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Xue C, Kowshik SS, Lteif D, Puducheri S, Jasodanand VH, Zhou OT, Walia AS, Guney OB, Zhang JD, Pham ST, Kaliaev A, Andreu-Arasa VC, Dwyer BC, Farris CW, Hao H, Kedar S, Mian AZ, Murman DL, O’Shea SA, Paul AB, Rohatgi S, Saint-Hilaire MH, Sartor EA, Setty BN, Small JE, Swaminathan A, Taraschenko O, Yuan J, Zhou Y, Zhu S, Karjadi C, Ang TFA, Bargal SA, Plummer BA, Poston KL, Ahangaran M, Au R, Kolachalama VB. AI-based differential diagnosis of dementia etiologies on multimodal data. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.08.24302531. [PMID: 38585870 PMCID: PMC10996713 DOI: 10.1101/2024.02.08.24302531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Differential diagnosis of dementia remains a challenge in neurology due to symptom overlap across etiologies, yet it is crucial for formulating early, personalized management strategies. Here, we present an AI model that harnesses a broad array of data, including demographics, individual and family medical history, medication use, neuropsychological assessments, functional evaluations, and multimodal neuroimaging, to identify the etiologies contributing to dementia in individuals. The study, drawing on 51,269 participants across 9 independent, geographically diverse datasets, facilitated the identification of 10 distinct dementia etiologies. It aligns diagnoses with similar management strategies, ensuring robust predictions even with incomplete data. Our model achieved a micro-averaged area under the receiver operating characteristic curve (AUROC) of 0.94 in classifying individuals with normal cognition, mild cognitive impairment and dementia. Also, the micro-averaged AUROC was 0.96 in differentiating the dementia etiologies. Our model demonstrated proficiency in addressing mixed dementia cases, with a mean AUROC of 0.78 for two co-occurring pathologies. In a randomly selected subset of 100 cases, the AUROC of neurologist assessments augmented by our AI model exceeded neurologist-only evaluations by 26.25%. Furthermore, our model predictions aligned with biomarker evidence and its associations with different proteinopathies were substantiated through postmortem findings. Our framework has the potential to be integrated as a screening tool for dementia in various clinical settings and drug trials, with promising implications for person-level management.
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Affiliation(s)
- Chonghua Xue
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Electrical & Computer Engineering, Boston University, MA, USA
| | - Sahana S. Kowshik
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Faculty of Computing & Data Sciences, Boston University, MA, USA
| | - Diala Lteif
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Computer Science, Boston University, MA, USA
| | - Shreyas Puducheri
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Varuna H. Jasodanand
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Olivia T. Zhou
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Anika S. Walia
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Osman B. Guney
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Electrical & Computer Engineering, Boston University, MA, USA
| | - J. Diana Zhang
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- School of Chemistry, University of New South Wales, Sydney, Australia
| | - Serena T. Pham
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Artem Kaliaev
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - V. Carlota Andreu-Arasa
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Brigid C. Dwyer
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Chad W. Farris
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Honglin Hao
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Sachin Kedar
- Departments of Neurology & Ophthalmology, Emory University School of Medicine, Atlanta, GA, USA
| | - Asim Z. Mian
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Daniel L. Murman
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Sarah A. O’Shea
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Aaron B. Paul
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - Saurabh Rohatgi
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Emmett A. Sartor
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Bindu N. Setty
- Department of Radiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Juan E. Small
- Department of Radiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | | | - Olga Taraschenko
- Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA
| | - Jing Yuan
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Yan Zhou
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuhan Zhu
- Department of Neurology, Brigham & Women’s Hospital, Boston, MA, USA
| | - Cody Karjadi
- The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Ting Fang Alvin Ang
- The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Sarah A. Bargal
- Department of Computer Science, Georgetown University, Washington DC, USA
| | | | | | - Meysam Ahangaran
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Rhoda Au
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- The Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Boston University Alzheimer’s Disease Research Center, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Vijaya B. Kolachalama
- Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
- Faculty of Computing & Data Sciences, Boston University, MA, USA
- Department of Computer Science, Boston University, MA, USA
- Boston University Alzheimer’s Disease Research Center, Boston, MA, USA
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Monane M, Johnson KG, Snider BJ, Turner RS, Drake JD, Maraganore DM, Bicksel JL, Jacobs DH, Ortega JL, Henderson J, Jiang Y, Huang S, Coppinger J, Fogelman I, West T, Braunstein JB. A blood biomarker test for brain amyloid impacts the clinical evaluation of cognitive impairment. Ann Clin Transl Neurol 2023; 10:1738-1748. [PMID: 37550958 PMCID: PMC10578891 DOI: 10.1002/acn3.51863] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/06/2023] [Accepted: 07/09/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVE The objective of this study was to examine clinicians' patient selection and result interpretation of a clinically validated mass spectrometry test measuring amyloid beta and ApoE blood biomarkers combined with patient age (PrecivityAD® blood test) in symptomatic patients evaluated for Alzheimer's disease (AD) or other causes of cognitive decline. METHODS The Quality Improvement and Clinical Utility PrecivityAD Clinician Survey (QUIP I, ClinicalTrials.gov Identifier: NCT05477056) was a prospective, single-arm cohort study among 366 patients evaluated by neurologists and other cognitive specialists. Participants underwent blood biomarker testing and received an amyloid probability score (APS), indicating the likelihood of a positive result on an amyloid positron emission tomography (PET) scan. The primary study outcomes were appropriateness of patient selection as well as result interpretation associated with PrecivityAD blood testing. RESULTS A 95% (347/366) concordance rate was noted between clinicians' patient selection and the test's intended use criteria. In the final analysis including these 347 patients (median age 75 years, 56% women), prespecified test result categories incorporated 133 (38%) low APS, 162 (47%) high APS, and 52 (15%) intermediate APS patients. Clinicians' pretest and posttest AD diagnosis probability changed from 58% to 23% in low APS patients and 71% to 89% in high APS patients (p < 0.0001). Anti-AD drug therapy decreased by 46% in low APS patients (p < 0.0001) and increased by 57% in high APS patients (p < 0.0001). INTERPRETATION These findings demonstrate the clinical utility of the PrecivityAD blood test in clinical care and may have added relevance as new AD therapies are introduced.
