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Geng C, Tan L, Chen C. Neuropsychiatric symptoms profile and markers of Alzheimer disease-type pathology in patients with Lewy body dementias. Brain Res 2024; 1833:148881. [PMID: 38519009 DOI: 10.1016/j.brainres.2024.148881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND To determine whether Lewy body dementia (LBD) patients with likely copathology of Alzheimer's disease (AD) exhibit greater neuropsychiatric symptom (NPS) compared to those without likely AD-type copathology. METHODS We enrolled 69 individuals diagnosed with Lewy body dementia (LBD), comprising both dementia with Lewy bodies (DLB) (n = 36) and Parkinson's disease dementia (PDD) (n = 33). These participants had accessible cerebrospinal fluid (CSF) markers related to Alzheimer's disease (AD) and cognitive data. We assessed CSF levels of β-amyloid 42 (Aβ42), phosphorylated tau (p-tau), and total tau (t-tau). Employing autopsy-validated CSF thresholds (t-tau/Aβ42 ratio > 0.3, n = 69), we categorized individuals into LBD with AD pathology (LBD + AD, n = 31) and LBD without apparent AD co-pathology (LBD - AD, n = 38). Moreover, the Hamilton Depression Scale (HAMD24), Hamilton Anxiety Scale (HAMA14), and Neuropsychiatric Inventory Questionnaire (NPI-Q) was used to assess the NPS. Spearman correlations were utilized to explore links between NPS and CSF marker profiles. RESULTS In terms of neuropsychiatric symptoms, LBD + AD patients demonstrated notably elevated levels of depressive symptoms (HAMD24) in comparison to LBD - AD patients (P < 0.001). However, based on PDD and DLB groups, no significant variations were noted in the neuropsychiatric symptoms(P>0.05). Moreover, CSF-derived biomarkers of Aβ42, and t-tau/Aβ42 were also associated with HAMD24 total scores in the LBD + AD subsample (P < 0.05). CONCLUSION There is an association between AD pathological markers and the NPS of LBD. The biologically based classification of LBD may be more advantageous in elucidating clinical heterogeneity than clinically defined syndromes.
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Affiliation(s)
- Chaofan Geng
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Leilei Tan
- Department of Neurology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China
| | - Chen Chen
- Department of Neurology, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, China.
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Barati N, Shojaeian A, Ramezani M, Kalhori F, Yavari Bazl MS, Zafari S, Asl SS, Motavallihaghi S. Investigating the effect of parasites (toxoplasma gondii RH strain, Leishmania major (MRHO/IR/75/ER), and hydatid cyst) antigens on Alzheimer's disease: An in vivo evaluation. Exp Neurol 2024; 377:114813. [PMID: 38735456 DOI: 10.1016/j.expneurol.2024.114813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/22/2024] [Accepted: 05/08/2024] [Indexed: 05/14/2024]
Abstract
This study aimed to investigate the effects of parasite antigens on Alzheimer's symptoms in animal model. Alzheimer's model was induced in Wistar rats using Amyloid-beta peptide, and treated with parasite crude antigens from T. gondii RH strain, L. major (MRHO/IR/75/ER), and HC. Spectrophotometry and real-time PCR were used to evaluate the oxidative stress levels, antioxidant enzyme activity, and gene expression of NLRP3, IL-8, IL-1β, and Caspase-1. Histological assays were performed to investigate structural changes in the hippocampus. Apoptosis was analyzed using an Annexin V Apoptosis by Flow cytometer. The levels of total oxidant, antioxidant, and SOD increased in the Alzheimer's group compared with the control group, but these factors were lower in the L. major group. The apoptosis in the treated groups was lower compared to the Alzheimer's group. IL-8 expression was significantly higher in all Alzheimer's groups, but decreased in the HC and L. major treated group compared to Alzheimer's. IL-1β and Caspase-1 expression were similarly increased in all groups compared with the control group, but decreased in the antigen-treated groups compared with Alzheimer's. NLRP3 expression was increased in all groups compared with the control group, with lower expression in HC group, but significantly decreased in L. major group compared with Alzheimer's. In histological results, only L. major group could play a therapeutic role in pathological damage of the hippocampus. The results showed that parasite antigens, specifically L. major antigens, may have neuroprotective effects that reduce oxidative stress, apoptosis, and histopathological changes in response to AD in animal model.
