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Wang M, Lu J, Zhang Y, Zhang Q, Wang L, Wu P, Brendel M, Rominger A, Shi K, Zhao Q, Jiang J, Zuo C. Characterization of tau propagation pattern and cascading hypometabolism from functional connectivity in Alzheimer's disease. Hum Brain Mapp 2024; 45:e26689. [PMID: 38703095 PMCID: PMC11069321 DOI: 10.1002/hbm.26689] [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: 01/17/2024] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 05/06/2024] Open
Abstract
Tau pathology and its spatial propagation in Alzheimer's disease (AD) play crucial roles in the neurodegenerative cascade leading to dementia. However, the underlying mechanisms linking tau spreading to glucose metabolism remain elusive. To address this, we aimed to examine the association between pathologic tau aggregation, functional connectivity, and cascading glucose metabolism and further explore the underlying interplay mechanisms. In this prospective cohort study, we enrolled 79 participants with 18F-Florzolotau positron emission tomography (PET), 18F-fluorodeoxyglucose PET, resting-state functional, and anatomical magnetic resonance imaging (MRI) images in the hospital-based Shanghai Memory Study. We employed generalized linear regression and correlation analyses to assess the associations between Florzolotau accumulation, functional connectivity, and glucose metabolism in whole-brain and network-specific manners. Causal mediation analysis was used to evaluate whether functional connectivity mediates the association between pathologic tau and cascading glucose metabolism. We examined 22 normal controls and 57 patients with AD. In the AD group, functional connectivity was associated with Florzolotau covariance (β = .837, r = 0.472, p < .001) and glucose covariance (β = 1.01, r = 0.499, p < .001). Brain regions with higher tau accumulation tend to be connected to other regions with high tau accumulation through functional connectivity or metabolic connectivity. Mediation analyses further suggest that functional connectivity partially modulates the influence of tau accumulation on downstream glucose metabolism (mediation proportion: 49.9%). Pathologic tau may affect functionally connected neurons directly, triggering downstream glucose metabolism changes. This study sheds light on the intricate relationship between tau pathology, functional connectivity, and downstream glucose metabolism, providing critical insights into AD pathophysiology and potential therapeutic targets.
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Affiliation(s)
- Min Wang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Jiaying Lu
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
| | - Ying Zhang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Qi Zhang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Luyao Wang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Ping Wu
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
| | | | - Axel Rominger
- Department of Nuclear Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
| | - Kuangyu Shi
- Department of Nuclear Medicine, InselspitalBern University Hospital, University of BernBernSwitzerland
- Computer Aided Medical Procedures, School of Computation, Information and TechnologyTechnical University of MunichMunichGermany
| | - Qianhua Zhao
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
- Department of Neurology, Huashan HospitalFudan UniversityShanghaiChina
| | - Jiehui Jiang
- School of Life SciencesShanghai UniversityShanghaiChina
| | - Chuantao Zuo
- Department of Nuclear Medicine & PET Center, Huashan HospitalFudan UniversityShanghaiChina
- National Clinical Research Center for Aging and Medicine, Huashan HospitalFudan UniversityShanghaiChina
- National Center for Neurological Disorders, Huashan HospitalFudan UniversityShanghaiChina
- Human Phenome InstituteFudan UniversityShanghaiChina
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Bischof GN, Jaeger E, Giehl K, Jessen F, Onur OA, O'Bryant S, Kara E, Weiss PH, Drzezga A. Cortical Tau Aggregation Patterns associated with Apraxia in Alzheimer's Disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.09.24305535. [PMID: 38645131 PMCID: PMC11030486 DOI: 10.1101/2024.04.09.24305535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Objectives Apraxia is a core feature of Alzheimer's disease, but the pathomechanism of this characteristic symptom is not well understood. Here, we systematically investigated apraxia profiles in a well-defined group of patients with Alzheimer's disease (AD; N=32) who additionally underwent PET imaging with the second-generation tau PET tracer [18F]PI-2620. We hypothesized that specific patterns of tau pathology might be related to apraxic deficits. Methods Patients (N=32) with a biomarker-confirmed diagnosis of Alzheimer's disease were recruited in addition to a sample cognitively unimpaired controls (CU 1 ; N=41). Both groups underwent in-depth neuropsychological assessment of apraxia (Dementia Apraxia Screening Test; DATE and the Cologne Apraxia Screening; KAS). In addition, static PET imaging with [18F]PI-2620 was performed to assess tau pathology in the AD patients. To specifically investigate the association of apraxia with regional tau-pathology, we compared the PET-data from this group with an independent sample of amyloid-negative cognitively intact participants (CU 2; N=54) by generation of z-score-deviation maps as well as voxel- based multiple regression analyses. Results We identified significant clusters of tau-aggregation in praxis-related regions (e.g., supramarginal gyrus, angular gyrus, temporal, parietal and occipital regions) that were associated with apraxia. These regions were similar between the two apraxia assessments. No correlations between tau-tracer uptake in primary motor cortical or subcortical brain regions and apraxia were observed. Conclusions These results suggest that tau deposition in specific cortical brain regions may induce local neuronal dysfunction leading to a dose-dependent functional decline in praxis performance.
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Lee J, Burkett BJ, Min HK, Senjem ML, Dicks E, Corriveau-Lecavalier N, Mester CT, Wiste HJ, Lundt ES, Murray ME, Nguyen AT, Reichard RR, Botha H, Graff-Radford J, Barnard LR, Gunter JL, Schwarz CG, Kantarci K, Knopman DS, Boeve BF, Lowe VJ, Petersen RC, Jack CR, Jones DT. Synthesizing images of tau pathology from cross-modal neuroimaging using deep learning. Brain 2024; 147:980-995. [PMID: 37804318 PMCID: PMC10907092 DOI: 10.1093/brain/awad346] [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: 02/20/2023] [Revised: 08/30/2023] [Accepted: 09/24/2023] [Indexed: 10/09/2023] Open
Abstract
Given the prevalence of dementia and the development of pathology-specific disease-modifying therapies, high-value biomarker strategies to inform medical decision-making are critical. In vivo tau-PET is an ideal target as a biomarker for Alzheimer's disease diagnosis and treatment outcome measure. However, tau-PET is not currently widely accessible to patients compared to other neuroimaging methods. In this study, we present a convolutional neural network (CNN) model that imputes tau-PET images from more widely available cross-modality imaging inputs. Participants (n = 1192) with brain T1-weighted MRI (T1w), fluorodeoxyglucose (FDG)-PET, amyloid-PET and tau-PET were included. We found that a CNN model can impute tau-PET images with high accuracy, the highest being for the FDG-based model followed by amyloid-PET and T1w. In testing implications of artificial intelligence-imputed tau-PET, only the FDG-based model showed a significant improvement of performance in classifying tau positivity and diagnostic groups compared to the original input data, suggesting that application of the model could enhance the utility of the metabolic images. The interpretability experiment revealed that the FDG- and T1w-based models utilized the non-local input from physically remote regions of interest to estimate the tau-PET, but this was not the case for the Pittsburgh compound B-based model. This implies that the model can learn the distinct biological relationship between FDG-PET, T1w and tau-PET from the relationship between amyloid-PET and tau-PET. Our study suggests that extending neuroimaging's use with artificial intelligence to predict protein specific pathologies has great potential to inform emerging care models.
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Affiliation(s)
- Jeyeon Lee
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Biomedical Engineering, Hanyang University, Seoul 04763, Korea
| | - Brian J Burkett
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ellen Dicks
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Carly T Mester
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Heather J Wiste
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Emily S Lundt
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Ross R Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | | | | | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - David T Jones
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
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Maruyama H, Gomi M, Lwin TT, Yoneyama A, Sasaki T. [ 18F]-FDG uptake in brain slices prepared from an aged mouse model of Alzheimer's disease using a dynamic autoradiography technique. Ann Nucl Med 2024; 38:120-130. [PMID: 37921921 DOI: 10.1007/s12149-023-01879-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/29/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography ([18F]-FDG-PET) is a imaging modality that has been used to measure of glucose metabolism in the brain in Alzheimer's disease (AD). Clinically, decreased glucose uptake has been reported in the brain of AD, although the precise underlying mechanisms have not yet been elucidated. To elucidate the mechanisms of decreased [18F]-FDG uptake in the AD by PET, [18F]-FDG uptake in the brain of aged model mouse of AD was investigated using a dynamic autoradiography technique "bioradiography". A X-ray phase-contrast imaging (X-PCI) and a histopathological evaluation were also investigated to elucidate the mechanisms underlying the relationships between decreased [18F]-FDG uptake and the pathological changes in the brain of AD mouse. METHODS In this study, AD model mouse (5XFAD, APP+/PS1+) were used. [18F]-FDG-bioradiography was conducted in fresh slices of brain tissue under the condition of resting (slices immersed in 5 mM K+ solution) and metabolically active (in 50 mM K+ solution). Amyloid β42 (Aβ42) deposition in the brain of AD mouse was confirmed by X-PCI. In addition, the positive cells of phosphated tau protein (P-tau) and deposition of Aβ42 were also examined by immunohistochemical staining. RESULTS No significant differences were observed between the two groups in the resting condition. In the activate condition of the brain, [18F]-FDG uptake was significantly decreased in AD mice compared to WT mice. In X-PCI showed Aβ deposition in the AD mouse, but not in the WT. The AD mouse also showed increased P-tau, accumulation of Aβ42, increase in neuronal apoptosis, and decrease in the number of neurons than that of the WT mouse. CONCLUSION Neuronal damage, and induction of neuronal apoptosis, decreased [18F]-FDG uptake, increased Aβ accumulation and P-tau induced neurofibrillary degeneration are observed in AD mouse. In clinical diagnosis, reduction of [18F]-FDG uptake by PET is one of the means of diagnosing the onset of AD. Our results suggest that decreased uptake of [18F]-FDG in the brains of AD may be associated with neuronal dysfunction and cell death in the brain.
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Affiliation(s)
- Hiroko Maruyama
- Cytopathology, Graduate School of Medical Sciences, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan.
| | - Misaki Gomi
- Cytopathology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Thet-Thet Lwin
- Molecular Imaging, Graduate School of Medical Sciences, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
| | - Akio Yoneyama
- SAGA Light Source, Synchrotron Light Research Center, 8-7 Yayoigaoka, Tosu, Saga, 841-0005, Japan
| | - Toru Sasaki
- Radiation Safety Management, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0373, Japan
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Caminiti SP, De Francesco S, Tondo G, Galli A, Redolfi A, Perani D. FDG-PET markers of heterogeneity and different risk of progression in amnestic MCI. Alzheimers Dement 2024; 20:159-172. [PMID: 37505996 PMCID: PMC10962797 DOI: 10.1002/alz.13385] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/19/2023] [Accepted: 06/12/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Amnestic mild cognitive impairment (aMCI) is emerging as a heterogeneous condition. METHODS We looked at a cohort of N = 207 aMCI subjects, with baseline fluorodeoxyglucose positron emission tomography (FDG-PET), T1 magnetic resonance imaging, cerebrospinal fluid (CSF), apolipoprotein E (APOE), and neuropsychological assessment. An algorithm based on FDG-PET hypometabolism classified each subject into subtypes, then compared biomarker measures and clinical progression. RESULTS Three subtypes emerged: hippocampal sparing-cortical hypometabolism, associated with younger age and the highest level of Alzheimer's disease (AD)-CSF pathology; hippocampal/cortical hypometabolism, associated with a high percentage of APOE ε3/ε4 or ε4/ε4 carriers; medial-temporal hypometabolism, characterized by older age, the lowest AD-CSF pathology, the most severe hippocampal atrophy, and a benign course. Within the whole cohort, the severity of temporo-parietal hypometabolism, correlated with AD-CSF pathology and marked the rate of progression of cognitive decline. DISCUSSION FDG-PET can distinguish clinically comparable aMCI at single-subject level with different risk of progression to AD dementia or stability. The obtained results can be useful for the optimization of pharmacological trials and automated-classification models. HIGHLIGHTS Algorithm based on FDG-PET hypometabolism demonstrates distinct subtypes across aMCI; Three different subtypes show heterogeneous biological profiles and risk of progression; The cortical hypometabolism is associated with AD pathology and cognitive decline; MTL hypometabolism is associated with the lowest conversion rate and CSF-AD pathology.
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Affiliation(s)
- Silvia Paola Caminiti
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Silvia De Francesco
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Giacomo Tondo
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alice Galli
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
| | - Alberto Redolfi
- Laboratory of NeuroinformaticsIRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Daniela Perani
- Vita‐Salute San Raffaele UniversityMilanItaly
- Division of NeuroscienceIRCCS San Raffaele Scientific InstituteMilanItaly
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Sokolovič L, Hofmann MJ, Mohammad N, Kukolja J. Neuropsychological differential diagnosis of Alzheimer's disease and vascular dementia: a systematic review with meta-regressions. Front Aging Neurosci 2023; 15:1267434. [PMID: 38020767 PMCID: PMC10657839 DOI: 10.3389/fnagi.2023.1267434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Diagnostic classification systems and guidelines posit distinguishing patterns of impairment in Alzheimer's (AD) and vascular dementia (VaD). In our study, we aim to identify which diagnostic instruments distinguish them. Methods We searched PubMed and PsychInfo for empirical studies published until December 2020, which investigated differences in cognitive, behavioral, psychiatric, and functional measures in patients older than 64 years and reported information on VaD subtype, age, education, dementia severity, and proportion of women. We systematically reviewed these studies and conducted Bayesian hierarchical meta-regressions to quantify the evidence for differences using the Bayes factor (BF). The risk of bias was assessed using the Newcastle-Ottawa-Scale and funnel plots. Results We identified 122 studies with 17,850 AD and 5,247 VaD patients. Methodological limitations of the included studies are low comparability of patient groups and an untransparent patient selection process. In the digit span backward task, AD patients were nine times more probable (BF = 9.38) to outperform VaD patients (β g = 0.33, 95% ETI = 0.12, 0.52). In the phonemic fluency task, AD patients outperformed subcortical VaD (sVaD) patients (β g = 0.51, 95% ETI = 0.22, 0.77, BF = 42.36). VaD patients, in contrast, outperformed AD patients in verbal (β g = -0.61, 95% ETI = -0.97, -0.26, BF = 22.71) and visual (β g = -0.85, 95% ETI = -1.29, -0.32, BF = 13.67) delayed recall. We found the greatest difference in verbal memory, showing that sVaD patients outperform AD patients (β g = -0.64, 95% ETI = -0.88, -0.36, BF = 72.97). Finally, AD patients performed worse than sVaD patients in recognition memory tasks (β g = -0.76, 95% ETI = -1.26, -0.26, BF = 11.50). Conclusion Our findings show inferior performance of AD in episodic memory and superior performance in working memory. We found little support for other differences proposed by diagnostic systems and diagnostic guidelines. The utility of cognitive, behavioral, psychiatric, and functional measures in differential diagnosis is limited and should be complemented by other information. Finally, we identify research areas and avenues, which could significantly improve the diagnostic value of cognitive measures.