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Affiliation(s)
| | - Kim G. Johnson
- Department of Psychiatry & Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
| | - B. Joy Snider
- Washington University School of MedicineSt. LouisMissouriUSA
| | | | - Jonathan D. Drake
- Warren Alpert Medical School at Brown UniversityProvidenceRhode IslandUSA
| | | | | | | | | | | | | | | | | | | | - Tim West
- C2N Diagnostics, LLCSt. LouisMissouriUSA
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Loveland PM, Yu JJ, Churilov L, Yassi N, Watson R. Investigation of Inflammation in Lewy Body Dementia: A Systematic Scoping Review. Int J Mol Sci 2023; 24:12116. [PMID: 37569491 PMCID: PMC10418754 DOI: 10.3390/ijms241512116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Inflammatory mechanisms are increasingly recognized as important contributors to the pathogenesis of neurodegenerative diseases, including Lewy body dementia (LBD). Our objectives were to, firstly, review inflammation investigation methods in LBD (dementia with Lewy bodies and Parkinson's disease dementia) and, secondly, identify alterations in inflammatory signals in LBD compared to people without neurodegenerative disease and other neurodegenerative diseases. A systematic scoping review was performed by searching major electronic databases (MEDLINE, Embase, Web of Science, and PSYCHInfo) to identify relevant human studies. Of the 2509 results screened, 80 studies were included. Thirty-six studies analyzed postmortem brain tissue, and 44 investigated living subjects with cerebrospinal fluid, blood, and/or brain imaging assessments. Largely cross-sectional data were available, although two longitudinal clinical studies investigated prodromal Lewy body disease. Investigations were focused on inflammatory immune cell activity (microglia, astrocytes, and lymphocytes) and inflammatory molecules (cytokines, etc.). Results of the included studies identified innate and adaptive immune system contributions to inflammation associated with Lewy body pathology and clinical disease features. Different signals in early and late-stage disease, with possible late immune senescence and dystrophic glial cell populations, were identified. The strength of these associations is limited by the varying methodologies, small study sizes, and cross-sectional nature of the data. Longitudinal studies investigating associations with clinical and other biomarker outcomes are needed to improve understanding of inflammatory activity over the course of LBD. This could identify markers of disease activity and support therapeutic development.
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Affiliation(s)
- Paula M. Loveland
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville 3000, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
| | - Jenny J. Yu
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville 3000, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
| | - Leonid Churilov
- Department of Neurology, Melbourne Brain Centre, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
- Melbourne Medical School, University of Melbourne, Parkville 3000, Australia
| | - Nawaf Yassi
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville 3000, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
- Department of Neurology, Melbourne Brain Centre, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
| | - Rosie Watson
- Population Health and Immunity Division, The Walter and Eliza Hall Institute of Medical Research, Parkville 3000, Australia
- Department of Medicine, The Royal Melbourne Hospital, University of Melbourne, Parkville 3000, Australia
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Ottenhoff L, Vijverberg EGB, Visser LNC, Verijp M, Prins ND, Van der Flier WM, Sikkes SAM. Experiences of and recommendations on clinical trial design in Alzheimer's disease from the participant's point of view: a mixed-methods study in two clinical trial centers in the Netherlands. Alzheimers Res Ther 2023; 15:72. [PMID: 37016435 PMCID: PMC10071606 DOI: 10.1186/s13195-023-01190-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 02/13/2023] [Indexed: 04/06/2023]
Abstract
INTRODUCTION In the context of the development of pharmaceutical interventions, expectations and experiences of participants are essential. Their insights may be particularly helpful to address the challenges of recruiting and retaining participants for Alzheimer's disease (AD) clinical trials. We examined clinical trial participants' experiences to optimize trial design in Alzheimer's disease (AD). METHOD In this mixed-methods study, we included adults who participated in sponsor-initiated AD trials at Brain Research Center, a clinical trial organization in the Netherlands. Participants (N = 71, age 69 ± 6.5, 54%F, 19 cognitively normal (CN), 19 mild cognitive impairment (MCI), and 33 AD dementia) first completed an online survey. Diagnostic group differences were investigated using chi-square tests or one-way ANOVAs. Next, a subsample (N = 12; 8 = CN, 4 = MCI) participated in focus groups to gain in-depth insight into their opinions on optimizing trial design from a participants' point of view. Audio recordings from focus group interviews were transcribed verbatim and analyzed by thematic content analysis by two independent researchers. RESULTS Most reported motives for enrolment included "to benefit future generations" (89%), followed by "for science" (66%) and "better monitoring" (42%). Frequent suggestions for increasing willingness to participate included a smaller chance to receive placebo (n = 38, 54%), shorter travel times (n = 27, 38%), and