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Affiliation(s)
- Nastaran Barati
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ali Shojaeian
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Ramezani
- Department of Anatomy, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fereshte Kalhori
- Department of Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Salman Zafari
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Soleimani Asl
- Department of Anatomy, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedmousa Motavallihaghi
- Department of Medical Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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Zeng Q, Wang Y, Wang S, Luo X, Li K, Xu X, Liu X, Hong L, Li J, Li Z, Zhang X, Zhong S, Liu Z, Huang P, Chen Y, Zhang M. Cerebrospinal fluid amyloid-β and cerebral microbleed are associated with distinct neuropsychiatric sub-syndromes in cognitively impaired patients. Alzheimers Res Ther 2024; 16:69. [PMID: 38570794 PMCID: PMC10988961 DOI: 10.1186/s13195-024-01434-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are prevalent in cognitively impaired individuals including Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). Whereas several studies have reported the associations between NPS with AD pathologic biomarkers and cerebral small vessel disease (SVD), but it remains unknown whether AD pathology and SVD contribute to different sub-syndromes independently or aggravate same symptoms synergistically. METHOD We included 445 cognitively impaired individuals (including 316 MCI and 129 AD) with neuropsychiatric, cerebrospinal fluid (CSF) biomarkers (Aβ42, p-tau, and t-tau) and multi-model MRI data. Psychiatric symptoms were accessed by using the Neuropsychiatric Inventory (NPI). Visual assessment of SVD (white matter hyperintensity, microbleed, perivascular space, lacune) on MRI images was performed by experienced radiologist. Linear regression analyses were conducted to test the association between neuropsychiatric symptoms with AD pathology and CSVD burden after adjustment for age, sex, education, apolipoprotein E (APOE) ε4 carrier status, and clinical diagnosis. RESULTS The NPI total scores were related to microbleed (estimate 2.424; 95% CI [0.749, 4.099]; P =0.005). Considering the sub-syndromes, the hyperactivity was associated with microbleed (estimate 0.925; 95% CI [0.115, 1.735]; P =0.025), whereas the affective symptoms were correlated to CSF level of Aβ42 (estimate -0.006; 95% CI [-0.011, -0.002]; P =0.005). Furthermore, we found the apathy sub-syndrome was associated with CSF t-tau/Aβ42 (estimate 0.636; 95% CI [0.078, 1.194]; P =0.041) and microbleed (estimate 0.693; 95% CI [0.046, 1.340]; P =0.036). In addition, we found a significant interactive effect between CSF t-tau/Aβ42 and microbleed (estimate 0.993; 95% CI [0.360, 1.626]; P =0.019) on severity of apathy sub-syndrome. CONCLUSION Our study showed that CSF Aβ42 was associated with affective symptoms, but microbleed was correlated with hyperactivity and apathy, suggesting the effect of AD pathology and SVD on different neuropsychiatric sub-syndromes.
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Affiliation(s)
- Qingze Zeng
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Yanbo Wang
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
- Department of Neurology, Xinhua Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuyue Wang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiao Luo
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Kaicheng Li
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaopei Xu
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xiaocao Liu
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Luwei Hong
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Jixuan Li
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Zheyu Li
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Xinyi Zhang
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Siyan Zhong
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Zhirong Liu
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Peiyu Huang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China
| | - Yanxing Chen
- Department of Neurology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China.
| | - Minming Zhang
- Department of Radiology, Zhejiang University School of Medicine Second Affiliated Hospital, Shangcheng District, No.88 Jiefang Road, Hangzhou, 310009, China.