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Affiliation(s)
- Leo Sokolovič
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
- Department of General and Biological Psychology, University of Wuppertal, Wuppertal, Germany
| | - Markus J. Hofmann
- Department of General and Biological Psychology, University of Wuppertal, Wuppertal, Germany
| | - Nadia Mohammad
- Department of General and Biological Psychology, University of Wuppertal, Wuppertal, Germany
| | - Juraj Kukolja
- Department of Neurology and Clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
- Faculty of Health, Witten/Herdecke University, Witten, Germany
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Dan L, Zhang Z. Alzheimer's disease: an axonal injury disease? Front Aging Neurosci 2023; 15:1264448. [PMID: 37927337 PMCID: PMC10620718 DOI: 10.3389/fnagi.2023.1264448] [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: 07/20/2023] [Accepted: 09/14/2023] [Indexed: 11/07/2023] Open
Abstract
Alzheimer's disease (AD) is the primary cause of dementia and is anticipated to impose a substantial economic burden in the future. Over a significant period, the widely accepted amyloid cascade hypothesis has guided research efforts, and the recent FDA approval of an anti- amyloid-beta (Aβ) protofibrils antibody, believed to decelerate AD progression, has further solidified its significance. However, the excessive emphasis placed on the amyloid cascade hypothesis has overshadowed the physiological nature of Aβ and tau proteins within axons. Axons, specialized neuronal structures, sustain damage during the early stages of AD, exerting a pivotal influence on disease progression. In this review, we present a comprehensive summary of the relationship between axonal damage and AD pathology, amalgamating the physiological roles of Aβ and tau proteins, along with the impact of AD risk genes such as APOE and TREM2. Furthermore, we underscore the exceptional significance of axonal damage in the context of AD.
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Affiliation(s)
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Bitra VR, Challa SR, Adiukwu PC, Rapaka D. Tau trajectory in Alzheimer's disease: Evidence from the connectome-based computational models. Brain Res Bull 2023; 203:110777. [PMID: 37813312 DOI: 10.1016/j.brainresbull.2023.110777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 07/08/2023] [Accepted: 10/06/2023] [Indexed: 10/11/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder with an impairment of cognition and memory. Current research on connectomics have now related changes in the network organization in AD to the patterns of accumulation and spread of amyloid and tau, providing insights into the neurobiological mechanisms of the disease. In addition, network analysis and modeling focus on particular use of graphs to provide intuition into key organizational principles of brain structure, that stipulate how neural activity propagates along structural connections. The utility of connectome-based computational models aids in early predicting, tracking the progression of biomarker-directed AD neuropathology. In this article, we present a short review of tau trajectory, the connectome changes in tau pathology, and the dependent recent connectome-based computational modelling approaches for tau spreading, reproducing pragmatic findings, and developing significant novel tau targeted therapies.
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Affiliation(s)
- Veera Raghavulu Bitra
- School of Pharmacy, Faculty of Health Sciences, University of Botswana, P/Bag-0022, Gaborone, Botswana.
| | - Siva Reddy Challa
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL 61614, USA; KVSR Siddartha College of Pharmaceutical Sciences, Vijayawada, Andhra Pradesh, India
| | - Paul C Adiukwu
- School of Pharmacy, Faculty of Health Sciences, University of Botswana, P/Bag-0022, Gaborone, Botswana
| | - Deepthi Rapaka
- Pharmacology Division, D.D.T. College of Medicine, Gaborone, Botswana.
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Abbate C. The Adult Neurogenesis Theory of Alzheimer's Disease. J Alzheimers Dis 2023:JAD221279. [PMID: 37182879 DOI: 10.3233/jad-221279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Alzheimer's disease starts in neural stem cells (NSCs) in the niches of adult neurogenesis. All primary factors responsible for pathological tau hyperphosphorylation are inherent to adult neurogenesis and migration. However, when amyloid pathology is present, it strongly amplifies tau pathogenesis. Indeed, the progressive accumulation of extracellular amyloid-β deposits in the brain triggers a state of chronic inflammation by microglia. Microglial activation has a significant pro-neurogenic effect that fosters the process of adult neurogenesis and supports neuronal migration. Unfortunately, this "reactive" pro-neurogenic activity ultimately perturbs homeostatic equilibrium in the niches of adult neurogenesis by amplifying tau pathogenesis in AD. This scenario involves NSCs in the subgranular zone of the hippocampal dentate gyrus in late-onset AD (LOAD) and NSCs in the ventricular-subventricular zone along the lateral ventricles in early-onset AD (EOAD), including familial AD (FAD). Neuroblasts carrying the initial seed of tau pathology travel throughout the brain via neuronal migration driven by complex signals and convey the disease from the niches of adult neurogenesis to near (LOAD) or distant (EOAD) brain regions. In these locations, or in close proximity, a focus of degeneration begins to develop. Then, tau pathology spreads from the initial foci to large neuronal networks along neural connections through neuron-to-neuron transmission.
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Affiliation(s)
- Carlo Abbate
- IRCCS Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy
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10
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Hoenig MC, Drzezga A. Clear-headed into old age: Resilience and resistance against brain aging-A PET imaging perspective. J Neurochem 2023; 164:325-345. [PMID: 35226362 DOI: 10.1111/jnc.15598] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 11/28/2022]
Abstract
With the advances in modern medicine and the adaptation towards healthier lifestyles, the average life expectancy has doubled since the 1930s, with individuals born in the millennium years now carrying an estimated life expectancy of around 100 years. And even though many individuals around the globe manage to age successfully, the prevalence of aging-associated neurodegenerative diseases such as sporadic Alzheimer's disease has never been as high as nowadays. The prevalence of Alzheimer's disease is anticipated to triple by 2050, increasing the societal and economic burden tremendously. Despite all efforts, there is still no available treatment defeating the accelerated aging process as seen in this disease. Yet, given the advances in neuroimaging techniques that are discussed in the current Review article, such as in positron emission tomography (PET) or magnetic resonance imaging (MRI), pivotal insights into the heterogenous effects of aging-associated processes and the contribution of distinct lifestyle and risk factors already have and are still being gathered. In particular, the concepts of resilience (i.e. coping with brain pathology) and resistance (i.e. avoiding brain pathology) have more recently been discussed as they relate to mechanisms that are associated with the prolongation and/or even stop of the progressive brain aging process. Better understanding of the underlying mechanisms of resilience and resistance may one day, hopefully, support the identification of defeating mechanism against accelerating aging.
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Affiliation(s)
- Merle C Hoenig
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany.,Department of Nuclear Medicine, Faculty of Medicine, University Hospital Cologne, Cologne, Germany
| | - Alexander Drzezga
- Research Center Juelich, Institute for Neuroscience and Medicine II, Molecular Organization of the Brain, Juelich, Germany.,Department of Nuclear Medicine, Faculty of Medicine, University Hospital Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn/Cologne, Germany
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Li L, Shi C, Guo T, Jagust WJ. Sequential Pathway Inference for Multimodal Neuroimaging Analysis. Stat (Int Stat Inst) 2022; 11:e433. [PMID: 35450402 PMCID: PMC9017676 DOI: 10.1002/sta4.433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/12/2021] [Indexed: 12/03/2023]
Abstract
Motivated by a multimodal neuroimaging study for Alzheimer's disease, in this article, we study the inference problem, i.e., hypothesis testing, of sequential mediation analysis. The existing sequential mediation solutions mostly focus on sparse estimation, while hypothesis testing is an utterly different and more challenging problem. Meanwhile, the few mediation testing solutions often ignore the potential dependency among the mediators, or cannot be applied to the sequential problem directly. We propose a statistical inference procedure to test mediation pathways when there are sequentially ordered multiple data modalities and each modality involves multiple mediators. We allow the mediators to be conditionally dependent, and the number of mediators within each modality to diverge with the sample size. We produce the explicit significance quantification and establish the theoretical guarantees in terms of asymptotic size, power, and false discovery control. We demonstrate the efficacy of the method through both simulations and an application to a multimodal neuroimaging pathway analysis of Alzheimer's disease.
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Affiliation(s)
- Lexin Li
- Department of Biostatistics and Epidemiology, University of California, Berkeley, CA, USA
| | - Chengchun Shi
- Department of Statistics, London School of Economics and Political Science, London, UK
| | - Tengfei Guo
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, China
| | - William J. Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
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Effect of cx-DHED on Abnormal Glucose Transporter Expression Induced by AD Pathologies in the 5xFAD Mouse Model. Int J Mol Sci 2022; 23:ijms231810602. [PMID: 36142509 PMCID: PMC9505457 DOI: 10.3390/ijms231810602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/06/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022] Open
Abstract
Alzheimer’s disease (AD) is a form of dementia associated with abnormal glucose metabolism resulting from amyloid-beta (Aβ) plaques and intracellular neurofibrillary tau protein tangles. In a previous study, we confirmed that carboxy-dehydroevodiamine∙HCl (cx-DHED), a derivative of DHED, was effective at improving cognitive impairment and reducing phosphorylated tau levels and synaptic loss in an AD mouse model. However, the specific mechanism of action of cx-DHED is unclear. In this study, we investigated how the cx-DHED attenuates AD pathologies in the 5xFAD mouse model, focusing particularly on abnormal glucose metabolism. We analyzed behavioral changes and AD pathologies in mice after intraperitoneal injection of cx-DHED for 2 months. As expected, cx-DHED reversed memory impairment and reduced Aβ plaques and astrocyte overexpression in the brains of 5xFAD mice. Interestingly, cx-DHED reversed the abnormal expression of glucose transporters in the brains of 5xFAD mice. In addition, otherwise low O-GlcNac levels increased, and the overactivity of phosphorylated GSK-3β decreased in the brains of cx-DHED-treated 5xFAD mice. Finally, the reduction in synaptic proteins was found to also improve by treatment with cx-DHED. Therefore, we specifically demonstrated the protective effects of cx-DHED against AD pathologies and suggest that cx-DHED may be a potential therapeutic drug for AD.
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Abstract
Alzheimer’s disease (AD) is the most common major neurocognitive disorder of ageing. Although largely ignored until about a decade ago, accumulating evidence suggests that deteriorating brain energy metabolism plays a key role in the development and/or progression of AD-associated cognitive decline. Brain glucose hypometabolism is a well-established biomarker in AD but was mostly assumed to be a consequence of neuronal dysfunction and death. However, its presence in cognitively asymptomatic populations at higher risk of AD strongly suggests that it is actually a pre-symptomatic component in the development of AD. The question then arises as to whether progressive AD-related cognitive decline could be prevented or slowed down by correcting or bypassing this progressive ‘brain energy gap’. In this review, we provide an overview of research on brain glucose and ketone metabolism in AD and its prodromal condition – mild cognitive impairment (MCI) – to provide a clearer basis for proposing keto-therapeutics as a strategy for brain energy rescue in AD. We also discuss studies using ketogenic interventions and their impact on plasma ketone levels, brain energetics and cognitive performance in MCI and AD. Given that exercise has several overlapping metabolic effects with ketones, we propose that in combination these two approaches might be synergistic for brain health during ageing. As cause-and-effect relationships between the different hallmarks of AD are emerging, further research efforts should focus on optimising the efficacy, acceptability and accessibility of keto-therapeutics in AD and populations at risk of AD.
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14
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Bilgel M, Wong DF, Moghekar AR, Ferrucci L, Resnick SM. Causal links among amyloid, tau, and neurodegeneration. Brain Commun 2022; 4:fcac193. [PMID: 35938073 PMCID: PMC9345312 DOI: 10.1093/braincomms/fcac193] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 05/19/2022] [Accepted: 07/22/2022] [Indexed: 07/27/2023] Open
Abstract
Amyloid-β pathology is associated with greater tau pathology and facilitates tau propagation from the medial temporal lobe to the neocortex, where tau is closely associated with local neurodegeneration. The degree of the involvement of amyloid-β versus existing tau pathology in tau propagation and neurodegeneration has not been fully elucidated in human studies. Careful quantification of these effects can inform the development and timing of therapeutic interventions. We conducted causal mediation analyses to investigate the relative contributions of amyloid-β and existing tau to tau propagation and neurodegeneration in two longitudinal studies of individuals without dementia: the Baltimore Longitudinal Study of Aging (N = 103, age range 57-96) and the Alzheimer's Disease Neuroimaging Initiative (N = 122, age range 56-92). As proxies of neurodegeneration, we investigated cerebral blood flow, glucose metabolism, and regional volume. We first confirmed that amyloid-β moderates the association between tau in the entorhinal cortex and in the inferior temporal gyrus, a neocortical region exhibiting early tau pathology (amyloid group × entorhinal tau interaction term β = 0.488, standard error [SE] = 0.126, P < 0.001 in the Baltimore Longitudinal Study of Aging; β = 0.619, SE = 0.145, P < 0.001 in the Alzheimer's Disease Neuroimaging Initiative). In causal mediation analyses accounting for this facilitating effect of amyloid, amyloid positivity had a statistically significant direct effect on inferior temporal tau as well as an indirect effect via entorhinal tau (average direct effect =0.47, P < 0.001 and average causal mediation effect =0.44, P = 0.0028 in Baltimore Longitudinal Study of Aging; average direct effect =0.43, P = 0.004 and average causal mediation effect =0.267, P = 0.0088 in Alzheimer's Disease Neuroimaging Initiative). Entorhinal tau mediated up to 48% of the total effect of amyloid on inferior temporal tau. Higher inferior temporal tau was associated with lower colocalized cerebral blood flow, glucose metabolism, and regional volume, whereas amyloid had only an indirect effect on these measures via tau, implying tau as the primary driver of neurodegeneration (amyloid-cerebral blood flow average causal mediation effect =-0.28, P = 0.021 in Baltimore Longitudinal Study of Aging; amyloid-volume average causal mediation effect =-0.24, P < 0.001 in Alzheimer's Disease Neuroimaging Initiative). Our findings suggest targeting amyloid or medial temporal lobe tau might slow down neocortical spread of tau and subsequent neurodegeneration, but a combination therapy may yield better outcomes.