sharing individual results of different assessments (n = 57, 80%), as well as receiving trial results (n = 52, 73). Highest visual analogue burden scores (0-100) were found for the lumbar puncture (M = 47.2, SD = 38.2) and cognitive assessments (M = 27.2, SD = 25.7). Results did not differ between diagnostic groups, nor between patient and caregiver participants (all p-values>.05). Two additional themes emerged from the focus groups: "trial design," such as follow-up visit(s) after participating, and "trial center," including the relevance of a professional and empathic staff. CONCLUSION Relevant factors include expectation management and careful planning of high-burden assessments, provision of individual feedback, and prioritizing professionalism and empathy throughout conduct of the trial. Our findings provide insight into participants' priorities to increase willingness to participate and can be used to optimize trial success.
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Affiliation(s)
- Lois Ottenhoff
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, De Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Brain Research Center Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Everard G B Vijverberg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, De Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Leonie N C Visser
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands, Amsterdam, The Netherlands
- Center for Alzheimer Research, Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Solna, Sweden
| | - Merike Verijp
- Brain Research Center Amsterdam, Amsterdam, The Netherlands
| | - Niels D Prins
- Brain Research Center Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M Van der Flier
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, De Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, De Boelelaan 1118, 1081, HZ, Amsterdam, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands.
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands.
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Loveland PM, Watson R, Yassi N. Diagnostic challenges for dementia in Australia: are blood-based biomarkers the solution? Intern Med J 2022; 52:2181-2185. [PMID: 37133369 PMCID: PMC10946735 DOI: 10.1111/imj.15973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/24/2022] [Indexed: 12/23/2022]
Abstract
The burden of dementia will increase as the Australian population ages and grows in coming decades. Early and accurate diagnosis remains challenging, and disproportionately so for particular groups, including rural communities. Recent advances in technology, however, now allow reliable measurement of blood biomarkers that could improve diagnosis in a range of settings. We discuss the most promising biomarker candidates for translation into clinical practice and research in the near future.
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Affiliation(s)
- Paula M. Loveland
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneMelbourneVictoriaAustralia
- Department of Medicine, The Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
| | - Rosie Watson
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneMelbourneVictoriaAustralia
- Department of Medicine, The Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
| | - Nawaf Yassi
- Population Health and Immunity DivisionThe Walter and Eliza Hall Institute of Medical ResearchMelbourneVictoriaAustralia
- Department of Medical BiologyThe University of MelbourneMelbourneVictoriaAustralia
- Department of Medicine, The Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
- Department of Neurology, Melbourne Brain Centre at The Royal Melbourne HospitalUniversity of MelbourneMelbourneVictoriaAustralia
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Schindler SE, Li Y, Li M, Despotis A, Park E, Vittert L, Hamilton BH, Womack KB, Saef B, Holtzman DM, Morris JC, Bateman RJ, Gupta MR. Using Alzheimer's disease blood tests to accelerate clinical trial enrollment. Alzheimers Dement 2022; 19:1175-1183. [PMID: 35934777 PMCID: PMC9902574 DOI: 10.1002/alz.12754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/03/2022] [Accepted: 06/22/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Screening potential participants in Alzheimer's disease (AD) clinical trials with amyloid positron emission tomography (PET) is often time consuming and expensive. METHODS A web-based application was developed to model the time and financial cost of screening for AD clinical trials. Four screening approaches were compared; three approaches included an AD blood test at different stages of the screening process. RESULTS The traditional screening approach using only amyloid PET was the most time consuming and expensive. Incorporating an AD blood test at any point in the screening process decreased both the time and financial cost of trial enrollment. Improvements in AD blood test accuracy over currently available tests only marginally increased savings. Use of a high specificity cut-off may improve the feasibility of screening with only an AD blood test. DISCUSSION Incorporating AD blood tests into screening for AD clinical trials may reduce the time and financial cost of enrollment. HIGHLIGHTS The time and cost of enrolling participants in Alzheimer's disease (AD) clinical trials were modeled. A web-based application was developed to enable evaluation of key parameters. AD blood tests may decrease the time and financial cost of clinical trial enrollment. Improvements in AD blood test accuracy only marginally increased savings. Use of a high specificity cut-off may enable screening with only an AD blood test.
