hundred and ninety-six patients suffering from a schizophrenia spectrum disorder. First, information on whether or not the change of the patient's condition is sufficient in order to declare that it is beyond a measurement error or random effect (= reliable change) was evaluated and in a second step it was observed if the reliable change was clinically meaningful (= clinically significant change). Different Positive and Negative Syndrome Scale for Schizophrenia (PANSS) thresholds were applied to define the clinically significant change (40, 45 and 50 points). These changes were then compared to established outcome criteria such as response and remission. Seventy-nine of the 396 patients (20%) showed a reliable improvement of symptoms, whereas 70% improved without achieving a reliable change of their condition. Of the 79 patients achieving a reliable change during treatment 8-15% concurrently showed a clinically significant change depending on the respective PANSS threshold. In contrast, 56% of the patients achieved response and 60% were in remission at discharge when applying established outcome criteria. Our results showed that a rather small number of schizophrenia patients were found to reliably change during inpatient treatment, with even less patients achieving a clinically significant change. The concept of reliable and clinically significant changes revealed to be a lot more stringent than today's established outcome criteria and should be critically evaluated regarding its use in schizophrenia patients.
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Affiliation(s)
- Rebecca Schennach
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.,Schoen Clinic Roseneck, Prien am Chiemsee, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Obermeier
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Seemüller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Markus Jäger
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Max Schmauss
- Psychiatric Clinic, District Hospital Augsburg, Germany
| | - Gerd Laux
- Psychiatric Clinic, Inn-Salzach Hospital Wasserburg/Inn, Germany
| | | | - Dieter Naber
- Department of Psychiatry and Psychotherapy, University of Hamburg, Germany
| | - Lutz G Schmidt
- Department of Psychiatry and Psychotherapy, University of Mainz, Germany
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Duesseldorf, Germany
| | | | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charite Berlin, Campus Benjamin Franklin, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
| | | | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Markus Gastpar
- Department of Psychiatry and Psychotherapy, University of Essen, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Ilja Spellmann
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany
| | - Michael Riedel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Munich, Germany.,Psychiatric Clinic, Vinzenz-von-Paul-Hospital, Rottweil, Germany
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38
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Louwersheimer E, Wolfsgruber S, Espinosa A, Lacour A, Heilmann-Heimbach S, Alegret M, Hernández I, Rosende-Roca M, Tárraga L, Boada M, Kornhuber J, Peters O, Frölich L, Hüll M, Rüther E, Wiltfang J, Scherer M, Riedel-Heller S, Jessen F, Nöthen MM, Maier W, Koene T, Scheltens P, Holstege H, Wagner M, Ruiz A, van der Flier WM, Becker T, Ramirez A. Alzheimer's disease risk variants modulate endophenotypes in mild cognitive impairment. Alzheimers Dement 2016; 12:872-81. [PMID: 26921674 DOI: 10.1016/j.jalz.2016.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 09/16/2015] [Revised: 12/09/2015] [Accepted: 01/20/2016] [Indexed: 10/22/2022]
Abstract
INTRODUCTION We evaluated the effect of Alzheimer's disease (AD) susceptibility loci on endophenotypes closely related with AD pathology in patients with mild cognitive impairment (MCI). METHODS We selected 1730 MCI patients from four independent data sets. Weighted polygenic risk scores (PGS) were constructed of 18 non-apolipoprotein E (APOE) AD risk variants. In addition, we determined APOE genotype. AD endophenotypes were cognitive decline over time and cerebrospinal fluid (CSF) biomarkers (aβ, tau, ptau). RESULTS PGS was modestly associated with cognitive decline over time, as measured by mini-mental state examination (MMSE) (β ± SE:-0.24 ± 0.10; P = .012), and with CSF levels of tau and ptau (tau: 1.38 ± 0.36, P = 1.21 × 10(-4); ptau: 1.40 ± 0.36, P = 1.02 × 10(-4)). DISCUSSION In MCI, we observed a joint effect of AD susceptibility loci on nonamyloid endophenotypes, suggesting a link of these genetic loci with neuronal degeneration in general rather than with Alzheimer-related amyloid deposition.
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Affiliation(s)
- Eva Louwersheimer
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands.
| | - Steffen Wolfsgruber
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ana Espinosa
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - André Lacour
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Montserrat Alegret
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Isabel Hernández
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Maitée Rosende-Roca
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Lluís Tárraga
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Mercè Boada
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité University Medicine, Berlin, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Michael Hüll
- Centre for Geriatric Medicine and Section of Gerontopsychiatry and Neuropsychology, Medical School, University of Freiburg, Freiburg, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Ted Koene
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands; Alzheimer Center and Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Henne Holstege
- Alzheimer Center and Department of Clinical Genetics, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Agustín Ruiz
- Alzheimer Research Center and Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Wiesje M van der Flier
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Centre, Amsterdam, The Netherlands; Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Tim Becker
- Institute for Community Medicine, Ernst Moritz Arndt University Greifswald, Greifswald, Germany
| | - Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany; Institute of Human Genetics, University of Bonn, Bonn, Germany.