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Affiliation(s)
- Murat Bilgel
- Correspondence to: Murat Bilgel Laboratory of Behavioral Neuroscience National Institute on Aging, 251 Bayview Blvd Suite 100, Rm 04B329, Baltimore, MD 21224, USA E-mail:
| | - Dean F Wong
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Abhay R Moghekar
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD 21224, USA
| | - Susan M Resnick
- Brain Aging and Behavior Section, Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD 21224, USA
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15
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Functional Imaging for Neurodegenerative Diseases. Presse Med 2022; 51:104121. [PMID: 35490910 DOI: 10.1016/j.lpm.2022.104121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/13/2022] [Accepted: 04/11/2022] [Indexed: 12/16/2022] Open
Abstract
Diagnosis and monitoring of neurodegenerative diseases has changed profoundly over the past twenty years. Biomarkers are now included in most diagnostic procedures as well as in clinical trials. Neuroimaging biomarkers provide access to brain structure and function over the course of neurodegenerative diseases. They have brought new insights into a wide range of neurodegenerative diseases and have made it possible to describe some of the imaging challenges in clinical populations. MRI mainly explores brain structure while molecular imaging, functional MRI and electro- and magnetoencephalography examine brain function. In this paper, we describe and analyse the current and potential contribution of MRI and molecular imaging in the field of neurodegenerative diseases.
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16
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Qiao Z, Wang G, Zhao X, Wang K, Fan D, Chen Q, Ai L. Neuropsychological Performance Is Correlated With Tau Protein Deposition and Glucose Metabolism in Patients With Alzheimer’s Disease. Front Aging Neurosci 2022; 14:841942. [PMID: 35663582 PMCID: PMC9158435 DOI: 10.3389/fnagi.2022.841942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 03/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study characterizes glucose metabolism and tau protein deposition distribution in patients with Alzheimer’s disease (AD) and to evaluate the relationships between neuropsychological performance and tau protein deposition or glucose metabolism using 18F-FDG and 18F-AV1451 positron emission tomography/computed tomography (PET/CT). Methods Sixty-four patients with β-amyloid-positive (Aβ+) AD and twenty-five healthy participants were enrolled in this study. All participants underwent 18F-FDG and 18F-AV1451 PET/CT. Clinical data and neuropsychological scores were collected. Patients with AD were divided into mild, moderate, and severe groups according to mini-mental state examination (MMSE) scores. The standardized uptake value ratios (SUVRs) for both FDG and AV1451 PET images were calculated using the cerebellar vermis as reference. The SUVRs of the whole cerebral cortex and each brain region were calculated. The volume of interest (VOI) was obtained using automated anatomical atlas (AAL) and Brodmann regions. Student’s t-test was used to perform intergroup comparisons of SUVR. The partial correlation coefficient between SUVR and neuropsychological scores was computed in an inter-subject manner using age and education as covariates. Results The mild subgroup showed a reduction in glucose metabolism and aggregation of tau protein in the temporoparietal cortex. With a decline in neuropsychiatric performance, the SUVR on FDG PET decreased and SUVR on tau PET increased gradually. The areas of glucose metabolism reduction and tau protein deposition appeared first in the parietal cortex, followed by the temporal and frontal cortex, successively. Both FDG and tau SUVRs significantly correlated with MMSE, Montreal cognitive assessment (MOCA), auditory verbal learning test (AVLT), Boston naming test (BNT), clock drawing task (CDT), and verbal fluency test (VFT) (p < 0.05). The SUVR on FDG PET significantly correlated with activities of daily living (ADL) and the Hamilton depression scale (HAMD). There was no significant correlation between the tau SUVRs and ADL or HAMD. Conclusion The extension of tau protein deposition was similar but not exactly consistent with the area of glucose metabolism reduction. Both tau and FDG SUVRs correlated with cognitive function in domain-specific patterns, and the results of FDG PET more closely correlated with neuropsychological function than tau PET results did.
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Affiliation(s)
- Zhen Qiao
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guihong Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Guihong Wang,
| | - Xiaobin Zhao
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Kai Wang
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Di Fan
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Qian Chen
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Lin Ai
- Department of Nuclear Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- *Correspondence: Lin Ai,
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17
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Li W, Zhao J, Shen C, Zhang J, Hu J, Xiao M, Zhang J, Chen M. Regional Brain Fusion: Graph Convolutional Network for Alzheimer's Disease Prediction and Analysis. Front Neuroinform 2022; 16:886365. [PMID: 35571869 PMCID: PMC9100702 DOI: 10.3389/fninf.2022.886365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
Alzheimer's disease (AD) has raised extensive concern in healthcare and academia as one of the most prevalent health threats to the elderly. Due to the irreversible nature of AD, early and accurate diagnoses are significant for effective prevention and treatment. However, diverse clinical symptoms and limited neuroimaging accuracy make diagnoses challenging. In this article, we built a brain network for each subject, which assembles several commonly used neuroimaging data simply and reasonably, including structural magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), and amyloid positron emission tomography (PET). Based on some existing research results, we applied statistical methods to analyze (i) the distinct affinity of AD burden on each brain region, (ii) the topological lateralization between left and right hemispheric sub-networks, and (iii) the asymmetry of the AD attacks on the left and right hemispheres. In the light of advances in graph convolutional networks for graph classifications and summarized characteristics of brain networks and AD pathologies, we proposed a regional brain fusion-graph convolutional network (RBF-GCN), which is constructed with an RBF framework mainly, including three sub-modules, namely, hemispheric network generation module, multichannel GCN module, and feature fusion module. In the multichannel GCN module, the improved GCN by our proposed adaptive native node attribute (ANNA) unit embeds within each channel independently. We not only fully verified the effectiveness of the RBF framework and ANNA unit but also achieved competitive results in multiple sets of AD stages' classification tasks using hundreds of experiments over the ADNI clinical dataset.
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Affiliation(s)
- Wenchao Li
- Intelligent Information Processing Laboratory, Hangzhou Dianzi University, Hangzhou, China
| | - Jiaqi Zhao
- Research Center for Healthcare Data Science, Zhejiang Lab, Hangzhou, China
| | - Chenyu Shen
- Intelligent Information Processing Laboratory, Hangzhou Dianzi University, Hangzhou, China
| | - Jingwen Zhang
- Department of Computer Science, Wake Forest University, Winston-Salem, NC, United States
| | - Ji Hu
- Intelligent Information Processing Laboratory, Hangzhou Dianzi University, Hangzhou, China
| | - Mang Xiao
- Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jiyong Zhang
- Intelligent Information Processing Laboratory, Hangzhou Dianzi University, Hangzhou, China
- *Correspondence: Jiyong Zhang
| | - Minghan Chen
- Department of Computer Science, Wake Forest University, Winston-Salem, NC, United States
- Minghan Chen
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18
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Duong MT, Das SR, Lyu X, Xie L, Richardson H, Xie SX, Yushkevich PA, Wolk DA, Nasrallah IM. Dissociation of tau pathology and neuronal hypometabolism within the ATN framework of Alzheimer's disease. Nat Commun 2022; 13:1495. [PMID: 35314672 PMCID: PMC8938426 DOI: 10.1038/s41467-022-28941-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 02/11/2022] [Indexed: 11/08/2022] Open
Abstract
Alzheimer's disease (AD) is defined by amyloid (A) and tau (T) pathologies, with T better correlated to neurodegeneration (N). However, T and N have complex regional relationships in part related to non-AD factors that influence N. With machine learning, we assessed heterogeneity in 18F-flortaucipir vs. 18F-fluorodeoxyglucose positron emission tomography as markers of T and neuronal hypometabolism (NM) in 289 symptomatic patients from the Alzheimer's Disease Neuroimaging Initiative. We identified six T/NM clusters with differing limbic and cortical patterns. The canonical group was defined as the T/NM pattern with lowest regression residuals. Groups resilient to T had less hypometabolism than expected relative to T and displayed better cognition than the canonical group. Groups susceptible to T had more hypometabolism than expected given T and exhibited worse cognitive decline, with imaging and clinical measures concordant with non-AD copathologies. Together, T/NM mismatch reveals distinct imaging signatures with pathobiological and prognostic implications for AD.
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Affiliation(s)
- Michael Tran Duong
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Sandhitsu R Das
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Xueying Lyu
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Long Xie
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Hayley Richardson
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sharon X Xie
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paul A Yushkevich
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David A Wolk
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Ilya M Nasrallah
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Bioengineering, School of Engineering and Applied Sciences, University of Pennsylvania, Philadelphia, PA, USA.
- Alzheimer's Disease Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Assessment of the In Vivo Relationship Between Cerebral Hypometabolism, Tau Deposition, TSPO Expression, and Synaptic Density in a Tauopathy Mouse Model: a Multi-tracer PET Study. Mol Neurobiol 2022; 59:3402-3413. [PMID: 35312967 PMCID: PMC9148291 DOI: 10.1007/s12035-022-02793-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 03/05/2022] [Indexed: 11/03/2022]
Abstract
Cerebral glucose hypometabolism is a typical hallmark of Alzheimer’s disease (AD), usually associated with ongoing neurodegeneration and neuronal dysfunction. However, underlying pathological processes are not fully understood and reproducibility in animal models is not well established. The aim of the present study was to investigate the regional interrelation of glucose hypometabolism measured by [18F]FDG positron emission tomography (PET) with various molecular targets of AD pathophysiology using the PET tracers [18F]PI-2620 for tau deposition, [18F]DPA-714 for TSPO expression associated with neuroinflammation, and [18F]UCB-H for synaptic density in a transgenic tauopathy mouse model. Seven-month-old rTg4510 mice (n = 8) and non-transgenic littermates (n = 8) were examined in a small animal PET scanner with the tracers listed above. Hypometabolism was observed throughout the forebrain of rTg4510 mice. Tau pathology, increased TSPO expression, and synaptic loss were co-localized in the cortex and hippocampus and correlated with hypometabolism. In the thalamus, however, hypometabolism occurred in the absence of tau-related pathology. Thus, cerebral hypometabolism was associated with two regionally distinct forms of molecular pathology: (1) characteristic neuropathology of the Alzheimer-type including synaptic degeneration and neuroinflammation co-localized with tau deposition in the cerebral cortex, and (2) pathological changes in the thalamus in the absence of other markers of AD pathophysiology, possibly reflecting downstream or remote adaptive processes which may affect functional connectivity. Our study demonstrates the feasibility of a multitracer approach to explore complex interactions of distinct AD-pathomechanisms in vivo in a small animal model. The observations demonstrate that multiple, spatially heterogeneous pathomechanisms can contribute to hypometabolism observed in AD mouse models and they motivate future longitudinal studies as well as the investigation of possibly comparable pathomechanisms in human patients.
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20
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Wang Y, Cai L, Zhou K, Cui M, Yao S. Biodistribution and Dosimetry Evaluation for a Novel Tau Tracer [18F]-S16 in Healthy Volunteers and Its Application in Assessment of Tau Pathology in Alzheimer’s Disease. Front Bioeng Biotechnol 2022; 9:812818. [PMID: 35223820 PMCID: PMC8866701 DOI: 10.3389/fbioe.2021.812818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 12/30/2021] [Indexed: 01/18/2023] Open
Abstract
Background: The goal of this study was to report a fully automated radiosynthetic procedure of a novel tau tracer [18F]-S16 and its safety, biodistribution, and dosimetry in healthy volunteers as well as the potential utility of [18F]-S16 positron emission tomography (PET) in Alzheimer’s disease (AD).Methods: The automated radiosynthesis of [18F]-S16 was performed on a GE Tracerlab FX2 N module. For the biodistribution and dosimetry study, healthy volunteers underwent a series of PET scans acquired at 10, 60, 120, and 240 min post-injection. The biodistribution and safety were assessed. For the AD study, both AD and healthy controls (HCs) underwent dynamic [18F]-S16 and static [18F]-FDG PET imaging. [18F]-S16 binding was assessed quantitatively using standardized uptake value ratios (SUVRs) measured at different regions of interest (ROIs). [18F]-S16 SUVRs were compared between the AD patients and HCs using the Mann–Whitney U-test. In AD patients with all cortical ROIs, Spearman rank-correlation analysis was used to calculate the voxel-wise correlations between [18F]-S16 and [18F]-FDG.Results: The automated radiosynthesis of [18F]-S16 was finished within 45 min, with a radiochemical yield of 30 ± 5% (n = 8, non-decay-corrected). The radiochemical purity was greater than 98%, and the specific activity was calculated to be 1,047 ± 450 GBq/μmol (n = 5), and [18F]-S16 was stable in vitro. In the healthy volunteer study, no adverse effect was observed within 24 h post-injection, and no defluorination was observed in vivo. The radiotracer could pass through the blood–brain barrier easily and was rapidly cleared from the circulation and excreted through the hepatic system. The whole-body mean effective dose was 15.3 ± 0.3 μSv/MBq. In AD patients, [18F]-S16 accumulation was identified as involving the parietal, temporal, precuneus, posterior cingulate, and frontal lobes. No specific [18F]-S16 cerebral uptake was identified in HCs. The SUVR of AD patients was significantly higher than that of HCs. No specific binding uptake was found in the choroid plexus, venous sinus, and white matter. A significant correlation was found between [18F]-S16 binding and hypometabolism across neocortical regions.Conclusion: [18F]-S16 could be synthesized automatically, and it showed favorable biodistribution and safety in humans. [18F]-S16 PET indicated a high image quality for imaging tau deposition in AD and distinguishing AD from HCs.