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Affiliation(s)
- Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA,Corresponding author: Suzanne E. Schindler, MD, PhD, Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO 63110, USA. Phone (314) 273-1655, Fax (314) 362-2244
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Melody Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Alyssa Despotis
- Olin Business School, Washington University, St. Louis, MO, USA
| | - Ethan Park
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Liberty Vittert
- Olin Business School, Washington University, St. Louis, MO, USA
| | | | - Kyle B. Womack
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Benjamin Saef
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, 63110, USA,Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, 63110, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, 63110, USA
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Schindler SE, Ney DE, Goss AL, Rabinovici G. ANA Investigates: The Future of Biomarkers in Alzheimer Disease. Ann Neurol 2022; 92:159-160. [PMID: 35689567 DOI: 10.1002/ana.26437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Suzanne E Schindler
- Deparment of Neurology, Washington University School of Medicine, St. Louis, MO & Knight Alzheimer Research Center, Washington University School of Medicine, St. Louis, MO
| | - Douglas E Ney
- Departments of Neurology and Neurosurgery, University of Colorado School of Medicine, Aurora, CO
| | - Adeline L Goss
- Department of Neurology, University of California San Francisco, San Francisco, CA
| | - Gil Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA
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Multimer Detection System-Oligomerized Amyloid Beta (MDS-OA β): A Plasma-Based Biomarker Differentiates Alzheimer's Disease from Other Etiologies of Dementia. Int J Alzheimers Dis 2022; 2022:9960832. [PMID: 35547155 PMCID: PMC9085320 DOI: 10.1155/2022/9960832] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/12/2022] [Indexed: 01/10/2023] Open
Abstract
With emerging amyloid therapies, documentation of the patient's amyloid status to confirm the etiology of a clinical diagnosis is warranted prior to instituting amyloid-based therapy. The Multimer Detection System-Oligomeric Amyloid-β (MDS-OAβ) is a noninvasive blood-based biomarker utilized to measure Aβ oligomerization tendency. We determined the difference in MDS-OAβ ratio across the groups: (a) no cognitive impairment or subjective cognitive impairment (NCI/SCI), (b) Alzheimer's disease (AD), (c) non-AD, and (d) mixed Alzheimer's disease-Vascular dementia (AD-VaD). MDS-OAβ level was not significantly different between AD and mixed AD-VaD, but both groups were significantly different from the NCI/SCI and from the non-AD group. An MDS-OAβ level of >1 could potentially indicate clinical variants of AD or mixed pathology (AD-VaD).
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Pomilio AB, Vitale AA, Lazarowski AJ. Neuroproteomics Chip-Based Mass Spectrometry and Other Techniques for Alzheimer´S Disease Biomarkers – Update. Curr Pharm Des 2022; 28:1124-1151. [DOI: 10.2174/1381612828666220413094918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/25/2022] [Indexed: 11/22/2022]
Abstract
Background:
Alzheimer's disease (AD) is a progressive neurodegenerative disease of growing interest given that there is cognitive damage and symptom onset acceleration. Therefore, it is important to find AD biomarkers for early diagnosis, disease progression, and discrimination of AD and other diseases.
Objective:
To update the relevance of mass spectrometry for the identification of peptides and proteins involved in AD useful as discriminating biomarkers.
Methods:
Proteomics and peptidomics technologies that show the highest possible specificity and selectivity for AD biomarkers are analyzed, together with the biological fluids used. In addition to positron emission tomography and magnetic resonance imaging, MALDI-TOF mass spectrometry is widely used to identify proteins and peptides involved in AD. The use of protein chips in SELDI technology and electroblotting chips for peptides makes feasible small amounts (L) of samples for analysis.
Results:
Suitable biomarkers are related to AD pathology, such as intracellular neurofibrillary tangles; extraneuronal senile plaques; neuronal and axonal degeneration; inflammation and oxidative stress. Recently, peptides were added to the candidate list, which are not amyloid-b or tau fragments, but are related to coagulation, brain plasticity, and complement/neuroinflammation systems involving the neurovascular unit.
Conclusion:
The progress made in the application of mass spectrometry and recent chip techniques is promising for discriminating between AD, mild cognitive impairment, and matched healthy controls. The application of this technique to blood samples from patients with AD has shown to be less invasive and fast enough to determine the diagnosis, stage of the disease, prognosis, and follow-up of the therapeutic response.
