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D'Souza GM, Churchill NW, Guan DX, Khoury MA, Graham SJ, Kumar S, Fischer CE, Schweizer TA. Interaction of Alzheimer Disease and Traumatic Brain Injury on Cortical Thickness. Alzheimer Dis Assoc Disord 2024; 38:14-21. [PMID: 38285961 DOI: 10.1097/wad.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/26/2023] [Indexed: 01/31/2024]
Abstract
INTRODUCTION Traumatic brain injury (TBI) is associated with an accelerated course of dementia, although biological relationships are incompletely understood. METHODS The study examined 1124 participants, including 343 with Alzheimer disease (AD), 127 with AD with TBI, 266 cognitively normal adults with TBI, and 388 cognitively normal adults without TBI. Cortical thickness was quantified from T1-weighted magnetic resonance imaging data. Multiple linear regression was used to determine the interaction between AD and TBI on cortical thickness. RESULTS Among those with AD, TBI was associated with an earlier age of AD onset but, counterintuitively, less cortical thinning in frontotemporal regions relative to non-AD controls. DISCUSSION AD with TBI represents a distinct group from AD, likely with distinct pathologic contributions beyond gray matter loss. This finding has important implications for the diagnosis and treatment of AD in the presence of TBI and indicates that models of AD, aging, and neural loss should account for TBI history.
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Affiliation(s)
- Gina M D'Souza
- Institute of Medical Science, University of Toronto
- Keenan Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto
| | - Nathan W Churchill
- Keenan Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto
- Neuroscience Research Program, St. Michael's Hospital
- Physics Department, Toronto Metropolitan University
| | - Dylan X Guan
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Marc A Khoury
- Institute of Medical Science, University of Toronto
- Keenan Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto
| | - Simon J Graham
- Departments of Medical Biophysics
- Physical Sciences Platform, Sunnybrook Research Institute
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute
| | - Sanjeev Kumar
- Institute of Medical Science, University of Toronto
- Psychiatry
- Centre for Addiction and Mental Health, Toronto, ON
| | - Corinne E Fischer
- Institute of Medical Science, University of Toronto
- Psychiatry
- Keenan Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto
| | - Tom A Schweizer
- Institute of Medical Science, University of Toronto
- Department of Surgery, Division of Neurosurgery
- Keenan Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St Michael's Hospital, Unity Health Toronto
- Neuroscience Research Program, St. Michael's Hospital
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Valcic M, Khoury MA, Kim J, Fornazzari L, Churchill NW, Ismail Z, De Luca V, Tsuang D, Schweizer TA, Munoz DG, Fischer CE. Correction: Valcic et al. Determining Whether Sex and Zygosity Modulates the Association between APOE4 and Psychosis in a Neuropathologically-Confirmed Alzheimer's Disease Cohort. Brain Sci. 2022, 12, 1266. Brain Sci 2022; 13:brainsci13010064. [PMID: 36672138 PMCID: PMC9831142 DOI: 10.3390/brainsci13010064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 12/07/2022] [Indexed: 12/31/2022] Open
Abstract
In the original publication [...].
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Affiliation(s)
- Mila Valcic
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Marc A. Khoury
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Julia Kim
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Luis Fornazzari
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Department of Neurology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Nathan W. Churchill
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, Community Health Sciences, and Pathology, Hotchkiss Brain Institute and O’Brien Institute of Public Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Vincenzo De Luca
- Division of Geriatric Psychiatry, Centre for Addiction & Mental Health, Toronto, ON M5T 1R8, Canada
| | - Debby Tsuang
- GRECC, VA Puget Sound and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA
| | - Tom A. Schweizer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P5, Canada
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - David G. Munoz
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Division of Pathology, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
- Correspondence:
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Valcic M, Khoury MA, Kim J, Fornazzari L, Churchill NW, Ismail Z, De Luca V, Tsuang D, Schweizer TA, Munoz DG, Fischer CE. Determining Whether Sex and Zygosity Modulates the Association between APOE4 and Psychosis in a Neuropathologically-Confirmed Alzheimer's Disease Cohort. Brain Sci 2022; 12:1266. [PMID: 36139002 PMCID: PMC9497154 DOI: 10.3390/brainsci12091266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND The APOE4 allele is a genetic risk factor for developing late-onset Alzheimer's disease (AD). Previous work by our group revealed that female APOE4 homozygotes with Lewy body (LB) pathology were more likely to experience psychosis compared to female APOE4 non-carriers, whereas in males there was no APOE4 dose-dependent significant effect. The objective of this study was to refine our previous findings by adjusting for covariates and determining the probability of an APOE4 sex-mediated effect on psychosis. METHODS Neuropathologically confirmed AD patients with LB pathology (n = 491) and without LB pathology (n = 716) were extracted from the National Alzheimer's Coordinating Center (NACC). Patients were classified as psychotic if they scored positively for delusions and/or hallucinations on the Neuropsychiatric Inventory. Analysis consisted of a preliminary unadjusted binary logistic regression and a Generalized Additive binary logistic regression Model (GAM) to predict the relationship between APOE4 status and sex on the presence of psychosis in both cohorts, adjusting for age, education and MMSE. RESULTS In the cohort with LB pathology, female APOE4 homozygotes were significantly more likely to experience psychosis compared to female APOE4 non-carriers (OR = 4.15, 95%CI [1.21, 14.2], p = 0.023). Female heterozygotes were also more likely to experience psychosis compared to female APOE4 non-carriers, but to a lesser extent (OR = 2.37, 95%CI [1.01, 5.59], p = 0.048). There was no significant difference in males with LB pathology or in any sex in the cohort without LB pathology. CONCLUSIONS Sex and zygosity influence the effect of APOE4 on psychosis in neuropathologically confirmed AD patients, with the effect being limited to females with LB pathology.