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Affiliation(s)
- Ying Wang
- Department of PET/CT Diagnostic, Tianjin Medical University General Hospital, Tianjin, China
| | - Li Cai
- Department of PET/CT Diagnostic, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaixiang Zhou
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, Beijing Normal University, Beijing, China
| | - Mengchao Cui
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, Beijing Normal University, Beijing, China
| | - Shaobo Yao
- Department of PET/CT Diagnostic, Tianjin Medical University General Hospital, Tianjin, China
- Department of Nuclear Medicine, Fujian Provincial Key Laboratory of Precision Medicine for Cancer, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
- *Correspondence: Shaobo Yao,
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21
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Raman F, Fang YHD, Grandhi S, Murchison CF, Kennedy RE, Morris JC, Massoumzadeh P, Benzinger T, Roberson ED, McConathy J. Dynamic Amyloid PET: Relationships to 18F-Flortaucipir Tau PET Measures. J Nucl Med 2022; 63:287-293. [PMID: 34049986 PMCID: PMC8805772 DOI: 10.2967/jnumed.120.254490] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/23/2021] [Indexed: 11/16/2022] Open
Abstract
Measuring amyloid and predicting tau status using a single amyloid PET study would be valuable for assessing brain AD pathophysiology. We hypothesized that early-frame amyloid PET (efAP) correlates with the presence of tau pathology because the initial regional brain concentrations of radioactivity are determined primarily by blood flow, which is expected to be decreased in the setting of tau pathology. Methods: The study included 120 participants (63 amyloid-positive and 57 amyloid-negative) with dynamic 18F-florbetapir PET and static 18F-flortaucipir PET scans obtained within 6 mo of each other. These subjects were predominantly cognitively intact in both the amyloid-positive (63%) and the amyloid-negative (93%) groups. Parameters for efAP quantification were optimized for stratification of tau PET positivity, assessed by either a tauopathy score or Braak regions. The ability of efAP to stratify tau positivity was measured using receiver-operating-characteristic analysis of area under the curve (AUC). Pearson r and Spearman ρ were used for parametric and nonparametric comparisons between efAP and tau PET, respectively. Standardized net benefit was used to evaluate improvement in using efAP as an additional copredictor over hippocampal volume in predicting tau PET positivity. Results: Measuring efAP within the hippocampus and summing the first 3 min of brain activity after injection showed the strongest discriminative ability to stratify for tau positivity (AUC, 0.67-0.89 across tau PET Braak regions) in amyloid-positive individuals. Hippocampal efAP correlated significantly with a global tau PET tauopathy score in amyloid-positive participants (r = -0.57, P < 0.0001). Compared with hippocampal volume, hippocampal efAP showed a stronger association with tau PET Braak stage (ρ = -0.58 vs. -0.37) and superior stratification of tau PET tauopathy score (AUC, 0.86 vs. 0.66; P = 0.002). Conclusion: Hippocampal efAP can provide additional information to conventional amyloid PET, including estimation of the likelihood of tau positivity in amyloid-positive individuals.
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Affiliation(s)
- Fabio Raman
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
- Center for Neurodegeneration and Experimental Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Yu-Hua Dean Fang
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Sameera Grandhi
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
| | - Charles F Murchison
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Richard E Kennedy
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
| | - John C Morris
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri; and
| | - Parinaz Massoumzadeh
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Tammie Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Erik D Roberson
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama
- Center for Neurodegeneration and Experimental Therapeutics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jonathan McConathy
- Department of Radiology, University of Alabama at Birmingham, Birmingham, Alabama;
- Alzheimer's Disease Center, University of Alabama at Birmingham, Birmingham, Alabama
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22
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Khan AF, Adewale Q, Baumeister TR, Carbonell F, Zilles K, Palomero-Gallagher N, Iturria-Medina Y. Personalized brain models identify neurotransmitter receptor changes in Alzheimer's disease. Brain 2021; 145:1785-1804. [PMID: 34605898 DOI: 10.1093/brain/awab375] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 09/08/2021] [Accepted: 09/09/2021] [Indexed: 11/12/2022] Open
Abstract
Alzheimer's disease (AD) involves many neurobiological alterations from molecular to macroscopic spatial scales, but we currently lack integrative, mechanistic brain models characterizing how factors across different biological scales interact to cause clinical deterioration in a way that is subject-specific or personalized. Neurotransmitter receptors, as important signaling molecules and potential drug targets, are key mediators of interactions between many neurobiological processes altered in AD. We present a neurotransmitter receptor-enriched multifactorial brain model, which integrates spatial distribution patterns of 15 neurotransmitter receptors from post-mortem autoradiography with multiple in-vivo neuroimaging modalities (tau, amyloid-β and glucose PET, and structural, functional and arterial spin labeling MRI) in a personalized, generative, whole-brain formulation. Applying this data-driven model to a heterogeneous aged population (N = 423, ADNI data), we observed that personalized receptor-neuroimaging interactions explained about 70% (± 20%) of the across-population variance in longitudinal changes to the six neuroimaging modalities, and up to 39.7% (P < 0.003, FWE-corrected) of inter-individual variability in AD cognitive deterioration via an axis primarily affecting executive function. Notably, based on their contribution to the clinical severity in AD, we found significant functional alterations to glutamatergic interactions affecting tau accumulation and neural activity dysfunction, and GABAergic interactions concurrently affecting neural activity dysfunction, amyloid and tau distributions, as well as significant cholinergic receptor effects on tau accumulation. Overall, GABAergic alterations had the largest effect on cognitive impairment (particularly executive function) in our AD cohort (N = 25). Furthermore, we demonstrate the clinical applicability of this approach by characterizing subjects based on individualized 'fingerprints' of receptor alterations. This study introduces the first robust, data-driven framework for integrating several neurotransmitter receptors, multi-modal neuroimaging and clinical data in a flexible and interpretable brain model. It enables further understanding of the mechanistic neuropathological basis of neurodegenerative progression and heterogeneity, and constitutes a promising step towards implementing personalized, neurotransmitter-based treatments.
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Affiliation(s)
- Ahmed Faraz Khan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada H3A 2B4.,McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Canada H3A 2B4.,Ludmer Centre for Neuroinformatics & Mental Health, Montreal, Canada H3A 2B4
| | - Quadri Adewale
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada H3A 2B4.,McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Canada H3A 2B4.,Ludmer Centre for Neuroinformatics & Mental Health, Montreal, Canada H3A 2B4
| | - Tobias R Baumeister
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada H3A 2B4.,McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Canada H3A 2B4.,Ludmer Centre for Neuroinformatics & Mental Health, Montreal, Canada H3A 2B4
| | | | - Karl Zilles
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany
| | - Nicola Palomero-Gallagher
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, 52425 Jülich, Germany.,Cécile and Oskar Vogt Institute of Brain Research, Medical Faculty, Heinrich-Heine University, 40225 Düsseldorf, Germany.,Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, RWTH Aachen, 52074 Aachen, Germany.,JARA, Translational Brain Medicine, 52074 Aachen, Germany
| | - Yasser Iturria-Medina
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada H3A 2B4.,McConnell Brain Imaging Center, Montreal Neurological Institute, Montreal, Canada H3A 2B4.,Ludmer Centre for Neuroinformatics & Mental Health, Montreal, Canada H3A 2B4
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23
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Chen MK, Mecca AP, Naganawa M, Gallezot JD, Toyonaga T, Mondal J, Finnema SJ, Lin SF, O’Dell RS, McDonald JW, Michalak HR, Vander Wyk B, Nabulsi NB, Huang Y, Arnsten AFT, van Dyck CH, Carson RE. Comparison of [ 11C]UCB-J and [ 18F]FDG PET in Alzheimer's disease: A tracer kinetic modeling study. J Cereb Blood Flow Metab 2021; 41:2395-2409. [PMID: 33757318 PMCID: PMC8393289 DOI: 10.1177/0271678x211004312] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/29/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022]
Abstract
[11C]UCB-J PET for synaptic vesicle glycoprotein 2 A (SV2A) has been proposed as a suitable marker for synaptic density in Alzheimer's disease (AD). We compared [11C]UCB-J binding for synaptic density and [18F]FDG uptake for metabolism (correlated with neuronal activity) in 14 AD and 11 cognitively normal (CN) participants. We assessed both absolute and relative outcome measures in brain regions of interest, i.e., K1 or R1 for [11C]UCB-J perfusion, VT (volume of distribution) or DVR to cerebellum for [11C]UCB-J binding to SV2A; and Ki or KiR to cerebellum for [18F]FDG metabolism. [11C]UCB-J binding and [18F]FDG metabolism showed a similar magnitude of reduction in the medial temporal lobe of AD -compared to CN participants. However, the magnitude of reduction of [11C]UCB-J binding in neocortical regions was less than that observed with [18F]FDG metabolism. Inter-tracer correlations were also higher in the medial temporal regions between synaptic density and metabolism, with lower correlations in neocortical regions. [11C]UCB-J perfusion showed a similar pattern to [18F]FDG metabolism, with high inter-tracer regional correlations. In summary, we conducted the first in vivo PET imaging of synaptic density and metabolism in the same AD participants and reported a concordant reduction in medial temporal regions but a discordant reduction in neocortical regions.
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Affiliation(s)
- Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Adam P Mecca
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jean-Dominique Gallezot
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jayanta Mondal
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Sjoerd J Finnema
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Shu-fei Lin
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Ryan S O’Dell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Julia W McDonald
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Hannah R Michalak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Brent Vander Wyk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Amy FT Arnsten
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
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24
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Strom A, Iaccarino L, Edwards L, Lesman-Segev OH, Soleimani-Meigooni DN, Pham J, Baker SL, Landau S, Jagust WJ, Miller BL, Rosen HJ, Gorno-Tempini ML, Rabinovici GD, La Joie R. Cortical hypometabolism reflects local atrophy and tau pathology in symptomatic Alzheimer's disease. Brain 2021; 145:713-728. [PMID: 34373896 PMCID: PMC9014741 DOI: 10.1093/brain/awab294] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 11/14/2022] Open
Abstract
Posterior cortical hypometabolism measured with [18F]-Fluorodeoxyglucose (FDG)-PET is a well-known marker of Alzheimer's disease-related neurodegeneration, but its associations with underlying neuropathological processes are unclear. We assessed cross-sectionally the relative contributions of three potential mechanisms causing hypometabolism in the retrosplenial and inferior parietal cortices: local molecular (amyloid and tau) pathology and atrophy, distant factors including contributions from the degenerating medial temporal lobe or molecular pathology in functionally connected regions, and the presence of the apolipoprotein E (APOE) ε4 allele. Two hundred and thirty-two amyloid-positive cognitively impaired patients from two cohorts (University of California, San Francisco, UCSF, and Alzheimer's Disease Neuroimaging Initiative, ADNI) underwent MRI and PET with FDG, amyloid-PET using [11C]-Pittsburgh Compound B, [18F]-Florbetapir, or [18F]-Florbetaben, and [18F]-Flortaucipir tau-PET within one year. Standard uptake value ratios (SUVR) were calculated using tracer-specific reference regions. Regression analyses were run within cohorts to identify variables associated with retrosplenial or inferior parietal FDG SUVR. On average, ADNI patients were older and were less impaired than UCSF patients. Regional patterns of hypometabolism were similar between cohorts, though there were cohort differences in regional gray matter atrophy. Local cortical thickness and tau-PET (but not amyloid-PET) were independently associated with both retrosplenial and inferior parietal FDG SUVR (ΔR2 = .09 to .21) across cohorts in models that also included age and disease severity (local model). Including medial temporal lobe volume improved the retrosplenial FDG model in ADNI (ΔR2 = .04, p = .008) but not UCSF (ΔR2 < .01, p = .52), and did not improve the inferior parietal models (ΔR2s < .01, ps > .37). Interaction analyses revealed that medial temporal volume was more strongly associated with retrosplenial FDG SUVR at earlier disease stages (p = .06 in UCSF, p = .046 in ADNI). Exploratory analyses across the cortex confirmed overall associations between hypometabolism and local tau pathology and thickness and revealed associations between medial temporal degeneration and hypometabolism in retrosplenial, orbitofrontal, and anterior cingulate cortices. Finally, our data did not support hypotheses of a detrimental effect of pathology in connected regions or of an effect of the APOE ε4 allele in impaired participants. Overall, in two independent groups of patients at symptomatic stages of Alzheimer's disease, cortical hypometabolism mainly reflected structural neurodegeneration and tau, but not amyloid, pathology.
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Affiliation(s)
- Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Orit H Lesman-Segev
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.,Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - David N Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - William J Jagust
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.,Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA.,Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
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25
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Wales RM, Leung HC. The Effects of Amyloid and Tau on Functional Network Connectivity in Older Populations. Brain Connect 2021; 11:599-612. [PMID: 33813858 DOI: 10.1089/brain.2020.0902] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Neuroimaging studies suggest that aged brains show altered connectivity within and across functional networks. Similar changes in functional network integrity are also linked to the accumulation of pathological proteins in the brain, such as amyloid-beta plaques and neurofibrillary tau tangles seen in Alzheimer's disease. However, less is known about the specific impacts of amyloid and tau on functional network connectivity in cognitively normal older adults who harbor these proteins. Methods: We briefly summarize recent neuroimaging studies of aging and then thoroughly review positron emission tomography and functional magnetic resonance imaging studies measuring the relationship between amyloid-tau pathology and functional connectivity in cognitively normal older individuals. Results: The literature overall suggests that amyloid-positive older individuals show minor cognitive dysfunction and aberrant default mode network connectivity compared with amyloid-negative individuals. Tau, however, is more closely associated with network hypoconnectivity and poorer cognition. Those with substantial amyloid and tau experience even greater cognitive decline compared with those with primarily amyloid or tau, suggesting a potential interaction. Multimodal neuroimaging studies suggest that older adults with pathological protein deposits show amyloid-related hyperconnectivity and tau-related hypoconnectivity in multiple functional networks, including the default mode and frontoparietal networks. Discussion: We propose an updated model considering the effects of amyloid and tau on functional connectivity in older individuals. Large, longitudinal neuroimaging studies with multiple levels of analysis are required to obtain a deeper understanding of the dynamic relationship between pathological protein accumulation and functional connectivity changes, as amyloid- and tau-induced connectivity alterations may have critical and time-varying effects on neurodegeneration and cognitive decline. Impact statement Amyloid and tau accumulation have been linked with altered functional connectivity in cognitively normal older adults. This review synthesized recent functional imaging literatures in a discussion of how amyloid and tau can interactively affect functional connectivity in nonlinear ways, which can explain previous conflicting findings. Changes in connectivity strength may depend on the accumulation of both amyloid and tau, and their integrative effects seem to have critical consequences on cognition. Elucidating the effects of these pathological proteins on brain functioning is paramount to understand the etiology of Alzheimer's disease and the aging process overall.