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Affiliation(s)
- Alicia B. Pomilio
- Departamento de Bioquímica Clínica, Área Hematología, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Av. Córdoba 2351, C1120AAF Buenos Aires, Argentina
| | - Arturo A. Vitale
- Departamento de Bioquímica Clínica, Área Hematología, Hospital de Clínicas “José de San Martín”, Universidad de Buenos Aires, Av. Córdoba 2351, C1120AAF Buenos Aires, Argentina
| | - Alberto J. Lazarowski
- Departamento de Bioquímica Clínica, Facultad de Farmacia y Bioquímica, Instituto de Fisiopatología y Bioquímica Clínica (INFIBIOC), Universidad de Buenos Aires, Córdoba 2351, C1120AAF Buenos Aires, Argentina
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Xin JY, Huang X, Sun Y, Jiang HS, Fan J, Yu NW, Guo FQ, Ye F, Xiao J, Le WD, Yang SJ, Xiang Y. Association Between Plasma Apolipoprotein M With Alzheimer’s Disease: A Cross-Sectional Pilot Study From China. Front Aging Neurosci 2022; 14:838223. [PMID: 35370599 PMCID: PMC8973919 DOI: 10.3389/fnagi.2022.838223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/17/2022] [Indexed: 12/19/2022] Open
Abstract
BackgroundRecent evidence of genetics and metabonomics indicated a potential role of apolipoprotein M (ApoM) in the pathogenesis of Alzheimer’s disease (AD). Here, we aimed to investigate the association between plasma ApoM with AD.MethodsA multicenter, cross-sectional study recruited patients with AD (n = 67), age- and sex-matched cognitively normal (CN) controls (n = 73). After the data collection of demographic characteristics, lifestyle risk factors, and medical history, we examined and compared the plasma levels of ApoM, tau phosphorylated at threonine 217 (p-tau217) and neurofilament light (NfL). Multivariate logistic regression analysis was applied to determine the association of plasma ApoM with the presence of AD. The correlation analysis was used to explore the correlations between plasma ApoM with cognitive function [Mini–Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)], activities of daily living (ADL), and the representative blood-based biomarkers (plasma p-tau217 and NfL). Receiver operating characteristic (ROC) analysis and Delong’s test were used to determine the diagnostic power of plasma ApoM.ResultsPlasma ApoM and its derived indicators (ratios of ApoM/TC, ApoM/TG, ApoM/HDL-C, and ApoM/LDL-C) were significantly higher in AD group than those in CN group (each p < 0.0001). After adjusted for the risk factors of AD, the plasma ApoM and its derived indicators were significantly associated with the presence of AD, respectively. ApoM (OR = 1.058, 95% CI: 1.027–1.090, p < 0.0001), ApoM/TC ratio (OR = 1.239, 95% CI: 1.120–1.372, p < 0.0001), ApoM/TG ratio (OR = 1.064, 95% CI: 1.035–1.095, p < 0.0001), ApoM/HDL-C ratio (OR = 1.069, 95% CI: 1.037–1.102, p < 0.0001), and ApoM/LDL-C ratio (OR = 1.064, 95% CI:1.023–1.106, p = 0.002). In total participants, plasma ApoM was significantly positively correlated with plasma p-tau217, plasma NfL, and ADL (each p < 0.0001) and significantly negatively correlated with MMSE and MoCA (each p < 0.0001), respectively. In further subgroup analyses, these associations remained in different APOEϵ 4 status participants and sex subgroups. ApoM/TC ratio (ΔAUC = 0.056, p = 0.044) and ApoM/TG ratio (ΔAUC = 0.097, p = 0.011) had a statistically remarkably larger AUC than ApoM, respectively. The independent addition of ApoM and its derived indicators to the basic model [combining age, sex, APOEϵ 4, and body mass index (BMI)] led to the significant improvement in diagnostic power, respectively (each p < 0.05).ConclusionAll the findings preliminarily uncovered the association between plasma ApoM and AD and provided more evidence of the potential of ApoM as a candidate biomarker of AD.
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Affiliation(s)
- Jia-Yan Xin
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
- Department of Neurology, General Hospital of Western Theater Command, Chengdu, China
| | - Xiao Huang
- Department of Clinical Medicine, North Sichuan Medical College, Nanchong, China
- Department of Neurology, General Hospital of Western Theater Command, Chengdu, China
| | - Ying Sun
- Department of Geriatrics, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hai-Song Jiang
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Jin Fan
- Department of Neurology, General Hospital of Western Theater Command, Chengdu, China
| | - Neng-wei Yu
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Fu-Qiang Guo
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Fang Ye
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jun Xiao
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei-dong Le
- Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, Chengdu, China
| | - Shao-Jie Yang
- Department of Neurology, Chengdu Eighth People’s Hospital, Chengdu, China
- *Correspondence: Shao-Jie Yang,
| | - Yang Xiang
- Department of Neurology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- Yang Xiang,
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11