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Koppara A, Wolfsgruber S, Kleineidam L, Schmidtke K, Frölich L, Kurz A, Schulz S, Hampel H, Heuser I, Peters O, Reischies FM, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Rüther E, Henn F, Wiltfang J, Maier W, Kornhuber J, Jessen F, Wagner M. O2‐02‐04: The latent dementia phenotype δ is associated with the CSF Alzheimer's disease biomarker signature in subjects with mild cognitive impairment. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.07.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Steffen Wolfsgruber
- University of BonnBonnGermany
- German Center for Neurodegenerative DiseasesBonnGermany
| | | | - Klaus Schmidtke
- Center for Geriatric MedicineOrtenau KlinikumOffenburg-GengenbachGermany
| | - Lutz Frölich
- Central Institute of Mental HealthMannheimGermany
| | - Alexander Kurz
- Klinikum Rechts der IsarTechische Universitaet MuenchenMunichGermany
| | | | - Harald Hampel
- Sorbonne Universites, Universite Pierre et Marie Curie‐Paris 6ParisFrance
- Institut de la Memoire et de la Maladie d'Alzheimer (IM2A)Hôpital de la Pitie-Salpêtriere, AP-HPParisFrance
- AXA Research Fund & UPMC ChairParisFrance
- INSERM U1127Institut du Cerveau et de la Moelle Epiniere (ICM)ParisFrance
| | | | | | | | | | | | | | | | | | - Johannes Pantel
- Department of General MedicineGoethe University Frankfurt a. M GermanyFrankfurt am MainGermany
- Goethe University FrankfurtFrankfurt am MainGermany
| | | | | | - Fritz Henn
- Brookhaven National LaboratoryUptonNYUSA
| | - Jens Wiltfang
- University Medical Center GoettingenGeorg-August-UniversityGoettingenGermany
| | - Wolfgang Maier
- University of BonnBonnGermany
- DZNEGerman Center for Neurodegenerative DiseasesBonnGermany
| | | | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE)BonnGermany
- University of CologneCologneGermany
| | - Michael Wagner
- University of BonnBonnGermany
- DZNEGerman Center for Neurodegenerative DiseasesBonnGermany
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40
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Jansen WJ, Ossenkoppele R, Knol DL, Tijms BM, Scheltens P, Verhey FRJ, Visser PJ, Aalten P, Aarsland D, Alcolea D, Alexander M, Almdahl IS, Arnold SE, Baldeiras I, Barthel H, van Berckel BNM, Bibeau K, Blennow K, Brooks DJ, van Buchem MA, Camus V, Cavedo E, Chen K, Chetelat G, Cohen AD, Drzezga A, Engelborghs S, Fagan AM, Fladby T, Fleisher AS, van der Flier WM, Ford L, Förster S, Fortea J, Foskett N, Frederiksen KS, Freund-Levi Y, Frisoni GB, Froelich L, Gabryelewicz T, Gill KD, Gkatzima O, Gómez-Tortosa E, Gordon MF, Grimmer T, Hampel H, Hausner L, Hellwig S, Herukka SK, Hildebrandt H, Ishihara L, Ivanoiu A, Jagust WJ, Johannsen P, Kandimalla R, Kapaki E, Klimkowicz-Mrowiec A, Klunk WE, Köhler S, Koglin N, Kornhuber J, Kramberger MG, Van Laere K, Landau SM, Lee DY, de Leon M, Lisetti V, Lleó A, Madsen K, Maier W, Marcusson J, Mattsson N, de Mendonça A, Meulenbroek O, Meyer PT, Mintun MA, Mok V, Molinuevo JL, Møllergård HM, Morris JC, Mroczko B, Van der Mussele S, Na DL, Newberg A, Nordberg A, Nordlund A, Novak GP, Paraskevas GP, Parnetti L, Perera G, Peters O, Popp J, Prabhakar S, Rabinovici GD, Ramakers IHGB, Rami L, Resende de Oliveira C, Rinne JO, Rodrigue KM, Rodríguez-Rodríguez E, Roe CM, Rot U, Rowe CC, Rüther E, Sabri O, Sanchez-Juan P, Santana I, Sarazin M, Schröder J, Schütte C, Seo SW, Soetewey F, Soininen H, Spiru L, Struyfs H, Teunissen CE, Tsolaki M, Vandenberghe R, Verbeek MM, Villemagne VL, Vos SJB, van Waalwijk van Doorn LJC, Waldemar G, Wallin A, Wallin ÅK, Wiltfang J, Wolk DA, Zboch M, Zetterberg H. Prevalence of cerebral amyloid pathology in persons without dementia: a meta-analysis. JAMA 2015; 313:1924-38. [PMID: 25988462 PMCID: PMC4486209 DOI: 10.1001/jama.2015.4668] [Citation(s) in RCA: 1025] [Impact Index Per Article: 113.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
IMPORTANCE Cerebral amyloid-β aggregation is an early pathological event in Alzheimer disease (AD), starting decades before dementia onset. Estimates of the prevalence of amyloid pathology in persons without dementia are needed to understand the development of AD and to design prevention studies. OBJECTIVE To use individual participant data meta-analysis to estimate the prevalence of amyloid pathology as measured with biomarkers in participants with normal cognition, subjective cognitive impairment (SCI), or mild cognitive impairment (MCI). DATA SOURCES Relevant biomarker studies identified by searching studies published before April 2015 using the MEDLINE and Web of Science databases and through personal communication with investigators. STUDY SELECTION Studies were included if they provided individual participant data for participants without dementia and used an a priori defined cutoff for amyloid positivity. DATA EXTRACTION AND SYNTHESIS Individual records were provided for 2914 participants with normal cognition, 697 with SCI, and 3972 with MCI aged 18 to 100 years from 55 studies. MAIN OUTCOMES AND MEASURES Prevalence of amyloid pathology on positron emission tomography or in cerebrospinal fluid according to AD risk factors (age, apolipoprotein E [APOE] genotype, sex, and education) estimated by generalized estimating equations. RESULTS The prevalence of amyloid pathology increased from age 50 to 90 years from 10% (95% CI, 8%-13%) to 44% (95% CI, 37%-51%) among participants with normal cognition; from 12% (95% CI, 8%-18%) to 43% (95% CI, 32%-55%) among patients with SCI; and from 27% (95% CI, 23%-32%) to 71% (95% CI, 66%-76%) among patients with MCI. APOE-ε4 carriers had 2 to 3 times higher prevalence estimates than noncarriers. The age at which 15% of the participants with normal cognition were amyloid positive was approximately 40 years for APOE ε4ε4 carriers, 50 years for ε2ε4 carriers, 55 years for ε3ε4 carriers, 65 years for ε3ε3 carriers, and 95 years for ε2ε3 carriers. Amyloid positivity was more common in highly educated participants but not associated with sex or biomarker modality. CONCLUSIONS AND RELEVANCE Among persons without dementia, the prevalence of cerebral amyloid pathology as determined by positron emission tomography or cerebrospinal fluid findings was associated with age, APOE genotype, and presence of cognitive impairment. These findings suggest a 20- to 30-year interval between first development of amyloid positivity and onset of dementia.