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Rabl M, Zullo L, Lewczuk P, Kornhuber J, Karikari TK, Blennow K, Zetterberg H, Bavato F, Quednow BB, Seifritz E, von Gunten A, Clark C, Popp J. Plasma neurofilament light, glial fibrillary acid protein, and phosphorylated tau 181 as biomarkers for neuropsychiatric symptoms and related clinical disease progression. Res Sq 2024:rs.3.rs-4116836. [PMID: 38562890 PMCID: PMC10984087 DOI: 10.21203/rs.3.rs-4116836/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are common in older people, may occur early in the development of dementia disorders, and have been associated with faster cognitive decline. Here, our objectives were to investigate whether plasma levels of neurofilament light chain (NfL), glial fibrillary acid protein (GFAP), and tau phosphorylated at threonine 181 (pTau181) are associated with current NPS and predict future NPS in non-demented older people. Furthermore, we tested whether the presence of NPS combined with plasma biomarkers are useful to predict Alzheimer's disease (AD) pathology and cognitive decline. METHODS One hundred and fifty-one participants with normal cognition (n=76) or mild cognitive impairment (n=75) were examined in a longitudinal brain aging study at the Memory Centers, University Hospital of Lausanne, Switzerland. Plasma levels of NfL, GFAP, and pTau181 along with CSF biomarkers of AD pathology were measured at baseline. NPS were assessed through the Neuropsychiatric Inventory Questionnaire (NPI-Q), along with the cognitive and functional performance at baseline and follow-up (mean: 20 months). Linear regression and ROC analyses were used to address the associations of interest. RESULTS Higher GFAP levels were associated with NPS at baseline (β=0.23, p=.008). Higher NfL and GFAP levels were associated with the presence of NPS at follow-up (β=0.29, p=.007 and β=0.28, p=.007, respectively) and with an increase in the NPI-Q severity score over time (β=0.23, p=.035 and β=0.27, p=.011, respectively). Adding NPS and the plasma biomarkers to a reference model improved the prediction of future NPS (AUC 0.73 to 0.84, p=.007) and AD pathology (AUC 0.79 to 0.86, p=.006), but not of cognitive decline (AUC 0.79 to 0.84, p=.068). CONCLUSION Plasma GFAP is associated with NPS while NfL and GFAP are both associated with future NPS and NPS severity. Considering the presence of NPS along with blood-based AD-biomarkers may improve diagnosis and prediction of clinical progression of NPS and inform clinical decision-making in non-demented older people.
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Affiliation(s)
- Miriam Rabl
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Leonardo Zullo
- Department of Psychiatry, Old Age Psychiatry Service, Lausanne University Hospital
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen and Friedrich-Alexander Universität Erlangen-Nürnberg
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg
| | - Francesco Bavato
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Erich Seifritz
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Armin von Gunten
- Department of Psychiatry, Old Age Psychiatry Service, Lausanne University Hospital
| | - Christopher Clark
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
| | - Julius Popp
- Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich
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Twait EL, Wu JH, Kamarioti M, Basten M, van der Flier WM, Gerritsen L, Geerlings MI. Association of amyloid-beta with depression or depressive symptoms in older adults without dementia: a systematic review and meta-analysis. Transl Psychiatry 2024; 14:25. [PMID: 38225253 PMCID: PMC10789765 DOI: 10.1038/s41398-024-02739-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 12/05/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024] Open
Abstract
Several lines of evidence have indicated that depression might be a prodromal symptom of Alzheimer's disease (AD). This systematic review and meta-analysis investigated the cross-sectional association between amyloid-beta, one of the key pathologies defining AD, and depression or depressive symptoms in older adults without dementia. A systematic search in PubMed yielded 689 peer-reviewed articles. After full-text screening, nine CSF studies, 11 PET studies, and five plasma studies were included. No association between amyloid-beta and depression or depressive symptoms were found using cerebrospinal fluid (CSF) (0.15; 95% CI: -0.08; 0.37), positron emission topography (PET) (Cohen's d: 0.09; 95% CI: -0.05; 0.24), or plasma (-0.01; 95% CI: -0.23; 0.22). However, subgroup analyses revealed an association in plasma studies of individuals with cognitive impairment. A trend of an association was found in the studies using CSF and PET. This systematic review and meta-analysis suggested that depressive symptoms may be part of the prodromal stage of dementia.
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Affiliation(s)
- Emma L Twait
- Amsterdam UMC, location Vrije Universiteit, Department of General Practice, Van der Boechorststraat 7, Amsterdam, The Netherlands
- Amsterdam Public Health; Aging & Later life, and Personalized Medicine, Amsterdam, The Netherlands
- Amsterdam Neuroscience; Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Jen-Hao Wu
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Maria Kamarioti
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Maartje Basten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Neurology, Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, The Netherlands
- Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Lotte Gerritsen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Amsterdam UMC, location Vrije Universiteit, Department of General Practice, Van der Boechorststraat 7, Amsterdam, The Netherlands.
- Amsterdam Neuroscience; Neurodegeneration, and Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, The Netherlands.
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands.
- Amsterdam UMC, location University of Amsterdam, Department of General Practice, Meibergdreef 9, Amsterdam, The Netherlands.