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Affiliation(s)
- Ryan Michael Wales
- Integrative Neuroscience Program, Department of Psychology, Stony Brook University, Stony Brook, New York, USA
| | - Hoi-Chung Leung
- Integrative Neuroscience Program, Department of Psychology, Stony Brook University, Stony Brook, New York, USA
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26
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Salmina AB, Kharitonova EV, Gorina YV, Teplyashina EA, Malinovskaya NA, Khilazheva ED, Mosyagina AI, Morgun AV, Shuvaev AN, Salmin VV, Lopatina OL, Komleva YK. Blood-Brain Barrier and Neurovascular Unit In Vitro Models for Studying Mitochondria-Driven Molecular Mechanisms of Neurodegeneration. Int J Mol Sci 2021; 22:4661. [PMID: 33925080 PMCID: PMC8125678 DOI: 10.3390/ijms22094661] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 04/24/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Pathophysiology of chronic neurodegeneration is mainly based on complex mechanisms related to aberrant signal transduction, excitation/inhibition imbalance, excitotoxicity, synaptic dysfunction, oxidative stress, proteotoxicity and protein misfolding, local insulin resistance and metabolic dysfunction, excessive cell death, development of glia-supported neuroinflammation, and failure of neurogenesis. These mechanisms tightly associate with dramatic alterations in the structure and activity of the neurovascular unit (NVU) and the blood-brain barrier (BBB). NVU is an ensemble of brain cells (brain microvessel endothelial cells (BMECs), astrocytes, pericytes, neurons, and microglia) serving for the adjustment of cell-to-cell interactions, metabolic coupling, local microcirculation, and neuronal excitability to the actual needs of the brain. The part of the NVU known as a BBB controls selective access of endogenous and exogenous molecules to the brain tissue and efflux of metabolites to the blood, thereby providing maintenance of brain chemical homeostasis critical for efficient signal transduction and brain plasticity. In Alzheimer's disease, mitochondria are the target organelles for amyloid-induced neurodegeneration and alterations in NVU metabolic coupling or BBB breakdown. In this review we discuss understandings on mitochondria-driven NVU and BBB dysfunction, and how it might be studied in current and prospective NVU/BBB in vitro models for finding new approaches for the efficient pharmacotherapy of Alzheimer's disease.
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Affiliation(s)
- Alla B. Salmina
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
- Research Center of Neurology, 125367 Moscow, Russia
| | - Ekaterina V. Kharitonova
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Yana V. Gorina
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Elena A. Teplyashina
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Natalia A. Malinovskaya
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Elena D. Khilazheva
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Angelina I. Mosyagina
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Andrey V. Morgun
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Anton N. Shuvaev
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Vladimir V. Salmin
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Olga L. Lopatina
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
| | - Yulia K. Komleva
- Research Institute of Molecular Medicine and Pathobiochemistry, Prof. V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, 660022 Krasnoyarsk, Russia; (E.V.K.); (Y.V.G.); (E.A.T.); (N.A.M.); (E.D.K.); (A.I.M.); (A.V.M.); (A.N.S.); (V.V.S.); (O.L.L.); (Y.K.K.)
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27
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Gonzalez-Escamilla G, Miederer I, Grothe MJ, Schreckenberger M, Muthuraman M, Groppa S. Metabolic and amyloid PET network reorganization in Alzheimer's disease: differential patterns and partial volume effects. Brain Imaging Behav 2021; 15:190-204. [PMID: 32125613 PMCID: PMC7835313 DOI: 10.1007/s11682-019-00247-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Alzheimer’s disease (AD) is a neurodegenerative disorder, considered a disconnection syndrome with regional molecular pattern abnormalities quantifiable by the aid of PET imaging. Solutions for accurate quantification of network dysfunction are scarce. We evaluate the extent to which PET molecular markers reflect quantifiable network metrics derived through the graph theory framework and how partial volume effects (PVE)-correction (PVEc) affects these PET-derived metrics 75 AD patients and 126 cognitively normal older subjects (CN). Therefore our goal is twofold: 1) to evaluate the differential patterns of [18F]FDG- and [18F]AV45-PET data to depict AD pathology; and ii) to analyse the effects of PVEc on global uptake measures of [18F]FDG- and [18F]AV45-PET data and their derived covariance network reconstructions for differentiating between patients and normal older subjects. Network organization patterns were assessed using graph theory in terms of “degree”, “modularity”, and “efficiency”. PVEc evidenced effects on global uptake measures that are specific to either [18F]FDG- or [18F]AV45-PET, leading to increased statistical differences between the groups. PVEc was further shown to influence the topological characterization of PET-derived covariance brain networks, leading to an optimised characterization of network efficiency and modularisation. Partial-volume effects correction improves the interpretability of PET data in AD and leads to optimised characterization of network properties for organisation or disconnection.
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Affiliation(s)
- Gabriel Gonzalez-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany.
| | - Isabelle Miederer
- Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE) - Rostock/Greifswald, Rostock, Germany
| | - Mathias Schreckenberger
- Department of Nuclear Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Muthuraman Muthuraman
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
| | - Sergiu Groppa
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr. 1, 55131, Mainz, Germany
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28
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Clinical validity of increased cortical uptake of [ 18F]flortaucipir on PET as a biomarker for Alzheimer's disease in the context of a structured 5-phase biomarker development framework. Eur J Nucl Med Mol Imaging 2021; 48:2097-2109. [PMID: 33547556 PMCID: PMC8175307 DOI: 10.1007/s00259-020-05118-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE In 2017, the Geneva Alzheimer's disease (AD) Biomarker Roadmap initiative adapted the framework of the systematic validation of oncological diagnostic biomarkers to AD biomarkers, with the aim to accelerate their development and implementation in clinical practice. With this work, we assess the maturity of [18F]flortaucipir PET and define its research priorities. METHODS The level of maturity of [18F]flortaucipir was assessed based on the AD Biomarker Roadmap. The framework assesses analytical validity (phases 1-2), clinical validity (phases 3-4), and clinical utility (phase 5). RESULTS The main aims of phases 1 (rationale for use) and 2 (discriminative ability) have been achieved. [18F]Flortaucipir binds with high affinity to paired helical filaments of tau and has favorable kinetic properties and excellent discriminative accuracy for AD. The majority of secondary aims of phase 2 were fully achieved. Multiple studies showed high correlations between ante-mortem [18F]flortaucipir PET and post-mortem tau (as assessed by histopathology), and also the effects of covariates on tracer binding are well studied. The aims of phase 3 (early detection ability) were only partially or preliminarily achieved, and the aims of phases 4 and 5 were not achieved. CONCLUSION Current literature provides partial evidence for clinical utility of [18F]flortaucipir PET. The aims for phases 1 and 2 were mostly achieved. Phase 3 studies are currently ongoing. Future studies including representative MCI populations and a focus on healthcare outcomes are required to establish full maturity of phases 4 and 5.
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29
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Weller A, Bischof GN, Schlüter P, Richter N, Dronse J, Onur O, Neumaier B, Kukolja J, Langen KJ, Fink G, Kunoth A, Shao Y, van Eimeren T, Drzezga A. Finding New Communities: A Principle of Neuronal Network Reorganization in Alzheimer's Disease. Brain Connect 2021; 11:225-238. [PMID: 33356820 DOI: 10.1089/brain.2020.0889] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Graph-theoretical analyses have been previously used to investigate changes in the functional connectome in patients with Alzheimer's disease (AD). However, these analyses generally assume static organizational principles, thereby neglecting a fundamental reconfiguration of functional connections in the face of neurodegeneration. Methods: Here, we focus on differences in the community structure of the functional connectome in young and old individuals and patients with AD. Patients with AD, moreover, underwent molecular imaging positron emission tomography by using [18F]AV1451 to measure tau burden, a major hallmark of AD. Results: Although the overall organizational principles of the community structure of the human functional connectome were preserved even in advanced healthy aging, they were considerably changed in AD. We discovered that the communities in AD are re-organized, with nodes changing their allegiance to communities, thus resulting in an overall less efficient re-organized community structure. We further discovered that nodes with a tendency to leave the communities displayed a relatively higher tau pathology burden. Discussion: Together, this study suggests that local tau pathology in AD is associated to fundamental changes in basic organizational principles of the human connectome. Our results shed new light on previous findings obtained by using the graph theory in AD and imply a general principle of the brain in response to neurodegeneration.
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Affiliation(s)
- Anna Weller
- Division of Mathematics, Department of Mathematics and Computer Science, University of Cologne, Cologne, Germany
| | - Gérard N Bischof
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,Research Center Juelich, Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Juelich, Germany
| | - Philipp Schlüter
- Institute for Geophysics and Meteorology, University of Cologne, Cologne, Germany
| | - Nils Richter
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Juelich, Germany.,Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Julian Dronse
- Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Oezguer Onur
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Juelich, Germany.,Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Bernd Neumaier
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3), Radiochemistry, Juelich, Germany
| | - Juraj Kukolja
- Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,Department of Neurology and clinical Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany.,Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Karl-Josef Langen
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-4), Medical Imaging Physics, Juelich, Germany
| | - Gereon Fink
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-3), Cognitive Neuroscience, Juelich, Germany.,Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Angela Kunoth
- Division of Mathematics, Department of Mathematics and Computer Science, University of Cologne, Cologne, Germany
| | - Yaping Shao
- Institute for Geophysics and Meteorology, University of Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,Department of Neurology, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, Multimodal Neuroimaging Group, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany.,Research Center Juelich, Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Juelich, Germany
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30
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Lesman-Segev OH, La Joie R, Iaccarino L, Lobach I, Rosen HJ, Seo SW, Janabi M, Baker SL, Edwards L, Pham J, Olichney J, Boxer A, Huang E, Gorno-Tempini M, DeCarli C, Hepker M, Hwang JHL, Miller BL, Spina S, Grinberg LT, Seeley WW, Jagust WJ, Rabinovici GD. Diagnostic Accuracy of Amyloid versus 18 F-Fluorodeoxyglucose Positron Emission Tomography in Autopsy-Confirmed Dementia. Ann Neurol 2021; 89:389-401. [PMID: 33219525 PMCID: PMC7856004 DOI: 10.1002/ana.25968] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 11/15/2020] [Accepted: 11/17/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the diagnostic accuracy of antemortem 11 C-Pittsburgh compound B (PIB) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) versus autopsy diagnosis in a heterogenous sample of patients. METHODS One hundred one participants underwent PIB and FDG PET during life and neuropathological assessment. PET scans were visually interpreted by 3 raters blinded to clinical information. PIB PET was rated as positive or negative for cortical retention, whereas FDG scans were read as showing an Alzheimer disease (AD) or non-AD pattern. Neuropathological diagnoses were assigned using research criteria. Majority visual reads were compared to intermediate-high AD neuropathological change (ADNC). RESULTS One hundred one participants were included (mean age = 67.2 years, 41 females, Mini-Mental State Examination = 21.9, PET-to-autopsy interval = 4.4 years). At autopsy, 32 patients showed primary AD, 56 showed non-AD neuropathology (primarily frontotemporal lobar degeneration [FTLD]), and 13 showed mixed AD/FTLD pathology. PIB showed higher sensitivity than FDG for detecting intermediate-high ADNC (96%, 95% confidence interval [CI] = 89-100% vs 80%, 95% CI = 68-92%, p = 0.02), but equivalent specificity (86%, 95% CI = 76-95% vs 84%, 95% CI = 74-93%, p = 0.80). In patients with congruent PIB and FDG reads (77/101), combined sensitivity was 97% (95% CI = 92-100%) and specificity was 98% (95% CI = 93-100%). Nine of 24 patients with incongruent reads were found to have co-occurrence of AD and non-AD pathologies. INTERPRETATION In our sample enriched for younger onset cognitive impairment, PIB-PET had higher sensitivity than FDG-PET for intermediate-high ADNC, with similar specificity. When both modalities are congruent, sensitivity and specificity approach 100%, whereas mixed pathology should be considered when PIB and FDG are incongruent. ANN NEUROL 2021;89:389-401.
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Affiliation(s)
- Orit H Lesman-Segev
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Diagnostic Imaging, Sheba Medical Center, Ramat Gan, Israel
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Leonardo Iaccarino
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Iryna Lobach
- Epidemiology and Biostatistics Department, University of California, San Francisco, San Francisco, CA, USA
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Mustafa Janabi
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Lauren Edwards
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Julie Pham
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - John Olichney
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Adam Boxer
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Eric Huang
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Marilu Gorno-Tempini
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Charles DeCarli
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Mackenzie Hepker
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ji-Hye L Hwang
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Salvatore Spina
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Lea T Grinberg
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William J Jagust
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
- Departments of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
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31
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Drzezga A, Bischof GN, Giehl K, van Eimeren T. PET and SPECT Imaging of Neurodegenerative Diseases. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00085-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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32
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Iaccarino L, La Joie R, Edwards L, Strom A, Schonhaut DR, Ossenkoppele R, Pham J, Mellinger T, Janabi M, Baker SL, Soleimani-Meigooni D, Rosen HJ, Miller BL, Jagust WJ, Rabinovici GD. Spatial Relationships between Molecular Pathology and Neurodegeneration in the Alzheimer's Disease Continuum. Cereb Cortex 2021; 31:1-14. [PMID: 32808011 PMCID: PMC7727356 DOI: 10.1093/cercor/bhaa184] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 06/01/2020] [Accepted: 06/08/2020] [Indexed: 12/12/2022] Open
Abstract
A deeper understanding of the spatial relationships of β-amyloid (Aβ), tau, and neurodegeneration in Alzheimer's disease (AD) could provide insight into pathogenesis and clinical trial design. We included 81 amyloid-positive patients (age 64.4 ± 9.5) diagnosed with AD dementia or mild cognitive impairment due to AD and available 11C-PiB (PIB), 18F-Flortaucipir (FTP),18F-FDG-PET, and 3T-MRI, and 31 amyloid-positive, cognitively normal participants (age 77.3 ± 6.5, no FDG-PET). W-score voxel-wise deviation maps were created and binarized for each imaging-modality (W > 1.64, P < 0.05) adjusting for age, sex, and total intracranial volume (sMRI-only) using amyloid-negative cognitively normal adults. For symptomatic patients, FDG-PET and atrophy W-maps were combined into neurodegeneration maps (ND). Aβ-pathology showed the greatest proportion of cortical gray matter suprathreshold voxels (spatial extent) for both symptomatic and asymptomatic participants (median 94-55%, respectively), followed by tau (79-11%) and neurodegeneration (41-3%). Amyloid > tau > neurodegeneration was the most frequent hierarchy for both groups (79-77%, respectively), followed by tau > amyloid > neurodegeneration (13-10%) and amyloid > neurodegeneration > tau (6-13%). For symptomatic participants, most abnormal voxels were PIB+/FTP+/ND- (median 35%), and the great majority of ND+ voxels (91%) colocalized with molecular pathology. Amyloid spatially exceeded tau and neurodegeneration, with individual heterogeneities. Molecular pathology and neurodegeneration showed a progressive overlap along AD course, indicating shared vulnerabilities or synergistic toxic mechanisms.