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Affiliation(s)
- Willemijn J Jansen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Rik Ossenkoppele
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands3Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the
| | - Dirk L Knol
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Betty M Tijms
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Philip Scheltens
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands2Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience
| | | | - Pauline Aalten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Dag Aarsland
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Daniel Alcolea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Ina S Almdahl
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Steven E Arnold
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Inês Baldeiras
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Hospital Center University of Coimbra, Portugal
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands
| | - Kristen Bibeau
- GlaxoSmithKline, Worldwide Epidemiology, Research Triangle Park, North Carolina
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - David J Brooks
- Division of Neuroscience, Medical Research Council Clinical Sciences Centre, Imperial College London, London, United Kingdom
| | - Mark A van Buchem
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Vincent Camus
- CHRU de Tours, CIC INSERM 1415, INSERM U930, and Université François Rabelais de Tours, Tours, France
| | - Enrica Cavedo
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy20Sorbonne University, University Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, Arizona
| | - Gael Chetelat
- Institut National de la Santé et de la Recherche Médicale (Inserm), U1077, Caen, France
| | - Ann D Cohen
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania
| | - Alexander Drzezga
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Anne M Fagan
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Adam S Fleisher
- Banner Alzheimer's Institute, Phoenix, Arizona27Eli Lilly, Indianapolis, Indiana28Department of Neurosciences, University of California, San Diego
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, VU University Medical Center, Neuroscience Campus Amsterdam, Amsterdam, the Netherlands6Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
| | - Lisa Ford
- Janssen Research and Development, Titusville, New Jersey
| | - Stefan Förster
- Department of Nuclear Medicine, Technischen Universitaet München, Munich, Germany
| | - Juan Fortea
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | | | - Kristian S Frederiksen
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Yvonne Freund-Levi
- Department of Geriatrics, Institution of NVS, Section of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- Laboratory of Epidemiology, Neuroimaging and Telemedicine, IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy88Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals, and University of Geneva, Geneva, Switzerland
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Tomasz Gabryelewicz
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland
| | - Kiran Dip Gill
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Biochemistry, Research Block-A, Chandigarh, India
| | - Olymbia Gkatzima
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Timo Grimmer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar der Technischen Universitaet München, Munich, Germany
| | - Harald Hampel
- AXA Research Fund and UPMC ChairSorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer and INSERM U1127, Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital
| | - Lucrezia Hausner
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Sabine Hellwig
- Center of Geriatrics and Gerontology, University Hospital Freiburg, Freiburg, Germany
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | | | - Lianna Ishihara
- GlaxoSmithKline, Worldwide Epidemiology, Epidemiology, Genetic Epidemiology and Neurology, United Kingdom
| | - Adrian Ivanoiu
- Memory Clinic and Neurochemistry Laboratory, Saint Luc University Hospital, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Peter Johannsen
- Memory Clinic, Danish Dementia Research Center, Rigshospitalet, Copenhagen, Denmark
| | - Ramesh Kandimalla
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Biochemistry, Research Block-A, Chandigarh, India46Radiation Oncology, Emory University, Atlanta, Georgia
| | - Elisabeth Kapaki
- First Department of Neurology, Neurochemistry Unit and Cognitive and Movement Disorders Clinic, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | | | - William E Klunk
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, Pennsylvania
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | | | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Milica G Kramberger
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Koen Van Laere
- Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - Susan M Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Mony de Leon
- School of Medicine, Center for Brain Health, New York University, New York
| | - Viviana Lisetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Alberto Lleó
- Neurology Department, Hospital de Sant Pau, Barcelona, Spain
| | - Karine Madsen
- Neurobiology Research Unit, Copenhagen University Hospital, Copenhagen, Denmark
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Marcusson
- Geriatric Medicine, Department of Clinical and Experimental Medicine, University of Linköping, Linköping, Sweden
| | - Niklas Mattsson
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Alexandre de Mendonça
- Institute of Molecular Medicine and Faculty of Medicine, University of Lisbon, Portugal
| | - Olga Meulenbroek
- Department of Geriatric Medicine, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Philipp T Meyer
- Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Mark A Mintun
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Vincent Mok
- Lui Che Woo Institute of Innovative Medicine, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - José Luis Molinuevo
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | - Hanne M Møllergård
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Leading National Research Centre in Bialystok (KNOW), Medical University of Bialystok, Bialystok, Poland
| | - Stefan Van der Mussele
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Duk L Na
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Andrew Newberg
- Myrna Brind Center of Integrative Medicine, Thomas Jefferson University and Hospital, Philadelphia, Pennsylvania
| | - Agneta Nordberg
- Dept NVS, Center for Alzheimer, Translational Alzheimer Neurobiology, Karolinska Institutet, and Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Arto Nordlund
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Gerald P Novak
- Janssen Research and Development, Titusville, New Jersey
| | - George P Paraskevas
- First Department of Neurology, Neurochemistry Unit and Cognitive and Movement Disorders Clinic, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Lucilla Parnetti
- Section of Neurology, Center for Memory Disturbances, University of Perugia, Perugia, Italy
| | - Gayan Perera
- Roche Products, Welwyn Garden City, United Kingdom69Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, United Kingdom
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité Berlin, German Center for Neurodegenrative Diseases (DZNE), Berlin, Germany
| | - Julius Popp