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Affiliation(s)
- Mila Valcic
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
| | - Marc A. Khoury
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
| | - Julia Kim
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
| | - Luis Fornazzari
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
- Department of Neurology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Nathan W. Churchill
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, Community Health Sciences, and Pathology, Hotchkiss Brain Institute and O’Brien Institute of Public Health, University of Calgary, Calgary, AB T2N 4Z6, Canada;
| | - Vincenzo De Luca
- Division of Geriatric Psychiatry, Centre for Addiction & Mental Health, Toronto, ON M5T 1R8, Canada;
| | - Debby Tsuang
- GRECC, VA Puget Sound and Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195-6560, USA;
| | - Tom A. Schweizer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P5, Canada
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - David G. Munoz
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Division of Pathology, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, Toronto, ON M5B 1T8, Canada; (M.V.); (M.A.K.); (J.K.); (L.F.); (N.W.C.); (T.A.S.); (D.G.M.)
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
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Khoury MA, Bahsoun MA, Fadhel A, Shunbuli S, Venkatesh S, Ghazvanchahi A, Mitha S, Chan K, Fornazzari LR, Churchill NW, Ismail Z, Munoz DG, Schweizer TA, Moody AR, Fischer CE, Khademi A. Delusional Severity Is Associated with Abnormal Texture in FLAIR MRI. Brain Sci 2022; 12:600. [PMID: 35624987 PMCID: PMC9139341 DOI: 10.3390/brainsci12050600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Background: This study examines the relationship between delusional severity in cognitively impaired adults with automatically computed volume and texture biomarkers from the Normal Appearing Brain Matter (NABM) in FLAIR MRI. Methods: Patients with mild cognitive impairment (MCI, n = 24) and Alzheimer’s Disease (AD, n = 18) with delusions of varying severities based on Neuropsychiatric Inventory-Questionnaire (NPI-Q) (1—mild, 2—moderate, 3—severe) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) were analyzed for this task. The NABM region, which is gray matter (GM) and white matter (WM) combined, was automatically segmented in FLAIR MRI volumes with intensity standardization and thresholding. Three imaging biomarkers were computed from this region, including NABM volume and two texture markers called “Integrity” and “Damage”. Together, these imaging biomarkers quantify structural changes in brain volume, microstructural integrity and tissue damage. Multivariable regression was used to investigate relationships between imaging biomarkers and delusional severities (1, 2 and 3). Sex, age, education, APOE4 and baseline cerebrospinal fluid (CSF) tau were included as co-variates. Results: Biomarkers were extracted from a total of 42 participants with longitudinal time points representing 164 imaging volumes. Significant associations were found for all three NABM biomarkers between delusion level 3 and level 1. Integrity was also sensitive enough to show differences between delusion level 1 and delusion level 2. A significant specified interaction was noted with severe delusions (level 3) and CSF tau for all imaging biomarkers (p < 0.01). APOE4 homozygotes were also significantly related to the biomarkers. Conclusion: Cognitively impaired older adults with more severe delusions have greater global brain disease burden in the WM and GM combined (NABM) as measured using FLAIR MRI. Relative to patients with mild delusions, tissue degeneration in the NABM was more pronounced in subjects with higher delusional symptoms, with a significant association with CSF tau. Future studies are required to establish potential tau-associated mechanisms of increased delusional severity.
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Affiliation(s)
- Marc A. Khoury
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
| | - Mohamad-Ali Bahsoun
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Ayad Fadhel
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
| | - Shukrullah Shunbuli
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
| | - Saanika Venkatesh
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Abdollah Ghazvanchahi
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Samir Mitha
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Karissa Chan
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON M5B 2K3, Canada
| | - Luis R. Fornazzari
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Division of Neurology, Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Nathan W. Churchill
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Zahinoor Ismail
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - David G. Munoz
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Tom A. Schweizer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON M5S 3G9, Canada
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1P5, Canada
| | - Alan R. Moody
- Department of Medical Imaging, University of Toronto, Toronto, ON M5T 1W7, Canada;
| | - Corinne E. Fischer
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - April Khademi
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Toronto, ON M5V 1T8, Canada; (M.A.K.); (A.F.); (S.S.); (S.V.); (L.R.F.); (N.W.C.); (D.G.M.); (T.A.S.); (A.K.)
- Institute for Biomedical Engineering, Science & Tech (iBEST), a Partnership between St. Michael’s Hospital and Ryerson University, Toronto, ON M5V 1T8, Canada; (M.-A.B.); (A.G.); (S.M.); (K.C.)
- Electrical, Computer and Biomedical Engineering Department, Ryerson University, Toronto, ON M5B 2K3, Canada
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Abstract
The expression of HLA and ABH antigens in fresh, frozen, and twice-frozen normal human meniscal tissue was evaluated with use of immunohistochemistry. A generalized expression of Class-I and Class-II HLA antigens was found in the endothelial and synovial cells of all three forms of tissue. Fibrochondrocytes were Class-I positive and Class-II negative. ABH antigens were expressed by endothelial cells in relationship to the blood group of the patient. Freezing preserved most of the HLA and ABH molecular structure. Although the normal meniscus consists of a relatively few chondrocytes embedded in an extracellular matrix, it also contains Class-II and ABH-positive endothelial cells and Class-II-positive synovial cells. These antigens are present at the moment of transplantation and could evoke an immune response in the host that would modulate the results of meniscal allografting.
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Affiliation(s)
- M A Khoury
- Department of Orthopaedics, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106
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