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Affiliation(s)
- Leonardo Iaccarino
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Renaud La Joie
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Lauren Edwards
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Amelia Strom
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Daniel R Schonhaut
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
| | - Rik Ossenkoppele
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam 1081 HV, The Netherlands
| | - Julie Pham
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Taylor Mellinger
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mustafa Janabi
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Suzanne L Baker
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - David Soleimani-Meigooni
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Howard J Rosen
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA 94158, USA
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA 94720, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA 94158, USA
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Richter N, Bischof GN, Dronse J, Nellessen N, Neumaier B, Langen KJ, Drzezga A, Fink GR, van Eimeren T, Kukolja J, Onur OA. Entorhinal Tau Predicts Hippocampal Activation and Memory Deficits in Alzheimer's Disease. J Alzheimers Dis 2020; 78:1601-1614. [PMID: 33164934 DOI: 10.3233/jad-200835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND To date, it remains unclear how amyloid plaques and neurofibrillary tangles are related to neural activation and, consequently, cognition in Alzheimer's disease (AD). Recent findings indicate that tau accumulation may drive hippocampal hyperactivity in cognitively normal aging, but it remains to be elucidated how tau accumulation is related to neural activation in AD. OBJECTIVE To determine whether the association between tau accumulation and hippocampal hyperactivation persists in mild cognitive impairment (MCI) and mild dementia or if the two measures dissociate with disease progression, we investigated the relationship between local tau deposits and memory-related neural activation in MCI and mild dementia due to AD. METHODS Fifteen patients with MCI or mild dementia due to AD underwent a neuropsychological assessment and performed an item memory task during functional magnetic resonance imaging. Cerebral tau accumulation was assessed using positron emission tomography and [18F]-AV-1451. RESULTS Entorhinal, but not global tau accumulation, was highly correlated with hippocampal activation due to visual item memory encoding and predicted memory loss over time. Neural activation in the posterior cingulate cortex and the fusiform gyrus was not significantly correlated with tau accumulation. CONCLUSION These findings extend previous observations in cognitively normal aging, demonstrating that entorhinal tau continues to be closely associated with hippocampal hyperactivity and memory performance in MCI and mild dementia due to AD. Furthermore, data suggest that this association is strongest in medial temporal lobe structures. In summary, our data provide novel insights into the relationship of tau accumulation to neural activation and memory in AD.
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Affiliation(s)
- Nils Richter
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gérard N Bischof
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Julian Dronse
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Nils Nellessen
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Bernd Neumaier
- Nuclear Chemistry, Institute of Neuroscience and Medicine (INM-5), Research Center Jülich, Jülich, Germany.,Institute for Radiochemistry and Experimental Molecular Imaging, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Karl-Josef Langen
- Medical Imaging Physics, Institute of Neuroscience and Medicine (INM-4), Research Center Jülich, Jülich, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gereon R Fink
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Thilo van Eimeren
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Nuclear Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Juraj Kukolja
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurology and Neurophysiology, Helios University Hospital Wuppertal, Wuppertal, Germany
| | - Oezguer A Onur
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Jülich, Germany.,Department of Neurology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
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34
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Cantero JL, Atienza M, Ramos-Cejudo J, Fossati S, Wisniewski T, Osorio RS. Plasma tau predicts cerebral vulnerability in aging. Aging (Albany NY) 2020; 12:21004-21022. [PMID: 33147571 PMCID: PMC7695405 DOI: 10.18632/aging.104057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/25/2020] [Indexed: 12/11/2022]
Abstract
Identifying cerebral vulnerability in late life may help prevent or slow the progression of aging-related chronic diseases. However, non-invasive biomarkers aimed at detecting subclinical cerebral changes in the elderly are lacking. Here, we have examined the potential of plasma total tau (t-tau) for identifying cerebral and cognitive deficits in normal elderly subjects. Patterns of cortical thickness and cortical glucose metabolism were used as outcomes of cerebral vulnerability. We found that increased plasma t-tau levels were associated with widespread reductions of cortical glucose uptake, thinning of the temporal lobe, and memory deficits. Importantly, tau-related reductions of glucose consumption in the orbitofrontal cortex emerged as a determining factor of the relationship between cortical thinning and memory loss. Together, these results support the view that plasma t-tau may serve to identify subclinical cerebral and cognitive deficits in normal aging, allowing detection of individuals at risk for developing aging-related neurodegenerative conditions.
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Affiliation(s)
- Jose L. Cantero
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Jaime Ramos-Cejudo
- Division of Brain Aging, Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA
| | - Silvia Fossati
- Alzheimer's Center at Temple, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA
| | - Thomas Wisniewski
- Departments of Neurology, Pathology and Psychiatry, Center for Cognitive Neurology, New York University School of Medicine, New York, NY 10016, USA
| | - Ricardo S. Osorio
- Division of Brain Aging, Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA
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35
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Koller EJ, Chakrabarty P. Tau-Mediated Dysregulation of Neuroplasticity and Glial Plasticity. Front Mol Neurosci 2020; 13:151. [PMID: 32973446 PMCID: PMC7472665 DOI: 10.3389/fnmol.2020.00151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 07/20/2020] [Indexed: 01/14/2023] Open
Abstract
The inability of individual neurons to compensate for aging-related damage leads to a gradual loss of functional plasticity in the brain accompanied by progressive impairment in learning and memory. Whereas this loss in neuroplasticity is gradual during normal aging, in neurodegenerative diseases such as Alzheimer’s disease (AD), this loss is accelerated dramatically, leading to the incapacitation of patients within a decade of onset of cognitive symptoms. The mechanisms that underlie this accelerated loss of neuroplasticity in AD are still not completely understood. While the progressively increasing proteinopathy burden, such as amyloid β (Aβ) plaques and tau tangles, definitely contribute directly to a neuron’s functional demise, the role of non-neuronal cells in controlling neuroplasticity is slowly being recognized as another major factor. These non-neuronal cells include astrocytes, microglia, and oligodendrocytes, which through regulating brain homeostasis, structural stability, and trophic support, play a key role in maintaining normal functioning and resilience of the neuronal network. It is believed that chronic signaling from these cells affects the homeostatic network of neuronal and non-neuronal cells to an extent to destabilize this harmonious milieu in neurodegenerative diseases like AD. Here, we will examine the experimental evidence regarding the direct and indirect pathways through which astrocytes and microglia can alter brain plasticity in AD, specifically as they relate to the development and progression of tauopathy. In this review article, we describe the concepts of neuroplasticity and glial plasticity in healthy aging, delineate possible mechanisms underlying tau-induced plasticity dysfunction, and discuss current clinical trials as well as future disease-modifying approaches.
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Affiliation(s)
- Emily J Koller
- Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States
| | - Paramita Chakrabarty
- Department of Neuroscience, University of Florida, Gainesville, FL, United States.,Center for Translational Research in Neurodegenerative Disease, University of Florida, Gainesville, FL, United States.,McKnight Brain Institute, University of Florida, Gainesville, FL, United States
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36
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Hammes J, Bischof GN, Bohn KP, Onur Ö, Schneider A, Fliessbach K, Hönig MC, Jessen F, Neumaier B, Drzezga A, van Eimeren T. One-Stop Shop: 18F-Flortaucipir PET Differentiates Amyloid-Positive and -Negative Forms of Neurodegenerative Diseases. J Nucl Med 2020; 62:240-246. [PMID: 32620704 DOI: 10.2967/jnumed.120.244061] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 05/30/2020] [Indexed: 02/06/2023] Open
Abstract
Tau protein aggregations are a hallmark of amyloid-associated Alzheimer disease and some forms of non-amyloid-associated frontotemporal lobar degeneration. In recent years, several tracers for in vivo tau imaging have been under evaluation. This study investigated the ability of 18F-flortaucipir PET not only to assess tau positivity but also to differentiate between amyloid-positive and -negative forms of neurodegeneration on the basis of different 18F-flortaucipir PET signatures. Methods: The 18F-flortaucipir PET data of 35 patients with amyloid-positive neurodegeneration, 19 patients with amyloid-negative neurodegeneration, and 17 healthy controls were included in a data-driven scaled subprofile model (SSM)/principal-component analysis (PCA) identifying spatial covariance patterns. SSM/PCA pattern expression strengths were tested for their ability to predict amyloid status in a receiver-operating-characteristic analysis and validated with a leave-one-out approach. Results: Pattern expression strengths predicted amyloid status with a sensitivity of 0.94 and a specificity of 0.83. A support vector machine classification based on pattern expression strengths in 2 different SSM/PCA components yielded a prediction accuracy of 98%. Anatomically, prediction performance was driven by parietooccipital gray matter in amyloid-positive patients versus predominant white matter binding in amyloid-negative patients. Conclusion: SSM/PCA-derived binding patterns of 18F-flortaucipir differentiate between amyloid-positive and -negative neurodegenerative diseases with high accuracy. 18F-flortaucipir PET alone may convey additional information equivalent to that from amyloid PET. Together with a perfusion-weighted early-phase acquisition (18F-FDG PET-equivalent), a single scan potentially contains comprehensive information on amyloid (A), tau (T), and neurodegeneration (N) status as required by recent biomarker classification algorithms (A/T/N).
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Affiliation(s)
- Jochen Hammes
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany .,Radiologische Allianz, Hamburg, Germany
| | - Gérard N Bischof
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Faculty of Mathematics and Natural Sciences, University of Cologne, Cologne, Germany
| | - Karl P Bohn
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Department of Nuclear Medicine, Inselspital University Hospital, University of Bern, Bern, Switzerland
| | - Özgür Onur
- Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Cognitive Neuroscience (INM-3), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Merle C Hönig
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Department of Psychiatry, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany; and
| | - Bernd Neumaier
- Nuclear Chemistry (INM-5), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany, and Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany.,Molecular Organization of the Brain (INM-2), Institute of Neuroscience and Medicine, Research Center Jülich, Jülich, Germany
| | - Thilo van Eimeren
- Multimodal Neuroimaging, Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,Department of Neurology, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany.,German Center for Neurodegenerative Diseases, Bonn and Cologne, Germany
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37
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Adams JN, Lockhart SN, Li L, Jagust WJ. Relationships Between Tau and Glucose Metabolism Reflect Alzheimer's Disease Pathology in Cognitively Normal Older Adults. Cereb Cortex 2020; 29:1997-2009. [PMID: 29912295 DOI: 10.1093/cercor/bhy078] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 02/22/2018] [Accepted: 03/20/2018] [Indexed: 12/26/2022] Open
Abstract
Tau is associated with hypometabolism in patients with Alzheimer's disease. In normal aging, the association between tau and glucose metabolism is not fully characterized. We used [18F] AV-1451, [18F] Fluorodeoxyglucose, and [11C] Pittsburgh Compound-B (PiB) PET to measure associations between tau and glucose metabolism in cognitively normal older adults (N = 49). Participants were divided into amyloid-negative (PiB-, n = 28) and amyloid-positive (PiB+, n = 21) groups to determine effects of amyloid-β. We assessed both local and across-brain regional tau-glucose metabolism associations separately in PiB-/PiB+ groups using correlation matrices and sparse canonical correlations. Relationships between tau and glucose metabolism differed by amyloid status, and were primarily spatially distinct. In PiB- subjects, tau was associated with broad regions of increased glucose metabolism. In PiB+ subjects, medial temporal lobe tau was associated with widespread hypometabolism, while tau outside of the medial temporal lobe was associated with decreased and increased glucose metabolism. We further found that regions with earlier tau spread were associated with stronger negative correlations with glucose metabolism. Our findings indicate that in normal aging, low levels of tau are associated with a phase of increased metabolism, while high levels of tau in the presence of amyloid-β are associated with hypometabolism at downstream sites.
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Affiliation(s)
- Jenna N Adams
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Samuel N Lockhart
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Lexin Li
- Department of Biostatistics, University of California, Berkeley, CA, USA
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.,Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Vilaplana E, Rodriguez-Vieitez E, Ferreira D, Montal V, Almkvist O, Wall A, Lleó A, Westman E, Graff C, Fortea J, Nordberg A. Cortical microstructural correlates of astrocytosis in autosomal-dominant Alzheimer disease. Neurology 2020; 94:e2026-e2036. [PMID: 32291295 PMCID: PMC7282881 DOI: 10.1212/wnl.0000000000009405] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 11/18/2019] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To study the macrostructural and microstructural MRI correlates of brain astrocytosis, measured with 11C-deuterium-L-deprenyl (11C-DED)-PET, in familial autosomal-dominant Alzheimer disease (ADAD). METHODS The total sample (n = 31) comprised ADAD mutation carriers (n = 10 presymptomatic, 39.2 ± 10.6 years old; n = 3 symptomatic, 55.5 ± 2.0 years old) and noncarriers (n = 18, 44.0 ± 13.7 years old) belonging to families with mutations in either the presenilin-1 or amyloid precursor protein genes. All participants underwent structural and diffusion MRI and neuropsychological assessment, and 20 participants (6 presymptomatic and 3 symptomatic mutation carriers and 11 noncarriers) also underwent 11C-DED-PET. RESULTS Vertex-wise interaction analyses revealed a differential relationship between carriers and noncarriers in the association between 11C-DED binding and estimated years to onset (EYO) and between cortical mean diffusivity (MD) and EYO. These differences were due to higher 11C-DED binding in presymptomatic carriers, with lower binding in symptomatic carriers compared to noncarriers, and to lower cortical MD in presymptomatic carriers, with higher MD in symptomatic carriers compared to noncarriers. Using a vertex-wise local correlation approach, 11C-DED binding was negatively correlated with cortical MD and positively correlated with cortical thickness. CONCLUSIONS Our proof-of-concept study is the first to show that microstructural and macrostructural changes can reflect underlying neuroinflammatory mechanisms in early stages of Alzheimer disease (AD). The findings support a role for neuroinflammation in AD pathogenesis, with potential implications for the correct interpretation of neuroimaging biomarkers as surrogate endpoints in clinical trials.