- Department of Psychiatry, Service of Old Age Psychiatry and Department of Clinical Neurosciences, Leenaards Memory Centre, University Hospital of Lausanne, Lausanne, Switzerland
| | - Sudesh Prabhakar
- Postgraduate Institute of Medical Education and Research (PGIMER), Department of Neurology, Nehru Hospital, Chandigarh, India
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California, San Francisco
| | - Inez H G B Ramakers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Lorena Rami
- Alzheimer's Disease and Other Cognitive Disorders Unit, IDIBAPS, Clinic University Hospital, Barcelona, Spain
| | | | - Juha O Rinne
- Turku PET Centre and Division of Clinical Neurosciences Turku, University of Turku and Turku University Hospital, Turku, Finland
| | | | | | - Catherine M Roe
- Knight Alzheimer's Disease Research Center, Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Uros Rot
- Center for Cognitive Impairments, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Christopher C Rowe
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Páscual Sanchez-Juan
- Neurology Service, Universitary Hospital Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - Isabel Santana
- Center for Neuroscience and Cell Biology, Faculty of Medicine, Hospital Center University of Coimbra, Portugal
| | - Marie Sarazin
- Neurologie de la Mémoire et du Langage, Centre Hospitalier Sainte-Anne, Université Paris 5, Paris, France
| | - Johannes Schröder
- Sektion Gerontopsychiatrie, Universität Heidelberg, Heidelberg, Germany
| | | | - Sang W Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Femke Soetewey
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Luiza Spiru
- Department of Geriatrics-Gerontology-Gerontopsychiatry, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Hanne Struyfs
- Reference Center for Biological Markers of Dementia (BIODEM), University of Antwerp, Antwerp, Belgium
| | - Charlotte E Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands
| | - Magda Tsolaki
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Rik Vandenberghe
- Laboratory for Cognitive Neurology and Alzheimer Research Centre KU Leuven, Catholic University Leuven, Leuven, Belgium
| | - Marcel M Verbeek
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Victor L Villemagne
- Department of Nuclear Medicine and Centre for PET, Austin Health, Melbourne, Australia
| | - Stephanie J B Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands
| | - Linda J C van Waalwijk van Doorn
- Departments of Neurology and Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Gunhild Waldemar
- Danish Dementia Research Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Denmark
| | - Anders Wallin
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
| | - Åsa K Wallin
- Clinical Memory Research Unit, Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center, Georg-August University, Göttingen, Germany
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Marzena Zboch
- Alzheimer Center, Wroclaw Medical University, Scinawa, Poland
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden87UCL Institute of Neurology, Queen Square, London, United Kingdom
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Morgen K, Schneider M, Frölich L, Tost H, Plichta MM, Kölsch H, Rakebrandt F, Rienhoff O, Jessen F, Peters O, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Hampel H, Teipel SJ, Pantel J, Heuser I, Wiltfang J, Rüther E, Kornhuber J, Maier W, Meyer-Lindenberg A. Apolipoprotein E-dependent load of white matter hyperintensities in Alzheimer's disease: a voxel-based lesion mapping study. Alzheimers Res Ther 2015; 7:27. [PMID: 25984242 PMCID: PMC4432954 DOI: 10.1186/s13195-015-0111-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2014] [Accepted: 02/23/2015] [Indexed: 11/10/2022]
Abstract
Introduction White matter (WM) magnetic resonance imaging (MRI) hyperintensities are common in Alzheimer’s disease (AD), but their pathophysiological relevance and relationship to genetic factors are unclear. In the present study, we investigated potential apolipoprotein E (APOE)-dependent effects on the extent and cognitive impact of WM hyperintensities in patients with AD. Methods WM hyperintensity volume on fluid-attenuated inversion recovery images of 201 patients with AD (128 carriers and 73 non-carriers of the APOE ε4 risk allele) was determined globally as well as regionally with voxel-based lesion mapping. Clinical, neuropsychological and MRI data were collected from prospective multicenter trials conducted by the German Dementia Competence Network. Results WM hyperintensity volume was significantly greater in non-carriers of the APOE ε4 allele. Lesion distribution was similar among ε4 carriers and non-carriers. Only ε4 non-carriers showed a correlation between lesion volume and cognitive performance. Conclusion The current findings indicate an increased prevalence of WM hyperintensities in non-carriers compared with carriers of the APOE ε4 allele among patients with AD. This is consistent with a possibly more pronounced contribution of heterogeneous vascular risk factors to WM damage and cognitive impairment in patients with AD without APOE ε4-mediated risk. Electronic supplementary material The online version of this article (doi:10.1186/s13195-015-0111-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katrin Morgen
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany ; AHG-Klinik für Psychosomatik, Kurbrunnenstr. 12, 67098, Bad Dürkheim, Germany
| | - Michael Schneider
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Lutz Frölich
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Heike Tost
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Michael M Plichta
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
| | - Heike Kölsch
- Institute of Human Genetics, University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Fabian Rakebrandt
- Department of Medical Informatics, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Holbeinstr. 13-15, 53175, Bonn, Germany
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Holger Jahn
- Department of Psychiatry and Psychotherapy, University of Hamburg, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Luckhaus
- Department of Psychiatry and Psychotherapy, University of Düsseldorf, Bergische Landstr. 2, 40629, Düsseldorf, Germany
| | - Michael Hüll
- Department of Psychiatry and Psychotherapy, University of Freiburg, Hauptstr. 5 79104, Freiburg, Germany
| | - Hermann-Josef Gertz
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, 04103, Leipzig, Germany
| | - Johannes Schröder
- Department of Psychiatry and Psychotherapy, University of Heidelberg, Voßstr. 5, 69115, Heidelberg, Germany
| | - Harald Hampel
- Département de Neurologie, Institut de la Mémoire et de la Maladie d'Alzheimer, Hôpital de la Salpêtrière Paris, Université Pierre et Marie Curie, 47 Blvd. de lHopital, 75013, Paris, France
| | - Stefan J Teipel
- Department of Psychiatry and Psychotherapy, University of Rostock and DZNE Rostock, Gehlsheimerstr. 20, 18147 Rostock, Rostock, Germany
| | - Johannes Pantel
- Institute of General Practice, University of Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Isabella Heuser
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Essen, Virchowstr. 174, 45147, Essen, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany
| | - Johannes Kornhuber
- Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Holbeinstr. 13-15, 53175, Bonn, Germany
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, J5, 68159, Mannheim, Germany