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Tissot C, Therriault J, Kunach P, L Benedet A, Pascoal TA, Ashton NJ, Karikari TK, Servaes S, Lussier FZ, Chamoun M, Tudorascu DL, Stevenson J, Rahmouni N, Poltronetti NM, Pallen V, Bezgin G, Kang MS, Mathotaarachchi SS, Wang YT, Fernandez Arias J, Ferreira PCL, Ferrari-Souza JP, Vanmechelen E, Blennow K, Zetterberg H, Gauthier S, Rosa-Neto P. Comparing tau status determined via plasma pTau181, pTau231 and [ 18F]MK6240 tau-PET. EBioMedicine 2022; 76:103837. [PMID: 35134647 PMCID: PMC8844756 DOI: 10.1016/j.ebiom.2022.103837] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 12/24/2021] [Accepted: 01/11/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Tau in Alzheimer's disease (AD) is assessed via cerebrospinal fluid (CSF) and Positron emission tomography (PET). Novel methods to detect phosphorylated tau (pTau) in blood have been recently developed. We aim to investigate agreement of tau status as determined by [18F]MK6240 tau-PET, plasma pTau181 and pTau231. METHODS We assessed cognitively unimpaired young, cognitively unimpaired, mild cognitive impairment and AD individuals with [18F]MK6240, plasma pTau181, pTau 231, [18F]AZD4694 amyloid-PET and MRI. A subset underwent CSF assessment. We conducted ROC curves to obtain cut-off values for plasma pTau epitopes. Individuals were categorized as positive or negative in all biomarkers. We then compared the distribution among concordant and discordant groups in relation to diagnosis, Aβ status, APOEε4 status, [18F]AZD4694 global SUVR, hippocampal volume and CSF pTau181. FINDINGS The threshold for positivity was 15.085 pg/mL for plasma pTau181 and 17.652 pg/mL for plasma pTau231. Most individuals had concordant statuses, however, 18% of plasma181/PET, 26% of plasma231/PET and 25% of the pTau231/pTau181 were discordant. Positivity to at least one biomarker was often accompanied by diagnosis of cognitive impairment, Aβ positivity, APOEε4 carriership, higher levels of [18F]AZD4694 global SUVR, hippocampal atrophy and CSF pTau181. INTERPRETATION Plasma pTau181, pTau231 and [18F]MK6240 seem to reflect different stages of tau progression. Plasma biomarkers can be useful in the context of diagnostic information and clinical trials, to evaluate the disease stage. Moreover, they seem to confidently evaluate tau-PET positivity. FUNDING Moreover, this study was supported by Weston Brain Institute, Canadian Institute of Health Research and Fonds de Recherche du Québec.
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Affiliation(s)
- Cécile Tissot
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Joseph Therriault
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Peter Kunach
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Andréa L Benedet
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada; Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Tharick A Pascoal
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada; University of Pittsburgh, Pittsburgh, PA, USA
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Sweden; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Clinical Neuroscience Institute, London, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Sweden; University of Pittsburgh, Pittsburgh, PA, USA
| | - Stijn Servaes
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Firoza Z Lussier
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Mira Chamoun
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | | | - Jenna Stevenson
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Nesrine Rahmouni
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Nina Margherita Poltronetti
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Vanessa Pallen
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Gleb Bezgin
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Min Su Kang
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Sulantha S Mathotaarachchi
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Yi-Ting Wang
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | - Jaime Fernandez Arias
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada
| | | | - João Pedro Ferrari-Souza
- University of Pittsburgh, Pittsburgh, PA, USA; Graduate program in Biological Sciences, Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | | | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden; UK Dementia Research Institute at UCL, London, United Kingdom
| | - Henrik Zetterberg
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Sweden; UK Dementia Research Institute at UCL, London, United Kingdom; Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
| | - Serge Gauthier
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Douglas Hospital Research Centre, Verdun, QC, Canada
| | - Pedro Rosa-Neto
- McGill University, Montreal, QC, Canada; McGill University Research Centre for Studies in Aging, Douglas Hospital, McGill University, 6875 La Salle Blvd - FBC room 3149, Verdun, QC H4H 1R3, Canada; Translational Neuroimaging Laboratory, Alzheimer's Disease Research Unit, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Department of Neurology and Neurosurgery, Psychiatry and Pharmacology and Therapeutics, McGill University, McGill University Research Centre for Studies in Aging, Douglas Research Institute, Montreal, Canada.
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12
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Scott GD, Arnold MR, Beach TG, Gibbons CH, Kanthasamy AG, Lebovitz RM, Lemstra AW, Shaw LM, Teunissen CE, Zetterberg H, Taylor AS, Graham TC, Boeve BF, Gomperts SN, Graff-Radford NR, Moussa C, Poston KL, Rosenthal LS, Sabbagh MN, Walsh RR, Weber MT, Armstrong MJ, Bang JA, Bozoki AC, Domoto-Reilly K, Duda JE, Fleisher JE, Galasko DR, Galvin JE, Goldman JG, Holden SK, Honig LS, Huddleston DE, Leverenz JB, Litvan I, Manning CA, Marder KS, Pantelyat AY, Pelak VS, Scharre DW, Sha SJ, Shill HA, Mari Z, Quinn JF, Irwin DJ. Fluid and Tissue Biomarkers of Lewy Body Dementia: Report of an LBDA Symposium. Front Neurol 2022; 12:805135. [PMID: 35173668 PMCID: PMC8841880 DOI: 10.3389/fneur.2021.805135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/27/2021] [Indexed: 12/14/2022] Open
Abstract
The Lewy Body Dementia Association (LBDA) held a virtual event, the LBDA Biofluid/Tissue Biomarker Symposium, on January 25, 2021, to present advances in biomarkers for Lewy body dementia (LBD), which includes dementia with Lewy bodies (DLBs) and Parkinson's disease dementia (PDD). The meeting featured eight internationally known scientists from Europe and the United States and attracted over 200 scientists and physicians from academic centers, the National Institutes of Health, and the pharmaceutical industry. Methods for confirming and quantifying the presence of Lewy body and Alzheimer's pathology and novel biomarkers were discussed.