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Affiliation(s)
- Eduard Vilaplana
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Elena Rodriguez-Vieitez
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Daniel Ferreira
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Victor Montal
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ove Almkvist
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Anders Wall
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Alberto Lleó
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Eric Westman
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Caroline Graff
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Juan Fortea
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Agneta Nordberg
- From the Memory Unit, Department of Neurology (E.V., V.M., A.L., J.F.), Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona; Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED (E.V., V.M., A.L., J.F.), Madrid, Spain; Department of Neurobiology (E.R.-V., D.F., O.A., E.W., A.N.), Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, and Division of Neurogeriatrics (C.G.), Karolinska Institutet, Stockholm Department of Psychology (O.A.), Stockholm University; The Aging Brain Unit (O.A., A.N.) and Unit for Hereditary Dementias (C.G.), Theme Aging, Karolinska University Hospital, Stockholm; Department of Surgical Sciences, Section of Nuclear Medicine & PET (A.W.), Uppsala University, Sweden; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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Caballero MÁA, Song Z, Rubinski A, Duering M, Dichgans M, Park DC, Ewers M. Age‐dependent amyloid deposition is associated with white matter alterations in cognitively normal adults during the adult life span. Alzheimers Dement 2020; 16:651-661. [DOI: 10.1002/alz.12062] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 12/10/2019] [Accepted: 01/03/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Zhuang Song
- Center for Vital LongevityUniversity of Texas at Dallas Dallas Texas
| | - Anna Rubinski
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
| | - Marco Duering
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
| | - Martin Dichgans
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich Germany
| | - Denise C. Park
- Center for Vital LongevityUniversity of Texas at Dallas Dallas Texas
| | - Michael Ewers
- Institute for Stroke and Dementia ResearchUniversity HospitalLMU Munich Munich Germany
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Dubey SK, Lakshmi KK, Krishna KV, Agrawal M, Singhvi G, Saha RN, Saraf S, Saraf S, Shukla R, Alexander A. Insulin mediated novel therapies for the treatment of Alzheimer's disease. Life Sci 2020; 249:117540. [PMID: 32165212 DOI: 10.1016/j.lfs.2020.117540] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 03/03/2020] [Accepted: 03/07/2020] [Indexed: 12/16/2022]
Abstract
Alzheimer's disease, a progressive neurodegenerative disorder, is one of the leading causes of death in the USA, along with cancer and cardiac disorders. AD is characterized by various neurological factors like amyloid plaques, tau hyperphosphorylation, mitochondrial dysfunction, acetylcholine deficiency, etc. Together, impaired insulin signaling in the brain is also observed as essential factor to be considered in AD pathophysiology. Hence, currently researchers focused on studying the effect of brain insulin metabolism and relation of diabetes with AD. Based on the investigations, AD is also considered as type 3 or brain diabetes. Besides the traditional view of correlating AD with aging, a better understanding of various pathological factors and effects of other physical ailments is necessary to develop a promising therapeutic approach. There is a vast scope of studying the relation of systemic insulin level, insulin signaling, its neuroprotective potency and effect of diabetes on AD progression. The present work describes worldwide status of AD and its relation with diabetes mellitus and insulin metabolism; pathophysiology of AD; different metabolic pathways associating insulin metabolism with AD; insulin receptor and signaling in the brain; glucose metabolism; insulin resistance; and various preclinical and clinical studies reported insulin-based therapies to treat AD via systemic route and through direct intranasal delivery to the brain.
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Affiliation(s)
- Sunil Kumar Dubey
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani (BITS-PILANI), Pilani Campus, Rajasthan, India.
| | - K K Lakshmi
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani (BITS-PILANI), Pilani Campus, Rajasthan, India
| | - Kowthavarapu Venkata Krishna
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani (BITS-PILANI), Pilani Campus, Rajasthan, India
| | - Mukta Agrawal
- Rungta College of Pharmaceutical Sciences and Research, Kohka-Kurud Road, Bhilai, Chhattisgarh 490 024, India
| | - Gautam Singhvi
- Department of Pharmacy, Birla Institute of Technology and Science, Pilani (BITS-PILANI), Pilani Campus, Rajasthan, India
| | - Ranendra Narayana Saha
- Department of Biotechnology, Birla Institute of Technology and Science, Pilani (BITS-PILANI), Dubai Campus, Dubai, United Arab Emirates
| | - Swarnlata Saraf
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh 492010, India
| | - Shailendra Saraf
- University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh 492010, India
| | - Rahul Shukla
- Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research (NIPER-R), New Transit Campus, Bijnor Road, Sarojini Nagar, Lucknow 226002, India
| | - Amit Alexander
- National Institute of Pharmaceutical Education and Research (NIPER-Guwahati), Department of Pharmaceuticals, Ministry of Chemicals & Fertilizers, Govt. of India, NH 37, NITS Mirza, Kamrup-781125, Guwahati, Assam, India.
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Ruppert MC, Greuel A, Tahmasian M, Schwartz F, Stürmer S, Maier F, Hammes J, Tittgemeyer M, Timmermann L, van Eimeren T, Drzezga A, Eggers C. Network degeneration in Parkinson’s disease: multimodal imaging of nigro-striato-cortical dysfunction. Brain 2020; 143:944-959. [DOI: 10.1093/brain/awaa019] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/21/2019] [Accepted: 12/11/2019] [Indexed: 11/14/2022] Open
Abstract
Abstract
The spreading hypothesis of neurodegeneration assumes an expansion of neural pathologies along existing neural pathways. Multimodal neuroimaging studies have demonstrated distinct topographic patterns of cerebral pathologies in neurodegeneration. For Parkinson’s disease the hypothesis so far rests largely on histopathological evidence of α-synuclein spreading in a characteristic pattern and progressive nigrostriatal dopamine depletion. Functional consequences of nigrostriatal dysfunction on cortical activity remain to be elucidated. Our goal was to investigate multimodal imaging correlates of degenerative processes in Parkinson’s disease by assessing dopamine depletion and its potential effect on striatocortical connectivity networks and cortical metabolism in relation to parkinsonian symptoms. We combined 18F-DOPA-PET, 18F-fluorodeoxyglucose (FDG)-PET and resting state functional MRI to multimodally characterize network alterations in Parkinson’s disease. Forty-two patients with mild-to-moderate stage Parkinson’s disease and 14 age-matched healthy control subjects underwent a multimodal imaging protocol and comprehensive clinical examination. A voxel-wise group comparison of 18F-DOPA uptake identified the exact location and extent of putaminal dopamine depletion in patients. Resulting clusters were defined as seeds for a seed-to-voxel functional connectivity analysis. 18F-FDG metabolism was compared between groups at a whole-brain level and uptake values were extracted from regions with reduced putaminal connectivity. To unravel associations between dopaminergic activity, striatocortical connectivity, glucose metabolism and symptom severity, correlations between normalized uptake values, seed-to-cluster β-values and clinical parameters were tested while controlling for age and dopaminergic medication. Aside from cortical hypometabolism, 18F-FDG-PET data for the first time revealed a hypometabolic midbrain cluster in patients with Parkinson’s disease that comprised caudal parts of the bilateral substantia nigra pars compacta. Putaminal dopamine synthesis capacity was significantly reduced in the bilateral posterior putamen and correlated with ipsilateral nigral 18F-FDG uptake. Resting state functional MRI data indicated significantly reduced functional connectivity between the dopamine depleted putaminal seed and cortical areas primarily belonging to the sensorimotor network in patients with Parkinson’s disease. In the inferior parietal cortex, hypoconnectivity in patients was significantly correlated with lower metabolism (left P = 0.021, right P = 0.018). Of note, unilateral network alterations quantified with different modalities corresponded with contralateral motor impairments. In conclusion, our results support the hypothesis that degeneration of nigrostriatal fibres functionally impairs distinct striatocortical connections, disturbing the efficient interplay between motor processing areas and impairing motor control in patients with Parkinson’s disease. The present study is the first to reveal trimodal evidence for network-dependent degeneration in Parkinson’s disease by outlining the impact of functional nigrostriatal pathway impairment on striatocortical functional connectivity networks and cortical metabolism.
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Affiliation(s)
- Marina C Ruppert
- Department of Neurology, University Hospital of Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | - Andrea Greuel
- Department of Neurology, University Hospital of Marburg, Germany
| | - Masoud Tahmasian
- Institue of Medical Science and Technology, Shahid Beheshti University, Tehran, Iran
| | - Frank Schwartz
- Department of Neurology, Hospital of the Brothers of Mercy, Trier, Germany
| | - Sophie Stürmer
- Max Planck Institute for Metabolism Research, Cologne, Germany
- Department of Neurology, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
| | - Franziska Maier
- Department of Psychiatry, University Hospital Cologne, Medical Faculty, Cologne, Germany
| | - Jochen Hammes
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
| | - Marc Tittgemeyer
- Max Planck Institute for Metabolism Research, Cologne, Germany
- Cluster of Excellence in Cellular Stress and Aging Associated Disease (CECAD), Cologne, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital of Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | - Thilo van Eimeren
- Department of Neurology, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-3), Research Center Jülich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Germany
| | - Alexander Drzezga
- Multimodal Neuroimaging Group, Department of Nuclear Medicine, Medical Faculty and University Hospital Cologne, University Hospital Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Germany
- Cognitive Neuroscience, Institute of Neuroscience and Medicine (INM-2), Research Center Jülich, Germany
| | - Carsten Eggers
- Department of Neurology, University Hospital of Marburg, Germany
- Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
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The A/T/N model applied through imaging biomarkers in a memory clinic. Eur J Nucl Med Mol Imaging 2019; 47:247-255. [PMID: 31792573 DOI: 10.1007/s00259-019-04536-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022]
Abstract
PURPOSE The A/T/N model is a research framework proposed to investigate Alzheimer's disease (AD) pathological bases (i.e., amyloidosis A, neurofibrillary tangles T, and neurodegeneration N). The application of this system on clinical populations is still limited. The aim of the study is to evaluate the topography of T distribution by 18F-flortaucipir PET in relation to A and N and to describe the A/T/N status through imaging biomarkers in memory clinic patients. METHODS Eighty-one patients with subjective and objective cognitive impairment were classified as A+/A- and N+/N- through amyloid PET and structural MRI. Tau deposition was compared across A/N subgroups at voxel level. T status was defined through a global cut point based on A/N subgroups and subjects were categorized following the A/T/N model. RESULTS A+N+ and A+N- subgroups showed higher tau burden compared to A-N- group, with A+N- showing significant deposition limited to the medial and lateral temporal regions. Global cut point discriminated A+N+ and A+N- from A-N- subjects. On A/T/N classification, 23% of patients showed a negative biomarker profile, 58% fell within the Alzheimer's continuum, and 19% of the sample was characterized by non-AD pathologic change. CONCLUSION Medial and lateral temporal regions represent a site of significant tau accumulation in A+ subjects and possibly a useful marker of early clinical changes. This is the first study in which the A/T/N model is applied using 18F-flortaucipir PET in a memory clinic population. The majority of patients showed a profile consistent with the Alzheimer's continuum, while a minor percentage showed a profile suggestive of possible other neurodegenerative diseases. These results support the applicability of the A/T/N model in clinical practice.
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Perani D, Iaccarino L, Jacobs AH. Application of advanced brain positron emission tomography-based molecular imaging for a biological framework in neurodegenerative proteinopathies. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2019; 11:327-332. [PMID: 31080871 PMCID: PMC6505113 DOI: 10.1016/j.dadm.2019.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION A rapid transition from a clinical-based classification to a pathology-based classification of neurodegenerative conditions, largely promoted by the increasing availability of imaging biomarkers, is emerging. The Framework for Innovative Multi-tracer molecular Brain Imaging, funded by the EU Joint Program - Neurodegenerative Disease Research 2016 "Working Groups for Harmonisation and Alignment in Brain Imaging Methods for Neurodegeneration," aimed at providing a roadmap for the applications of established and new molecular imaging techniques in dementia. METHODS We consider current and future implications of adopting a pathology-based framework for the use and development of positron emission tomography techniques. RESULTS This approach will enhance efforts to understand the multifactorial etiology of Alzheimer's disease and other dementias. DISCUSSION The availability of pathology biomarkers will soon transform clinical and research practice. Crucially, a comprehensive understanding of strengths and caveats of these techniques will promote an informed use to take full advantage of these tools.