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Heilmann S, Drichel D, Clarimon J, Fernández V, Lacour A, Wagner H, Thelen M, Hernández I, Fortea J, Alegret M, Blesa R, Mauleón A, Roca MR, Kornhuber J, Peters O, Heun R, Frölich L, Hüll M, Heneka MT, Rüther E, Riedel-Heller S, Scherer M, Wiltfang J, Jessen F, Becker T, Tárraga L, Boada M, Maier W, Lleó A, Ruiz A, Nöthen MM, Ramirez A. PLD3 in non-familial Alzheimer's disease. Nature 2015; 520:E3-5. [PMID: 25832411 DOI: 10.1038/nature14039] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 10/16/2014] [Indexed: 12/18/2022]
Affiliation(s)
- Stefanie Heilmann
- 1] Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany [2] Department of Genomics, Life &Brain Center, University of Bonn, 53127 Bonn, Germany
| | - Dmitriy Drichel
- German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Jordi Clarimon
- 1] Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital Santa Creu i Sant Pau, Autonomous University Barcelona, 08025 Barcelona, Spain [2] Center for Networking Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Victoria Fernández
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - André Lacour
- German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany
| | - Holger Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Mathias Thelen
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Isabel Hernández
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Juan Fortea
- 1] Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital Santa Creu i Sant Pau, Autonomous University Barcelona, 08025 Barcelona, Spain [2] Center for Networking Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Montserrat Alegret
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Rafael Blesa
- 1] Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital Santa Creu i Sant Pau, Autonomous University Barcelona, 08025 Barcelona, Spain [2] Center for Networking Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Ana Mauleón
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Maitée Rosende Roca
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Clinic Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, 91054 Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité University Medicine, 14050 Berlin, Germany
| | - Reinhard Heun
- Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159 Mannheim, Germany
| | - Michael Hüll
- Centre for Geriatric Medicine and Section of Gerontopsychiatry and Neuropsychology, Medical School, University of Freiburg, 79106 Freiburg, Germany
| | - Michael T Heneka
- 1] German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany [2] Clinical Neuroscience Unit, Department of Neurology, University of Bonn, 53127 Bonn, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, 04103 Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Frank Jessen
- 1] German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany [2] Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany [3] Department of Psychiatry and Psychotherapy, University of Cologne, 50937 Cologne, Germany
| | - Tim Becker
- 1] German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany [2] Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, 53127 Bonn, Germany
| | - Lluís Tárraga
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Mercè Boada
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Wolfgang Maier
- 1] German Center for Neurodegenerative Diseases (DZNE), 53175 Bonn, Germany [2] Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
| | - Alberto Lleó
- 1] Memory Unit, Neurology Department and Sant Pau Biomedical Research Institute, Hospital Santa Creu i Sant Pau, Autonomous University Barcelona, 08025 Barcelona, Spain [2] Center for Networking Biomedical Research in Neurodegenerative Diseases (CIBERNED), 28029 Madrid, Spain
| | - Agustin Ruiz
- Memory Clinic of Fundaciò ACE, Catalan Institute of Applied Neurosciences, 08028 Barcelona, Spain
| | - Markus M Nöthen
- 1] Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany [2] Department of Genomics, Life &Brain Center, University of Bonn, 53127 Bonn, Germany
| | - Alfredo Ramirez
- 1] Institute of Human Genetics, University of Bonn, 53127 Bonn, Germany [2] Department of Psychiatry and Psychotherapy, University of Bonn, 53127 Bonn, Germany
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Rüther E, Jungkunz G, Greil W, Zimmer R. Effect of tranylcypromine stereoisomers on depressive syndromes. Mod Probl Pharmacopsychiatry 2015; 19:203-10. [PMID: 6865964 DOI: 10.1159/000407516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Wolfsgruber S, Jessen F, Koppara A, Kleineidam L, Schmidtke K, Frölich L, Kurz A, Schulz S, Hampel H, Heuser I, Peters O, Reischies FM, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Rüther E, Henn F, Wiltfang J, Maier W, Kornhuber J, Wagner M. Subjective cognitive decline is related to CSF biomarkers of AD in patients with MCI. Neurology 2015; 84:1261-8. [PMID: 25716354 DOI: 10.1212/wnl.0000000000001399] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test whether, in individuals with mild cognitive impairment (MCI), different measures of subjective cognitive decline (SCD) in the memory domain predict abnormal CSF biomarkers of Alzheimer disease (AD). METHODS We analyzed the multicenter baseline (cross-sectional) data of 245 patients with MCI. SCD was measured quantitatively with the Subjective Memory Decline Scale (SMDS) and qualitatively by assessing particular concerns associated with self-experienced worsening of memory. Logistic regression models were used to examine associations between SCD and abnormal CSF biomarkers, taking into account objective memory impairment, depressive symptoms, and education as covariates. RESULTS Abnormal CSF β-amyloid 1-42 (Aβ42) and more depressive symptoms were associated with higher SMDS scores and with the report of memory concerns. Risk of abnormal CSF Aβ42 increased by an estimated 57% for a 1-SD increase in SMDS scores and was doubled in patients who had SMDS scores >4 or who reported memory concerns, respectively. In addition, both SCD measures predicted risk of having a biomarker signature indicative of prodromal AD defined as presence of low CSF Aβ42 together with either high CSF tau or CSF phosphorylated tau 181 levels. CONCLUSIONS In MCI, specific aspects of SCD severity and quality are related to CSF biomarkers indicative of AD. This extends findings in pre-MCI samples and calls for an improved operational assessment of SCD in MCI. This might be useful for sample enrichment strategies for increased likelihood of AD pathology.
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Affiliation(s)
- Steffen Wolfsgruber
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne.
| | - Frank Jessen
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Alexander Koppara
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Luca Kleineidam
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Klaus Schmidtke
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Lutz Frölich
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Alexander Kurz
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Stefanie Schulz
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Harald Hampel
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Isabella Heuser
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Oliver Peters
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Friedel M Reischies
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Holger Jahn
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Christian Luckhaus
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Michael Hüll
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Hermann-Josef Gertz