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Babulal GM, Chen L, Murphy SA, Doherty JM, Johnson AM, Morris JC. Neuropsychiatric Symptoms and Alzheimer Disease Biomarkers Independently Predict Progression to Incident Cognitive Impairment. Am J Geriatr Psychiatry 2023; 31:1190-1199. [PMID: 37544835 PMCID: PMC10861300 DOI: 10.1016/j.jagp.2023.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVES To investigate the effect of neuropsychiatric symptoms and depression symptoms, respectively, and Alzheimer disease (AD) biomarkers (cerebrospinal fluid [CSF] or Positron Emission Tomography [PET] imaging) on the progression to incident cognitive impairment among cognitively normal older adults. DESIGN Prospective, observation, longitudinal study. SETTING Knight Alzheimer Disease Research Center (ADRC) at Washington University School of Medicine. PARTICIPANTS Older adults aged 65 and above who participated in AD longitudinal studies (n = 286). MEASUREMENTS CSF and PET biomarkers, Clinical Dementia Rating (CDR), Geriatric Depression Scale (GDS), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS Participants had an average follow-up of eight years, and 31 progressed from CDR 0 to CDR >0. After adjusting for sex, age, and education in the Cox proportional hazards survival models, neuropsychiatric symptoms as a time-dependent covariate was statistically significant in the three CSF (Aβ42/Aβ40, t-Tau/Aβ42, p-Tau/Aβ42) PET imaging models (HR = 1.33-1.50). The biomarkers were also significant as main effects (HR = 2.00-4.04). Change in depression symptoms was not significant in any models. The interactions between biomarkers and neuropsychiatric symptoms and depression were not statistically significant. CONCLUSIONS Changes in neuropsychiatric symptoms increase the risk of progression to cognitive impairment among healthy, cognitively normal adults, independent of AD biomarkers. Routine assessment of neuropsychiatric symptoms could provide valuable clinical information about cognitive functioning and preclinical disease state.
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Affiliation(s)
- Ganesh M Babulal
- Department of Neurology (GMB, SAM, JCM), Washington University in St. Louis, St. Louis, MO; Institute of Public Health (GMB), Washington University in St. Louis, St. Louis, MO; Department of Psychology, Faculty of Humanities (GMB), University of Johannesburg, Johannesburg, South Africa; Department of Clinical Research and Leadership (GMB), The George Washington University School of Medicine and Health Sciences, Washington, DC.
| | - Ling Chen
- Division of Biostatistics (LC), Washington University in St. Louis, St. Louis, MO
| | - Samantha A Murphy
- Department of Neurology (GMB, SAM, JCM), Washington University in St. Louis, St. Louis, MO
| | - Jason M Doherty
- Department of Neurology (GMB, SAM, JCM), Washington University in St. Louis, St. Louis, MO
| | - Ann M Johnson
- Center for Clinical Studies (AMJ), Washington University in St. Louis, St. Louis, MO
| | - John C Morris
- Department of Neurology (GMB, SAM, JCM), Washington University in St. Louis, St. Louis, MO; Hope Center for Neurological Disorders (JCM), Washington University in St. Louis, St. Louis, MO
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Reyna NC, Clark BJ, Hamilton DA, Pentkowski NS. Anxiety and Alzheimer's disease pathogenesis: focus on 5-HT and CRF systems in 3xTg-AD and TgF344-AD animal models. Front Aging Neurosci 2023; 15:1251075. [PMID: 38076543 PMCID: PMC10699143 DOI: 10.3389/fnagi.2023.1251075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/25/2023] [Indexed: 02/12/2024] Open
Abstract
Dementia remains one of the leading causes of morbidity and mortality in older adults. Alzheimer's disease (AD) is the most common type of dementia, affecting over 55 million people worldwide. AD is characterized by distinct neurobiological changes, including amyloid-beta protein deposits and tau neurofibrillary tangles, which cause cognitive decline and subsequent behavioral changes, such as distress, insomnia, depression, and anxiety. Recent literature suggests a strong connection between stress systems and AD progression. This presents a promising direction for future AD research. In this review, two systems involved in regulating stress and AD pathogenesis will be highlighted: serotonin (5-HT) and corticotropin releasing factor (CRF). Throughout the review, we summarize critical findings in the field while discussing common limitations with two animal models (3xTg-AD and TgF344-AD), novel pharmacotherapies, and potential early-intervention treatment options. We conclude by highlighting promising future pharmacotherapies and translational animal models of AD and anxiety.