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Affiliation(s)
- Gregory D. Scott
- Department of Pathology, Oregon Health and Science University, Portland, OR, United States
- Department of Pathology and Laboratory Services, VA Portland Medical Center, Portland, OR, United States
| | - Moriah R. Arnold
- Graduate Program in Biomedical Sciences, School of Medicine M.D./Ph.D. Program, Oregon Health and Science University, Portland, OR, United States
| | - Thomas G. Beach
- Civin Laboratory for Neuropathology and Brain and Body Donation Program, Banner Sun Health Research Institute, Sun City, AZ, United States
| | - Christopher H. Gibbons
- Department of Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
| | - Anumantha G. Kanthasamy
- Department of Physiology and Pharmacology, Center for Brain Sciences and Neurodegenerative Diseases, University of Georgia, Athens, GA, United States
| | | | - Afina W. Lemstra
- Department of Neurology, Amsterdam University Medical Center (UMC), Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam University Medical Center (UMC), Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, University College London (UCL) Institute of Neurology, London, United Kingdom
- UK Dementia Research Institute at University College London, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | | | - Todd C. Graham
- Lewy Body Dementia Association, Lilburn, GA, United States
| | - Bradley F. Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, MN, United States
| | - Stephen N. Gomperts
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | | | - Charbel Moussa
- Department of Neurology, Georgetown University Medical Center, Washington DC, CA, United States
| | - Kathleen L. Poston
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Liana S. Rosenthal
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Marwan N. Sabbagh
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Ryan R. Walsh
- Barrow Neurological Institute and Muhammed Ali Parkinson Center, Phoenix, AZ, United States
| | - Miriam T. Weber
- Department of Neurology, University of Rochester, Rochester, NY, United States
| | - Melissa J. Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, United States
| | - Jee A. Bang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andrea C. Bozoki
- Department of Neurology, University of North Carolina, Chapel Hill, NC, United States
| | | | - John E. Duda
- Parkinson's Disease Research, Education and Clinical Center, Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jori E. Fleisher
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, United States
| | - Douglas R. Galasko
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - James E. Galvin
- Department of Neurology, Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jennifer G. Goldman
- Shirley Ryan Abilitylab and Department of Physical Medicine and Rehabilitation and Neurology, Parkinson's Disease and Movement Disorders, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Samantha K. Holden
- Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lawrence S. Honig
- Columbia University Irving Medical Center, New York, NY, United States
| | - Daniel E. Huddleston
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - James B. Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, United States
| | - Irene Litvan
- Department of Neurosciences, University of California, San Diego, San Diego, CA, United States
| | - Carol A. Manning
- Department of Neurology, University of Virginia, Charlottesville, VA, United States
| | - Karen S. Marder
- Columbia University Irving Medical Center, New York, NY, United States
| | - Alexander Y. Pantelyat
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Victoria S. Pelak
- Departments of Neurology and Ophthalmology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Douglas W. Scharre
- Department of Neurology, Ohio State University Wexner Medical Center, Columbus, OH, United States
| | - Sharon J. Sha
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, United States
| | - Holly A. Shill
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Zoltan Mari
- Lou Ruvo Center for Brain Health, Cleveland Clinic Lerner College of Medicine, Las Vegas, NV, United States
| | - Joseph F. Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR, United States
- Department of Neurology, VA Portland Medical Center, Portland, OR, United States
| | - David J. Irwin
- Department of Neurology, University of Pennsylvania Health System, Philadelphia, PA, United States
- Digital Neuropathology Laboratory, Philadelphia, PA, United States
- Lewy Body Disease Research Center of Excellence, Philadelphia, PA, United States
- Frontotemporal Degeneration Center, Philadelphia, PA, United States
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13
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Thomas KR, Bangen KJ, Edmonds EC, Weigand AJ, Walker KS, Bondi MW, Galasko DR. Objective subtle cognitive decline and plasma phosphorylated tau181: Early markers of Alzheimer's disease-related declines. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12238. [PMID: 34692978 PMCID: PMC8515224 DOI: 10.1002/dad2.12238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Objectively-defined subtle cognitive decline (Obj-SCD) and plasma phosphorylated-tau181 (p-tau181) are promising early Alzheimer's disease (AD) markers. However, associations between Obj-SCD and p-tau181, and their combined prognostic potential, are unknown. METHODS Baseline and 4-year longitudinal p-tau181 changes were compared across cognitively unimpaired (CU; n = 402), Obj-SCD (n = 199), and mild cognitive impairment (MCI; n = 346) groups. CU and Obj-SCD participants were further classified as p-tau181-positive or negative. RESULTS CU and Obj-SCD has lower baseline p-tau181 than MCI and did not differ from one another. Longitudinally, Obj-SCD had the steepest p-tau181 increase. Obj-SCD/p-tau181-positive participants had the fastest rates of amyloid accumulation, cognitive decline, and functional decline. CONCLUSIONS Despite assumptions that cognitive changes invariably follow biomarker changes, early neuropsychological difficulties may emerge before/concurrently with plasma p-tau181 changes. Combining Obj-SCD and p-tau181, two potentially accessible early markers, was associated with the faster declines in AD-related outcomes.