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Johannes Schröder
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Johannes Pantel
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Otto Rienhoff
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Eckart Rüther
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Fritz Henn
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Jens Wiltfang
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Wolfgang Maier
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Johannes Kornhuber
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
| | - Michael Wagner
- From the Department of Psychiatry (S.W., F.J., A. Koppara, L.K., W.M., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (S.W., F.J. A. Koppara, L.K., W.M., M.W.), Bonn; Center for Geriatric Medicine (K.S.), Ortenau Klinikum, Offenburg-Gengenbach; Department of Gerontopsychiatry (L.F.), Central Institute of Mental Health, Mannheim; Department of Psychiatry (A. Kurz), Technical University of Munich; Department of Neurology (S.S.), University of Aachen; Department of Psychiatry and Psychotherapy (S.S., E.R., J.W.), University of Göttingen, Germany; AXA Research Fund & UPMC Chair Sorbonne Universités (H.H.), Université Pierre et Marie Curie, Paris; Institut de la Mémoire et de la Maladie d'Alzheimer (H.H.), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris; INSERM U1127 (H.H.), Institut du Cerveau et de la Moelle épinière, Paris, France; Department of Psychiatry (I.H., O.P., F.M.R.), Charité Berlin, Campus Benjamin Franklin, Berlin; Department of Psychiatry (H.J.), University of Hamburg; Department of Psychiatry (C.L.), University of Düsseldorf; Center for Geriatric Medicine and Gerontology (M.H.), University of Freiburg; Department of Psychiatry (H.-J.G.), University of Leipzig; Department of Psychiatry (J.S.), University of Heidelberg; Department of General Medicine (J.P.), University of Frankfurt, Frankfurt am Main; Department of Medical Informatics (O.R.), University of Göttingen, Germany; Brookhaven National Laboratory (F.H.), Upton, New York; and Department of Psychiatry (J.K.), Friedrich-Alexander University Erlangen, Germany. F.J. is currently with the Department of Psychiatry, University of Cologne
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Vos SJB, Verhey F, Frölich L, Kornhuber J, Wiltfang J, Maier W, Peters O, Rüther E, Nobili F, Morbelli S, Frisoni GB, Drzezga A, Didic M, van Berckel BNM, Simmons A, Soininen H, Kłoszewska I, Mecocci P, Tsolaki M, Vellas B, Lovestone S, Muscio C, Herukka SK, Salmon E, Bastin C, Wallin A, Nordlund A, de Mendonça A, Silva D, Santana I, Lemos R, Engelborghs S, Van der Mussele S, Freund-Levi Y, Wallin ÅK, Hampel H, van der Flier W, Scheltens P, Visser PJ. Prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage. Brain 2015; 138:1327-38. [PMID: 25693589 DOI: 10.1093/brain/awv029] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 12/15/2014] [Indexed: 12/16/2022] Open
Abstract
Three sets of research criteria are available for diagnosis of Alzheimer's disease in subjects with mild cognitive impairment: the International Working Group-1, International Working Group-2, and National Institute of Aging-Alzheimer Association criteria. We compared the prevalence and prognosis of Alzheimer's disease at the mild cognitive impairment stage according to these criteria. Subjects with mild cognitive impairment (n = 1607), 766 of whom had both amyloid and neuronal injury markers, were recruited from 13 cohorts. We used cognitive test performance and available biomarkers to classify subjects as prodromal Alzheimer's disease according to International Working Group-1 and International Working Group-2 criteria and in the high Alzheimer's disease likelihood group, conflicting biomarker groups (isolated amyloid pathology or suspected non-Alzheimer pathophysiology), and low Alzheimer's disease likelihood group according to the National Institute of Ageing-Alzheimer Association criteria. Outcome measures were the proportion of subjects with Alzheimer's disease at the mild cognitive impairment stage and progression to Alzheimer's disease-type dementia. We performed survival analyses using Cox proportional hazards models. According to the International Working Group-1 criteria, 850 (53%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 50% compared to 21% for subjects without prodromal Alzheimer's disease. According to the International Working Group-2 criteria, 308 (40%) subjects had prodromal Alzheimer's disease. Their 3-year progression rate to Alzheimer's disease-type dementia was 61% compared to 22% for subjects without prodromal Alzheimer's disease. According to the National Institute of Ageing-Alzheimer Association criteria, 353 (46%) subjects were in the high Alzheimer's disease likelihood group, 49 (6%) in the isolated amyloid pathology group, 220 (29%) in the suspected non-Alzheimer pathophysiology group, and 144 (19%) in the low Alzheimer's disease likelihood group. The 3-year progression rate to Alzheimer's disease-type dementia was 59% in the high Alzheimer's disease likelihood group, 22% in the isolated amyloid pathology group, 24% in the suspected non-Alzheimer pathophysiology group, and 5% in the low Alzheimer's disease likelihood group. Our findings support the use of the proposed research criteria to identify Alzheimer's disease at the mild cognitive impairment stage. In clinical settings, the use of both amyloid and neuronal injury markers as proposed by the National Institute of Ageing-Alzheimer Association criteria offers the most accurate prognosis. For clinical trials, selection of subjects in the National Institute of Ageing-Alzheimer Association high Alzheimer's disease likelihood group or the International Working Group-2 prodromal Alzheimer's disease group could be considered.
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Affiliation(s)
- Stephanie J B Vos
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, The Netherlands
| | - Frans Verhey
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, The Netherlands
| | - Lutz Frölich
- 2 Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Johannes Kornhuber
- 3 Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen, Erlangen, Germany
| | - Jens Wiltfang
- 4 Department of Psychiatry and Psychotherapy, University Medical Centre (UMG), Georg-August-University, Göttingen, Germany
| | - Wolfgang Maier
- 5 Department of Psychiatry and Psychotherapy, University of Bonn, German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Oliver Peters
- 6 Department of Psychiatry and Psychotherapy, Charité Berlin, Berlin, Germany
| | - Eckart Rüther
- 7 Department of Psychiatry and Psychotherapy, University of Göttingen, Göttingen, Germany
| | - Flavio Nobili
- 8 Clinical Neurophysiology Service, Department of Neurosciences, Ophthalmology and Genetics, University of Genoa, Genoa, Italy
| | - Silvia Morbelli
- 9 Nuclear Medicine, Department of Internal Medicine, University of Genoa, Genoa, Italy
| | - Giovanni B Frisoni
- 10 IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy 11 University Hospitals and University of Geneva, Geneva, Switzerland
| | - Alexander Drzezga
- 12 Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Mira Didic
- 13 Service de Neurologie et Neuropsychologie, Pôle de neurosciences cliniques, AP-HM Timone, Aix Marseille Université, INS UMR_S 1106, 13005, Marseille, France
| | - Bart N M van Berckel
- 14 Department of Nuclear Medicine and PET Research, VU University Medical CentRE, Amsterdam, The Netherlands
| | - Andrew Simmons