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Affiliation(s)
- Nicole C. Reyna
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
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Ferreira DA, Macedo LBC, Foss MP. Neuropsychiatric symptoms as a prodromal factor in Alzheimer's type neurodegenerative disease: a scoping review. Clin Neuropsychol 2023:1-22. [PMID: 37881945 DOI: 10.1080/13854046.2023.2273574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 10/16/2023] [Indexed: 10/27/2023]
Abstract
Objective: Identifying neuropsychiatric symptoms (NPS) can aid in the early detection of Alzheimer's disease (AD); however, there is still a need for a greater consensus. This review aims to delineate the predominant NPS, compile a comprehensive list of the most commonly employed NPS assessment tools, and corroborate the principal findings regarding the link between NPS and neuropsychological assessment and neurobiological substrates. Methods: To conduct this scoping review, we followed the Preferred Reporting Items for Systematic Reviews guidelines and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). We searched for relevant articles published between 2017 and 2023 in MEDLINE, PsycINFO, PubMed, Web of Science, and Cochrane Library. Results: Of the 61 eligible articles, depression, anxiety, and apathy were the main NPSs. The Neuropsychiatric Inventory Questionnaire and Neuropsychiatric Inventory were the primary assessment tools used to evaluate NPS. Correlations between NPS severity and neurobiological markers were considered clinically significant. Furthermore, clinical procedures prioritized the use of global cognitive screening tools, assessments of executive functions, and functionality evaluations. Conclusion: Standardization of procedures is necessary because of the diversity of methods. The data show that NPS can predict the etiology, severity, form, and type of disease progression, serving as a precursor sign of AD. The results of the most common cognitive screening tools and NPS instruments provided an interesting overview of future clinical approaches.
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Affiliation(s)
- Diego Alves Ferreira
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Lorena Barbosa Cunha Macedo
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Maria Paula Foss
- Department of Neuroscience and Behavior Science, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
- Faculty of Philosophy, Sciences, and Letters of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Arenare G, Manca R, Caffarra P, Venneri A. Associations between Neuropsychiatric Symptoms and Alzheimer's Disease Biomarkers in People with Mild Cognitive Impairment. Brain Sci 2023; 13:1195. [PMID: 37626552 PMCID: PMC10452057 DOI: 10.3390/brainsci13081195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Neuropsychiatric symptoms (NPS) are associated with faster decline in mild cognitive impairment (MCI). This study aimed to investigate the association between NPS severity and Alzheimer's disease (AD) biomarkers, i.e., amyloid-β (Aβ), phosphorylated tau protein (p-tau) and hippocampal volume ratio (HR), to characterise in more detail MCI patients with a poor prognosis. METHODS A total of 506 individuals with MCI and 99 cognitively unimpaired older adults were selected from the ADNI dataset. The patients were divided into three different groups based on their NPI-Q total scores: no NPS (n = 198), mild NPS (n = 160) and severe NPS (n = 148). Regression models were used to assess the association between the severity of NPS and each biomarker level and positivity status. RESULTS Cerebrospinal fluid Aβ levels were positively associated with older age and lower MMSE scores, while higher p-tau levels were associated with female sex and lower MMSE scores. Only patients with severe NPS had a lower HR (β = -0.18, p = 0.050), i.e., more pronounced medio-temporal atrophy, than those without NPS. DISCUSSION Only HR was associated with the presence of NPS, partially in line with previous evidence showing that severe NPS may be explained primarily by greater grey matter loss. Future longitudinal studies will be needed to ascertain the relevance of this finding.