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Affiliation(s)
- Kelsey R. Thomas
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Katherine J. Bangen
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Emily C. Edmonds
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Alexandra J. Weigand
- San Diego State University/University of California Joint Doctoral Program in Clinical PsychologySan DiegoCaliforniaUSA
| | - Kayla S. Walker
- Research ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
- Advancing Diversity in Aging Research (ADAR) ProgramSan Diego State UniversitySan DiegoCaliforniaUSA
| | - Mark W. Bondi
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
- Psychology ServiceVA San Diego Healthcare SystemSan DiegoCaliforniaUSA
| | - Douglas R. Galasko
- Department of NeurosciencesUniversity of California San Diego School of MedicineLa JollaCaliforniaUSA
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14
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Wolff JL, Benge JF, Cassel CK, Monin JK, Reuben DB. Emerging topics in dementia care and services. J Am Geriatr Soc 2021; 69:1763-1773. [PMID: 34245585 DOI: 10.1111/jgs.17341] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/16/2021] [Accepted: 05/19/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND The National Institute on Aging (NIA), in conjunction with the Department of Health and Human Services as part of the National Alzheimer's Project Act (NAPA), convened a 2020 Dementia Care, Caregiving, and Services Research Summit Virtual Meeting Series. This review article summarizes three areas of emerging science that are likely to grow in importance given advances in measurement, technologies, and diagnostic tests that were presented at the Summit. RESULTS Dr. Cassel discussed novel ethical considerations that have resulted from scientific advances that have enabled early diagnosis of pre-clinical dementia. Dr. Monin then summarized issues regarding emotional experiences in persons with dementia and their caregivers and care partners, including the protective impact of positive emotion and heterogeneity of differences in emotion by dementia type and individual characteristics that affect emotional processes with disease progression. Finally, Dr. Jared Benge provided an overview of the role of technologies in buffering the impact of cognitive change on real-world functioning and their utility in safety and monitoring of function and treatment adherence, facilitating communication and transportation, and increasing access to specialists in underserved or remote areas. CONCLUSIONS National policy initiatives, supported by strong advocacy and increased federal investments, have accelerated the pace of scientific inquiry and innovation related to dementia care and services but have raised some new concerns regarding ethics, disparities, and attending to individual needs, capabilities, and preferences.
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Affiliation(s)
- Jennifer L Wolff
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jared F Benge
- Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Christine K Cassel
- Department of Medicine, University of California, San Francisco, San Francisco, California, USA
| | - Joan K Monin
- Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - David B Reuben
- Department of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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15
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Campese N, Palermo G, Del Gamba C, Beatino MF, Galgani A, Belli E, Del Prete E, Della Vecchia A, Vergallo A, Siciliano G, Ceravolo R, Hampel H, Baldacci F. Progress regarding the context-of-use of tau as biomarker of Alzheimer's disease and other neurodegenerative diseases. Expert Rev Proteomics 2021; 18:27-48. [PMID: 33545008 DOI: 10.1080/14789450.2021.1886929] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction: Tau protein misfolding and accumulation in toxic species is a critical pathophysiological process of Alzheimer's disease (AD) and other neurodegenerative disorders (NDDs). Tau biomarkers, namely cerebrospinal fluid (CSF) total-tau (t-tau), 181-phosphorylated tau (p-tau), and tau-PET tracers, have been recently embedded in the diagnostic criteria for AD. Nevertheless, the role of tau as a diagnostic and prognostic biomarker for other NDDs remains controversial.Areas covered: We performed a systematical PubMed-based review of the most recent advances in tau-related biomarkers for NDDs. We focused on papers published from 2015 to 2020 assessing the diagnostic or prognostic value of each biomarker.Expert opinion: The assessment of tau biomarkers in alternative easily accessible matrices, through the development of ultrasensitive techniques, represents the most significant perspective for AD-biomarker research. In NDDs, novel tau isoforms (e.g. p-tau217) or proteolytic fragments (e.g. N-terminal fragments) may represent candidate diagnostic and prognostic biomarkers and may help monitoring disease progression. Protein misfolding amplification assays, allowing the identification of different tau strains (e.g. 3 R- vs. 4 R-tau) in CSF, may constitute a breakthrough for the in vivo stratification of NDDs. Tau-PET may help tracking the spatial-temporal evolution of tau pathophysiology in AD but its application outside the AD-spectrum deserves further studies.
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Affiliation(s)
- Nicole Campese
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giovanni Palermo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Del Gamba
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Alessandro Galgani
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Elisabetta Belli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Eleonora Del Prete
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Andrea Vergallo
- GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
| | - Gabriele Siciliano
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Roberto Ceravolo
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Harald Hampel
- GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
| | - Filippo Baldacci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.,GRC N° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard De L'hôpital, Sorbonne University, Paris, France
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