- 15 Department of Neuroimaging, Centre for Neuroimaging Science, King's College London, Institute of Psychiatry, London, UK
| | - Hilkka Soininen
- 16 Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | | | - Patrizia Mecocci
- 18 Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Magda Tsolaki
- 19 Aristotle University of Thessaloniki, Memory and Dementia Center, 3rd Department of Neurology, "G Papanicolaou" General Hospital, Thessaloniki, Greece
| | - Bruno Vellas
- 20 UMR INSERM 1027, CHU Toulouse, Toulouse, France
| | - Simon Lovestone
- 21 University of Oxford, Department of Psychiatry, Oxford, UK
| | - Cristina Muscio
- 10 IRCCS San Giovanni di Dio Fatebenefratelli, Brescia, Italy 22 Fondazione Europea Ricerca Biomedica (FERB), Centro di Eccellenza Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy 23 Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Sanna-Kaisa Herukka
- 16 Institute of Clinical Medicine, Neurology, University of Eastern Finland and Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Eric Salmon
- 24 Memory Clinic, Department of Neurology, CHU Liège, Belgium 25 Cyclotron Research Centre, University of Liège, Liège, Belgium
| | - Christine Bastin
- 25 Cyclotron Research Centre, University of Liège, Liège, Belgium
| | - Anders Wallin
- 26 Department of Psychiatry and Neurochemistry, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Arto Nordlund
- 26 Department of Psychiatry and Neurochemistry, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Alexandre de Mendonça
- 27 Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal
| | - Dina Silva
- 27 Institute of Molecular Medicine, Faculty of Medicine, University of Lisbon, Portugal
| | - Isabel Santana
- 28 Department of Neurology, Coimbra University Hospital, Coimbra, Portugal
| | - Raquel Lemos
- 29 Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Sebastiaan Engelborghs
- 30 Reference Centre for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium 31 Department of Neurology and Memory Clinic, Hospital Network Antwerp, Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Stefan Van der Mussele
- 30 Reference Centre for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Yvonne Freund-Levi
- 32 Department of Neurobiology, Caring Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, and Department of Geriatric Medicine, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - Åsa K Wallin
- 33 Lund University, Clinical Sciences Malmö, Clinical Memory Research Unit, Lund, Sweden
| | - Harald Hampel
- 34 Centre des Maladies Cognitives et Comportementales, Institut du Cerveau et de la Moelle épinière, Paris, France; Université Pierre et Marie Curie-Paris 6, AP-HP, Hôpital de la Salpêtrière, Paris, France
| | - Wiesje van der Flier
- 35 Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- 35 Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht, The Netherlands 35 Alzheimer Centre and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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47
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Ramirez A, van der Flier WM, Herold C, Ramonet D, Heilmann S, Lewczuk P, Popp J, Lacour A, Drichel D, Louwersheimer E, Kummer MP, Cruchaga C, Hoffmann P, Teunissen C, Holstege H, Kornhuber J, Peters O, Naj AC, Chouraki V, Bellenguez C, Gerrish A, Heun R, Frölich L, Hüll M, Buscemi L, Herms S, Kölsch H, Scheltens P, Breteler MM, Rüther E, Wiltfang J, Goate A, Jessen F, Maier W, Heneka MT, Becker T, Nöthen MM. SUCLG2 identified as both a determinator of CSF Aβ1-42 levels and an attenuator of cognitive decline in Alzheimer's disease. Hum Mol Genet 2014; 23:6644-58. [PMID: 25027320 DOI: 10.1093/hmg/ddu372] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Cerebrospinal fluid amyloid-beta 1-42 (Aβ1-42) and phosphorylated Tau at position 181 (pTau181) are biomarkers of Alzheimer's disease (AD). We performed an analysis and meta-analysis of genome-wide association study data on Aβ1-42 and pTau181 in AD dementia patients followed by independent replication. An association was found between Aβ1-42 level and a single-nucleotide polymorphism in SUCLG2 (rs62256378) (P = 2.5×10(-12)). An interaction between APOE genotype and rs62256378 was detected (P = 9.5 × 10(-5)), with the strongest effect being observed in APOE-ε4 noncarriers. Clinically, rs62256378 was associated with rate of cognitive decline in AD dementia patients (P = 3.1 × 10(-3)). Functional microglia experiments showed that SUCLG2 was involved in clearance of Aβ1-42.
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Affiliation(s)
- Alfredo Ramirez
- Department of Psychiatry and Psychotherapy, Institute of Human Genetics,
| | - Wiesje M van der Flier
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, 1081 HZ, Amsterdam, The Netherlands, Department of Epidemiology & Biostatistics, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
| | - Christine Herold
- German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | | | - Stefanie Heilmann
- Institute of Human Genetics, Department of Genomics, Life & Brain Center
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | | | - André Lacour
- German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Dmitriy Drichel
- German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Eva Louwersheimer
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, 1081 HZ, Amsterdam, The Netherlands, Department of Epidemiology & Biostatistics, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
| | - Markus P Kummer
- Clinical Neuroscience Unit, Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Carlos Cruchaga
- Department of Psychiatry, Hope Center for Neurological Disorders, School of Medicine
| | - Per Hoffmann
- Institute of Human Genetics, Department of Genomics, Life & Brain Center, Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, CH-4058, Basel, Switzerland
| | - Charlotte Teunissen
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, 1081 HZ, Amsterdam, The Netherlands, Department of Epidemiology & Biostatistics, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
| | - Henne Holstege
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, 1081 HZ, Amsterdam, The Netherlands, Department of Epidemiology & Biostatistics, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, and Friedrich-Alexander Universität Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité, 14050, Berlin, Germany
| | - Adam C Naj
- Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania, PA 19104, Philadelphia, USA
| | - Vincent Chouraki
- Department of Neurology, Boston University School of Medicine, MA 02118, Boston, USA, The Framingham Heart Study, MA 01702, Framingham, USA
| | - Céline Bellenguez
- Inserm, U744, Lille 59000, France, Université Lille 2, Lille 59000, France, Institut Pasteur de Lille, Lille 59000, France
| | - Amy Gerrish
- Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics & Genomics, Cardiff University, Cardiff, UK
| | | | | | | | - Lutz Frölich
- Department of Geriatric Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, 68159, Mannheim, Germany
| | - Michael Hüll
- Centre for Geriatric Medicine and Section of Gerontopsychiatry and Neuropsychology, Medical School, University of Freiburg, 79106, Freiburg, Germany
| | - Lara Buscemi
- Department of Fundamental Neurosciences, UNIL, 1005 Lausanne, Switzerland and
| | - Stefan Herms
- Institute of Human Genetics, Department of Genomics, Life & Brain Center, Division of Medical Genetics, University Hospital and Department of Biomedicine, University of Basel, CH-4058, Basel, Switzerland
| | | | - Philip Scheltens