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Affiliation(s)
- Giulia Arenare
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Riccardo Manca
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
- Department of Life Sciences, Brunel University London, Uxbridge UB8 3BH, UK
| | - Paolo Caffarra
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | - Annalena Venneri
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
- Department of Life Sciences, Brunel University London, Uxbridge UB8 3BH, UK
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10
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Krell‐Roesch J, Zaniletti I, Syrjanen JA, Kremers WK, Algeciras‐Schimnich A, Dage JL, van Harten AC, Fields JA, Knopman DS, Jack CR, Petersen RC, Vassilaki M, Geda YE. Plasma-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms: A community-based study. Alzheimers Dement (Amst) 2023; 15:e12461. [PMID: 37529120 PMCID: PMC10387518 DOI: 10.1002/dad2.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION We examined associations between plasma-derived biomarkers of Alzheimer's disease (AD) and neuropsychiatric symptoms (NPS) in community-dwelling older adults. METHODS Cross-sectional study involving 1005 persons ≥50 years of age (mean 74 years, 564 male, 118 cognitively impaired), who completed plasma-derived biomarker (amyloid beta 42 [Aβ42]/Aβ40, phosphorylated tau 181 [p-tau181], p-tau217, total tau [t-tau], neurofilament light [NfL]), and NPS assessment. RESULTS P-tau181 (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.41-3.00, p < 0.001), p-tau217 (OR 1.70, 95% CI 1.10-2.61, p = 0.016), and t-tau (OR 1.44, 95% CI 1.08-1.92, p = 0.012) were associated with appetite change. We also found that p-tau181 and p-tau217 were associated with increased symptoms of agitation (OR 1.93, 95% CI 1.20-3.11, p = 0.007 and OR 2.04, 95% CI 1.21-3.42, p = 0.007, respectively), and disinhibition (OR 2.39, 95% CI 1.45-3.93, p = 0.001 and OR 2.30, 95% CI 1.33-3.98, p = 0.003, respectively). Aβ42/Aβ40 and NfL were not associated with NPS. CONCLUSION Higher plasma-derived p-tau181 and p-tau217 levels are associated with increased symptoms of appetite change, agitation, and disinhibition. These findings may support the validity of plasma tau biomarkers for predicting behavioral symptoms that often accompany cognitive impairment. HIGHLIGHTS We studied 1005 community-dwelling persons aged ≥ 50 yearsHigher plasma tau levels are associated with increased neuropsychiatric symptomsAβ42/Aβ40 and NfL are not associated with neuropsychiatric symptomsClinicians should treat neuropsychiatric symptoms in persons with high plasma-derived tau.
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Affiliation(s)
- Janina Krell‐Roesch
- Institute of Sports and Sports ScienceKarlsruhe Institute of TechnologyKarlsruheGermany
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Isabella Zaniletti
- Department of Quantitative Health SciencesMayo ClinicScottsdaleArizonaUSA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | - Jeffrey L. Dage
- Department of Neurology and Stark Neurosciences Research InstituteIndiana University School of MedicineIndianapolisIndianaUSA
| | - Argonde C. van Harten
- Alzheimer Center, Department of NeurologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
| | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Yonas E. Geda
- Department of Neurology and the Franke Barrow Global Neuroscience Education CenterBarrow Neurological InstitutePhoenixArizonaUSA
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11
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Wander CM, Li YD, Bao H, Asrican B, Luo YJ, Sullivan HA, Chao THH, Zhang WT, Chéry SL, Tart DS, Chen ZK, Shih YYI, Wickersham IR, Cohen TJ, Song J. Compensatory remodeling of a septo-hippocampal GABAergic network in the triple transgenic Alzheimer's mouse model. J Transl Med 2023; 21:258. [PMID: 37061718 PMCID: PMC10105965 DOI: 10.1186/s12967-023-04078-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/25/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by a progressive loss of memory that cannot be efficiently managed by currently available AD therapeutics. So far, most treatments for AD that have the potential to improve memory target neural circuits to protect their integrity. However, the vulnerable neural circuits and their dynamic remodeling during AD progression remain largely undefined. METHODS Circuit-based approaches, including anterograde and retrograde tracing, slice electrophysiology, and fiber photometry, were used to investigate the dynamic structural and functional remodeling of a GABAergic circuit projected from the medial septum (MS) to the dentate gyrus (DG) in 3xTg-AD mice during AD progression. RESULTS We identified a long-distance GABAergic circuit that couples highly connected MS and DG GABAergic neurons during spatial memory encoding. Furthermore, we found hyperactivity of DG interneurons during early AD, which persisted into late AD stages. Interestingly, MS GABAergic projections developed a series of adaptive strategies to combat DG interneuron hyperactivity. During early-stage AD, MS-DG GABAergic projections exhibit increased inhibitory synaptic strength onto DG interneurons to inhibit their activities. During late-stage AD, MS-DG GABAergic projections form higher anatomical connectivity with DG interneurons and exhibit aberrant outgrowth to increase the inhibition onto DG interneurons. CONCLUSION We report the structural and functional remodeling of the MS-DG GABAergic circuit during disease progression in 3xTg-AD mice. Dynamic MS-DG GABAergic circuit remodeling represents a compensatory mechanism to combat DG interneuron hyperactivity induced by reduced GABA transmission.