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Affiliation(s)
- Daniela Perani
- Vita-Salute San Raffaele University, Milan, Italy
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Nuclear Medicine Unit, San Raffaele Hospital, Milan, Italy
| | - Leonardo Iaccarino
- Vita-Salute San Raffaele University, Milan, Italy
- In Vivo Human Molecular and Structural Neuroimaging Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andreas H. Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany
- Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany
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44
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Drzezga A. The Network Degeneration Hypothesis: Spread of Neurodegenerative Patterns Along Neuronal Brain Networks. J Nucl Med 2019; 59:1645-1648. [PMID: 30385641 DOI: 10.2967/jnumed.117.206300] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany, and German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
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45
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Vanhoutte M, Semah F, Leclerc X, Sillaire AR, Jaillard A, Kuchcinski G, Delbeuck X, Fahmi R, Pasquier F, Lopes R. Three-year changes of cortical 18F-FDG in amnestic vs. non-amnestic sporadic early-onset Alzheimer's disease. Eur J Nucl Med Mol Imaging 2019; 47:304-318. [PMID: 31606833 DOI: 10.1007/s00259-019-04519-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/30/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To examine and compare longitudinal changes of cortical glucose metabolism in amnestic and non-amnestic sporadic forms of early-onset Alzheimer's disease and assess potential associations with neuropsychological performance over a 3-year period time. METHODS Eighty-two participants meeting criteria for early-onset (< 65 years) sporadic form of probable Alzheimer's disease and presenting with a variety of clinical phenotypes (47 amnestic and 35 non-amnestic forms) were included at baseline and followed up for 1.44 ± 1.23 years. All of the participants underwent a work-up at baseline and every year during the follow-up period, which includes clinical examination, neuropsychological testing, genotyping, cerebrospinal fluid biomarker assays, and structural MRI and 18F-FDG PET. Vertex-wise partial volume-corrected glucose metabolic maps across the entire cortical surface were generated and longitudinally assessed together with the neuropsychological scores using linear mixed-effects modeling as a function of amnestic and non-amnestic sporadic forms of early-onset Alzheimer's disease. RESULTS Similar evolution patterns of glucose metabolic decline between amnestic and non-amnestic forms were observed in widespread neocortical cortices. However, only non-amnestic forms appeared to have a greater reduction of glucose metabolism in lateral orbitofrontal and bilateral medial temporal cortices associated with more severe declines of neuropsychological performance compared with amnestic forms. Furthermore, results suggest that glucose metabolic decline in amnestic forms would progress along an anterior-to-posterior axis, whereas glucose metabolic decline in non-amnestic forms would progress along a posterior-to-anterior axis. CONCLUSIONS We found differences in spatial distribution and temporal trajectory of glucose metabolic decline between amnestic and non-amnestic early-onset Alzheimer's disease groups, suggesting that one might want to consider treating the two forms of the disease as two separate entities.
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Affiliation(s)
- Matthieu Vanhoutte
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France. .,Department of Nuclear Medicine, CHU Lille, F-59000, Lille, France. .,Department of Neuroradiology, CHU Lille, F-59000, Lille, France.
| | - Franck Semah
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France.,Department of Nuclear Medicine, CHU Lille, F-59000, Lille, France
| | - Xavier Leclerc
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France.,Department of Neuroradiology, CHU Lille, F-59000, Lille, France
| | - Adeline Rollin Sillaire
- Department of Neurology, CHU Lille, F-59000, Lille, France.,Inserm U1171, CHU Lille, Memory Center, DISTALZ, University of Lille, F-59000, Lille, France
| | - Alice Jaillard
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France.,Department of Nuclear Medicine, CHU Lille, F-59000, Lille, France
| | - Grégory Kuchcinski
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France.,Department of Neuroradiology, CHU Lille, F-59000, Lille, France
| | - Xavier Delbeuck
- Inserm U1171, CHU Lille, Memory Center, DISTALZ, University of Lille, F-59000, Lille, France.,Department of Neuropsychology, CHU Lille, F-59000, Lille, France
| | - Rachid Fahmi
- Siemens Medical Solutions USA, Inc., Molecular Imaging, Knoxville, TN, USA
| | - Florence Pasquier
- Department of Neurology, CHU Lille, F-59000, Lille, France.,Inserm U1171, CHU Lille, Memory Center, DISTALZ, University of Lille, F-59000, Lille, France
| | - Renaud Lopes
- Inserm U1171, CHU Lille, University of Lille, F-59000, Lille, France.,Department of Neuroradiology, CHU Lille, F-59000, Lille, France
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46
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Abstract
Technologies for imaging the pathophysiology of Alzheimer disease (AD) now permit studies of the relationships between the two major proteins deposited in this disease - amyloid-β (Aβ) and tau - and their effects on measures of neurodegeneration and cognition in humans. Deposition of Aβ in the medial parietal cortex appears to be the first stage in the development of AD, although tau aggregates in the medial temporal lobe (MTL) precede Aβ deposition in cognitively healthy older people. Whether aggregation of tau in the MTL is the first stage in AD or a fairly benign phenomenon that may be transformed and spread in the presence of Aβ is a major unresolved question. Despite a strong link between Aβ and tau, the relationship between Aβ and neurodegeneration is weak; rather, it is tau that is associated with brain atrophy and hypometabolism, which, in turn, are related to cognition. Although there is support for an interaction between Aβ and tau resulting in neurodegeneration that leads to dementia, the unknown nature of this interaction, the strikingly different patterns of brain Aβ and tau deposition and the appearance of neurodegeneration in the absence of Aβ and tau are challenges to this model that ultimately must be explained.
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47
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Benvenutto A, Giusiano B, Koric L, Gueriot C, Didic M, Felician O, Guye M, Guedj E, Ceccaldi M. Imaging Biomarkers of Neurodegeneration in Alzheimer's Disease: Distinct Contributions of Cortical MRI Atrophy and FDG-PET Hypometabolism. J Alzheimers Dis 2019; 65:1147-1157. [PMID: 30124446 DOI: 10.3233/jad-180292] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Neurodegeneration biomarkers are routinely used in the diagnosis of Alzheimer's disease (AD). OBJECTIVE To evaluate the respective contributions of two neuroimaging biomarkers, structural MRI and 18FDG-PET, in the assessment of neurodegeneration in AD dementia. METHODS Patients with mild AD dementia diagnosed based on clinical and cerebrospinal fluid criteria and cognitively healthy subjects, from the Marseille cohort ADAge with cognitive, structural MRI and 18FDG-PET assessments, were included. Extent of atrophy on MRI and of hypometabolism on 18FDG-PET were individually evaluated in each patient using a voxel-based analysis on whole-brain approach and compared to healthy subjects. Patients were divided in distinct groups according to their atrophy extent on the one hand and to their hypometabolism extent on the other, then, to their imaging profile combining the extent of the two biomarkers. RESULTS Fifty-two patients were included. The MMSE score was significantly lower in the "Extensive hypometabolism" group than in the "Limited hypometabolism" group (respectively 19.5/30 versus 23/30). A lower Innotest Amyloid Tau Index was associated with an extensive hypometabolism (p = 0.04). There were more patients with low educational level in the "Extensive atrophy" group, while a higher educational level was more found in the "Limited atrophy" group (p = 0.005). CONCLUSION 18FDG-PET hypometabolism extent is associated with the pathological processes and clinical severity of AD, while MRI atrophy seems to be influenced by the cognitive reserve. In the context of mild AD dementia, these two biomarkers of neurodegeneration are thus not interchangeable and require to be considered in combination rather than in isolation.
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Affiliation(s)
- Agnès Benvenutto
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Bernard Giusiano
- Department of Public Health, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Lejla Koric
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - Claude Gueriot
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Mira Didic
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Olivier Felician
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, Timone University Hospital, CEMEREM, Marseille, France
| | - Eric Guedj
- Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France.,Department of Nuclear Medecine, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,CERIMED, Aix-Marseille Univ, Marseille, France
| | - Mathieu Ceccaldi
- Neurology and Neuropsychology Department and CMMR PACA Ouest, Assistance Publique-Hôpitaux de Marseille, Marseille, France.,Institut de Neurosciences des Systèmes, Aix-Marseille Univ, INSERM UMR 1106, Marseille, France
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48
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Jagust W, Jack CR, Bennett DA, Blennow K, Haeberlein SB, Holtzman DM, Jessen F, Karlawish J, Liu E, Molinuevo JL, Montine T, Phelps C, Rankin KP, Rowe CC, Scheltens P, Siemers E, Sperling R. "Alzheimer's disease" is neither "Alzheimer's clinical syndrome" nor "dementia". Alzheimers Dement 2019; 15:153-157. [PMID: 30642435 DOI: 10.1016/j.jalz.2018.11.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
| | | | - David A Bennett
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | | | - David M Holtzman
- Department of Neurology, Washington University, St. Louis, MO, USA
| | - Frank Jessen
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Jason Karlawish
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Enchi Liu
- Prothena Biosciences, Inc, South San Francisco, CA, USA
| | - Jose Luis Molinuevo
- BarcelonaBeta Brain Research Center, Pasqual Maragall Foundation and Hospital Clinic-IDIBAPS, Barcelona, Spain
| | - Thomas Montine
- Department of Pathology, Stanford University, Stanford, CA, USA
| | | | - Katherine P Rankin
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Christopher C Rowe
- Department of Molecular Imaging, Austin Health, University of Melbourne, Melbourne, Australia
| | - Philip Scheltens
- Department of Neurology, VU University Medical Center, Amsterdam, Netherlands
| | - Eric Siemers
- Formerly at Eli Lilly and Company, Indianapolis, IN, USA
| | - Reisa Sperling
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
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49
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Timmers T, Ossenkoppele R, Wolters EE, Verfaillie SCJ, Visser D, Golla SSV, Barkhof F, Scheltens P, Boellaard R, van der Flier WM, van Berckel BNM. Associations between quantitative [ 18F]flortaucipir tau PET and atrophy across the Alzheimer's disease spectrum. ALZHEIMERS RESEARCH & THERAPY 2019; 11:60. [PMID: 31272512 PMCID: PMC6610969 DOI: 10.1186/s13195-019-0510-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 06/06/2019] [Indexed: 01/09/2023]
Abstract
Background Neuropathological studies have linked tau aggregates to neuronal loss. To describe the spatial distribution of neurofibrillary tangle pathology in post-mortem tissue, Braak staging has been used. The aim of this study was to examine in vivo associations between tau pathology, quantified with [18F]flortaucipir PET in regions corresponding to Braak stages, and atrophy across the Alzheimer’s disease (AD) spectrum. Methods We included 100 subjects, including 58 amyloid-β positive patients with mild cognitive impairment (MCI, n = 6) or AD dementia (n = 52) and 42 controls with subjective cognitive decline (36% amyloid-β positive). All subjects underwent a dynamic [18F]flortaucipir PET to generate non-displaceable binding potential (BPND) maps. We extracted average [18F]flortaucipir BPND entorhinal, Braak III–IV (limbic) and Braak V–VI (neocortical) regions of interest (ROIs). T1-weighted MRI was used to assess gray matter (GM) volumes. We performed linear regression analyses using [18F]flortaucipir BPND ROIs as independent and GM density (ROI or voxelwise) as dependent variable. Results In MCI/AD subjects (age [mean ± SD] 65 ± 8 years, MMSE 23 ± 4), [18F]flortaucipir BPND was higher than in controls (age 65 ± 8, MMSE 29 ± 1) across all ROIs (entorhinal 0.06 ± 0.21 vs 0.46 ± 0.25 p < 0.001, Braak III–IV 0.11 ± 0.10 vs 0.46 ± 0.26, p < 0.001, Braak V–VI 0.07 ± 0.07 vs 0.38 ± 0.29, p < 0.001). In MCI/AD, greater [18F]flortaucipir BPND in entorhinal cortex was associated with lower GM density in medial temporal lobe (β − 0.40, p < 0.001). Greater [18F]flortaucipir BPND in ROI Braak III–IV and Braak V–VI was associated with smaller GM density in lateral and inferior temporal, parietal, occipital, and frontal lobes (range standardized βs − 0.30 to − 0.55, p < 0.01), but not in medial temporal lobe (β − 0.22, p 0.07). [18F]Flortaucipir BPND in ROI Braak I–II was not associated with GM density loss anywhere. When quantifying [18F]flortaucipir BPND across brain lobes, we observed both local and distant associations with GM atrophy. In controls, there were no significant associations between [18F]flortaucipir BPND and GM density (standardized βs ranging from − 0.24 to 0.02, all p > 0.05). Conclusions In MCI/AD patients, [18F]flortaucipir binding in entorhinal, limbic, and neocortical regions was associated with cortical atrophy. Electronic supplementary material The online version of this article (10.1186/s13195-019-0510-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tessa Timmers
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands. .,Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Rik Ossenkoppele
- Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Emma E Wolters
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Sander C J Verfaillie
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Denise Visser
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Sandeep S V Golla
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Frederik Barkhof
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Institutes of Neurology and Healthcare Engineering, UCLK, London, UK
| | - Philip Scheltens
- Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Wiesje M van der Flier
- Amsterdam Alzheimer Center, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
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50
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Perani D, Iaccarino L, Lammertsma AA, Windhorst AD, Edison P, Boellaard R, Hansson O, Nordberg A, Jacobs AH. A new perspective for advanced positron emission tomography-based molecular imaging in neurodegenerative proteinopathies. Alzheimers Dement 2019; 15:1081-1103. [PMID: 31230910 DOI: 10.1016/j.jalz.2019.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/21/2019] [Accepted: 02/20/2019] [Indexed: 12/12/2022]
Abstract
Recent studies in neurodegenerative conditions have increasingly highlighted that the same neuropathology can trigger different clinical phenotypes or, vice-versa, that similar phenotypes can be triggered by different neuropathologies. This evidence has called for the adoption of a pathology spectrum-based approach to study neurodegenerative proteinopathies. These conditions share brain deposition of abnormal protein aggregates, leading to aberrant biochemical, metabolic, functional, and structural changes. Positron emission tomography (PET) is a well-recognized and unique tool for the in vivo assessment of brain neuropathology, and novel PET techniques are emerging for the study of specific protein species. Today, key applications of PET range from early research and clinical diagnostic tools to their use in clinical trials for both participants screening and outcome evaluation. This position article critically reviews the role of distinct PET molecular tracers for different neurodegenerative proteinopathies, highlighting their strengths, weaknesses, and opportunities, with special emphasis on methodological challenges and future applications.
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Affiliation(s)
- Daniela Perani
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Leonardo Iaccarino
- Vita-Salute San Raffaele University, Nuclear Medicine Unit San Raffaele Hospital, Division of Neuroscience San Raffaele Scientific Institute, Milan, Italy
| | - Adriaan A Lammertsma
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Albert D Windhorst
- Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Edison
- Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK; Neurology Imaging Unit, Imperial College London, London, UK
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Center for Alzheimer Research, Stockholm, Sweden
| | - Andreas H Jacobs
- European Institute for Molecular Imaging, University of Münster, Münster, Germany; Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany.
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