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, 1081 HZ, Amsterdam, The Netherlands, Department of Epidemiology & Biostatistics, VU University Medical Center, 1007 MB, Amsterdam, The Netherlands
| | - Monique M Breteler
- German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Eckart Rüther
- Department of Psychiatry and Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University of Göttingen, 37075 Göttingen, Germany
| | - Alison Goate
- Department of Psychiatry, Department of Genetics, Washington University, St. Louis, MO 63110, USA
| | - Frank Jessen
- Department of Psychiatry and Psychotherapy, German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Michael T Heneka
- Clinical Neuroscience Unit, Department of Neurology, German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Tim Becker
- Institute for Medical Biometry, Informatics, and Epidemiology, University of Bonn, 53127, Bonn, Germany, German Center for Neurodegenerative Diseases (DZNE), 53175, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, Department of Genomics, Life & Brain Center
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48
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Wolfsgruber S, Wagner M, Schmidtke K, Frölich L, Kurz A, Schulz S, Hampel H, Heuser I, Peters O, Reischies FM, Jahn H, Luckhaus C, Hüll M, Gertz HJ, Schröder J, Pantel J, Rienhoff O, Rüther E, Henn F, Wiltfang J, Maier W, Kornhuber J, Jessen F. Memory concerns, memory performance and risk of dementia in patients with mild cognitive impairment. PLoS One 2014; 9:e100812. [PMID: 25019225 PMCID: PMC4096405 DOI: 10.1371/journal.pone.0100812] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 05/14/2014] [Indexed: 12/31/2022] Open
Abstract
Background Concerns about worsening memory (“memory concerns”; MC) and impairment in memory performance are both predictors of Alzheimer's dementia (AD). The relationship of both in dementia prediction at the pre-dementia disease stage, however, is not well explored. Refined understanding of the contribution of both MC and memory performance in dementia prediction is crucial for defining at-risk populations. We examined the risk of incident AD by MC and memory performance in patients with mild cognitive impairment (MCI). Methods We analyzed data of 417 MCI patients from a longitudinal multicenter observational study. Patients were classified based on presence (n = 305) vs. absence (n = 112) of MC. Risk of incident AD was estimated with Cox Proportional-Hazards regression models. Results Risk of incident AD was increased by MC (HR = 2.55, 95%CI: 1.33–4.89), lower memory performance (HR = 0.63, 95%CI: 0.56–0.71) and ApoE4-genotype (HR = 1.89, 95%CI: 1.18–3.02). An interaction effect between MC and memory performance was observed. The predictive power of MC was greatest for patients with very mild memory impairment and decreased with increasing memory impairment. Conclusions Our data suggest that the power of MC as a predictor of future dementia at the MCI stage varies with the patients' level of cognitive impairment. While MC are predictive at early stage MCI, their predictive value at more advanced stages of MCI is reduced. This suggests that loss of insight related to AD may occur at the late stage of MCI.
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Affiliation(s)
- Steffen Wolfsgruber
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
- * E-mail:
| | - Michael Wagner
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Klaus Schmidtke
- Center for Geriatric Medicine, Ortenau Klinikum, Offenburg-Gengenbach, Germany
| | - Lutz Frölich
- Department of Gerontopsychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - Alexander Kurz
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Stefanie Schulz
- Department of Neurology, University of Aachen, Aachen, Germany
- Department of Psychiatry, University of Göttingen, Göttingen, Germany
| | - Harald Hampel
- Department of Psychiatry, Ludwig Maximilian University, Munich, Germany
| | - Isabella Heuser
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Oliver Peters
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Friedel M. Reischies
- Department of Psychiatry, Charité Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Holger Jahn
- Department of Psychiatry, University of Hamburg, Hamburg, Germany
| | - Christian Luckhaus
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Michael Hüll
- Center for Geriatric Medicine and Gerontology, University of Freiburg, Freiburg, Germany
| | | | - Johannes Schröder
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Johannes Pantel
- Institute of General Practice, University of Frankfurt, Frankfurt am Main, Germany
| | - Otto Rienhoff
- Department of Medical Informatics, University of Göttingen, Göttingen, Germany
| | - Eckart Rüther
- Department of Psychiatry, University of Göttingen, Göttingen, Germany
| | - Fritz Henn
- Brookhaven National Laboratory, Upton, New York, United States of America
| | - Jens Wiltfang
- Department of Psychiatry University of Essen, Essen, Germany
| | - Wolfgang Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
| | - Johannes Kornhuber
- Department of Psychiatry, Friedrich-Alexander-University Erlangen, Erlangen, Germany
| | - Frank Jessen
- Department of Psychiatry, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
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49
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Rüther E. [Ethical principles in psychiatric action]. Psychiatr Prax 2014; 41 Suppl 1:S8-10. [PMID: 24983582 DOI: 10.1055/s-0034-1370012] [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] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
There is no specific psychiatric ethic. The ethical principles for practical actions in psychiatry have to be adapted on the basis of the generally accepted ethical principles, which are based on psychobiologically developed ethic of love: honesty, discretion, empathy, patience, distance, consistency, accountability, tolerance, economic neutrality.
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Affiliation(s)
- Eckart Rüther
- Klinik für Psychiatrie und Psychotherapie, Universität Göttingen
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50
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Ramirez A, Heilmann S, Drichel D, Hernandez I, Lleó A, Lacour A, Rosende‐Roca M, Mauleon A, Ruiz S, Alegret M, Espinosa A, Sotolongo O, Blesa R, Fortea J, Kornhuber J, Peters O, Heun R, Frölich L, Hüll M, Kölsch H, Heneka M, Rüther E, Wiltfang J, Tarraga L, Clarimón J, Jessen F, Nöthen MM, Boada M, Maier W, Becker T, Ruiz A. P1‐046: ROLE OF PLD3 RARE VARIANTS IN EUROPEAN SPORADIC ALZHEIMER'S DISEASE PATIENTS. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | | | - Isabel Hernandez
- Fundació ACE, Institut Català de Neurociències AplicadesBarcelonaSpain
| | | | | | | | | | - Susana Ruiz
- Memory Clinic of Fundacio ACE, Institut Català de Neurociències AplicadesBarcelonaSpain
| | | | | | - Oscar Sotolongo
- Memory Clinic of Fundacio ACE, Institut Català de Neurociències AplicadesBarcelonaSpain
| | - Rafael Blesa
- Department of Neurology, Universitat Autonoma de BarcelonaBarcelonaSpain
| | - Juan Fortea
- Department of Neurology, Universitat Autonoma de BarcelonaBarcelonaSpain
| | | | | | - Reiner Heun
- Department of PsychiatryRoyal Derby HospitalDerbyUnited Kingdom
| | - Lutz Frölich
- Medical Faculty Mannheim, University of HeidelbergMannheimGermany
| | - Michael Hüll
- University of Freiburg Medical SchoolFreiburgGermany
| | | | | | | | | | - Lluis Tarraga
- Fundació ACE, Institut Català de Neurociències AplicadesBarcelonaSpain
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