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Affiliation(s)
- Connor M Wander
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Ya-Dong Li
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA.
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA.
- Songjiang Research Institute, Songjiang hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201699, China.
| | - Hechen Bao
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Brent Asrican
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Yan-Jia Luo
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
- Department of Anaesthesiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 201699, China
| | - Heather A Sullivan
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Tzu-Hao Harry Chao
- Department of Neurology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Wei-Ting Zhang
- Department of Neurology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Samantha L Chéry
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Dalton S Tart
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Ze-Ka Chen
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Yen-Yu Ian Shih
- Department of Neurology, University of North Carolina, Chapel Hill, NC, 27599, USA
- Biomedical Research Imaging Center, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Ian R Wickersham
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Todd J Cohen
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA
- Department of Neurology, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Juan Song
- Department of Pharmacology, University of North Carolina, Chapel Hill, NC, 27599, USA.
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, 27599, USA.
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12
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Demnitz-King H, Saba L, Lau Y, Munns L, Zabihi S, Schlosser M, Del-Pino-Casado R, Orgeta V, Marchant NL. Association between anxiety symptoms and Alzheimer's disease biomarkers in cognitively healthy adults: A systematic review and meta-analysis. J Psychosom Res 2023; 166:111159. [PMID: 36709611 DOI: 10.1016/j.jpsychores.2023.111159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Anxiety has been identified as both a risk factor and prodromal symptom for Alzheimer's disease (AD) and related dementias, however, the underlying neurobiological correlates remain unknown. The aim of this systematic review and meta-analysis was to examine the association between anxiety symptoms and two defining markers of AD neuropathology: amyloid-beta (Aβ) and tau. METHODS Systematic literature searches were conducted across 5 databases. Studies investigating the relationship between anxiety and AD neuropathology (i.e., Aβ and/or tau) in cognitively healthy adults were eligible. Where possible, effect sizes were combined across studies, for Aβ and tau separately, using random-effects meta-analyses. Sensitivity analyses were performed to assess whether results differed according to anxiety type (i.e., state and trait) and biomarker assessment modality (i.e., positron emission tomography and cerebrospinal fluid). RESULTS Twenty-seven studies reporting data from 14 unique cohorts met eligibility criteria. Random-effects meta-analyses revealed no associations between self-reported anxiety symptoms and either Aβ (13 studies, Fisher's z = 0.02, 95% confidence interval [CI] -0.01-0.05, p = 0.194) or tau (4 studies, Fisher's z = 0.04, 95% CI -0.02-0.09, p = 0.235). Results remained unchanged across sensitivity analyses. CONCLUSIONS In cognitively healthy adults, meta-analytic syntheses revealed no associations between anxiety symptoms and either Aβ or tau. There is a critical need, however, for larger studies with follow-up periods to examine the effect of anxiety symptom onset, severity, and chronicity on AD neuropathology. Additionally, further research investigating other potential neurobiological correlates is crucial to advance scientific understanding of the relationship between anxiety and dementia.
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Affiliation(s)
| | - Lisa Saba
- Division of Psychiatry, University College London, London, United Kingdom
| | - Yolanda Lau
- Division of Psychiatry, University College London, London, United Kingdom
| | - Lydia Munns
- Division of Psychiatry, University College London, London, United Kingdom; Department of Psychology, University of York, York, United Kingdom
| | - Sedigheh Zabihi
- Division of Psychiatry, University College London, London, United Kingdom
| | - Marco Schlosser
- Division of Psychiatry, University College London, London, United Kingdom; Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London, United Kingdom
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom.
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13
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Marquié M, García-Gutiérrez F, Orellana A, Montrreal L, de Rojas I, García-González P, Puerta R, Olivé C, Cano A, Hernández I, Rosende-Roca M, Vargas L, Tartari JP, Esteban-De Antonio E, Bojaryn U, Ricciardi M, Ariton DM, Pytel V, Alegret M, Ortega G, Espinosa A, Pérez-Cordón A, Sanabria Á, Muñoz N, Lleonart N, Aguilera N, García-Sánchez A, Alarcón-Martín E, Tárraga L, Ruiz A, Boada M, Valero S. The Synergic Effect of AT(N) Profiles and Depression on the Risk of Conversion to Dementia in Patients with Mild Cognitive Impairment. Int J Mol Sci 2023; 24. [PMID: 36674881 DOI: 10.3390/ijms24021371] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Few studies have addressed the impact of the association between Alzheimer's disease (AD) biomarkers and NPSs in the conversion to dementia in patients with mild cognitive impairment (MCI), and no studies have been conducted on the interaction effect of these two risk factors. AT(N) profiles were created using AD-core biomarkers quantified in cerebrospinal fluid (CSF) (normal, brain amyloidosis, suspected non-Alzheimer pathology (SNAP) and prodromal AD). NPSs were assessed using the Neuropsychiatric Inventory Questionnaire (NPI-Q). A total of 500 individuals with MCI were followed-up yearly in a memory unit. Cox regression analysis was used to determine risk of conversion, considering additive and multiplicative interactions between AT(N) profile and NPSs on the conversion to dementia. A total of 224 participants (44.8%) converted to dementia during the 2-year follow-up study. Pathologic AT(N) groups (brain amyloidosis, prodromal AD and SNAP) and the presence of depression and apathy were associated with a higher risk of conversion to dementia. The additive combination of the AT(N) profile with depression exacerbates the risk of conversion to dementia. A synergic effect of prodromal AD profile with depressive symptoms is evidenced, identifying the most exposed individuals to conversion among MCI patients.
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14
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Shah J, Siddiquee MMR, Krell-Roesch J, Syrjanen JA, Kremers WK, Vassilaki M, Forzani E, Wu T, Geda YE. Neuropsychiatric Symptoms and Commonly Used Biomarkers of Alzheimer's Disease: A Literature Review from a Machine Learning Perspective. J Alzheimers Dis 2023; 92:1131-1146. [PMID: 36872783 PMCID: PMC11102734 DOI: 10.3233/jad-221261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
There is a growing interest in the application of machine learning (ML) in Alzheimer's disease (AD) research. However, neuropsychiatric symptoms (NPS), frequent in subjects with AD, mild cognitive impairment (MCI), and other related dementias have not been analyzed sufficiently using ML methods. To portray the landscape and potential of ML research in AD and NPS studies, we present a comprehensive literature review of existing ML approaches and commonly studied AD biomarkers. We conducted PubMed searches with keywords related to NPS, AD biomarkers, machine learning, and cognition. We included a total of 38 articles in this review after excluding some irrelevant studies from the search results and including 6 articles based on a snowball search from the bibliography of the relevant studies. We found a limited number of studies focused on NPS with or without AD biomarkers. In contrast, multiple statistical machine learning and deep learning methods have been used to build predictive diagnostic models using commonly known AD biomarkers. These mainly included multiple imaging biomarkers, cognitive scores, and various omics biomarkers. Deep learning approaches that combine these biomarkers or multi-modality datasets typically outperform single-modality datasets. We conclude ML may be leveraged to untangle the complex relationships of NPS and AD biomarkers with cognition. This may potentially help to predict the progression of MCI or dementia and develop more targeted early intervention approaches based on NPS.
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Affiliation(s)
- Jay Shah
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA
| | - Md Mahfuzur Rahman Siddiquee
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA
| | - Janina Krell-Roesch
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Jeremy A. Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Walter K. Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Erica Forzani
- Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Teresa Wu
- School of Computing and Augmented Intelligence, Arizona State University, Tempe, AZ, USA
- ASU-Mayo Center for Innovative Imaging, Tempe, AZ, USA
| | - Yonas E. Geda
- Department of Neurology and the Franke Global Neuroscience Education Center, Barrow Neurological Institute, Phoenix, AZ, USA
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15
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Valiengo L, Pinto BS, Marinho KAP, Santos LA, Tort LC, Benatti RG, Teixeira BB, Miranda CS, Cardeal HB, Suen PJC, Loureiro JC, Vaughan RAR, Dini Mattar RAMPF, Lessa M, Oliveira PS, Silva VA, Gattaz WF, Brunoni AR, Forlenza OV. Treatment of depression in the elderly with repetitive transcranial magnetic stimulation using theta-burst stimulation: Study protocol for a randomized, double-blind, controlled trial. Front Hum Neurosci 2022; 16:941981. [PMID: 36118977 PMCID: PMC9471379 DOI: 10.3389/fnhum.2022.941981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/04/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Transcranial magnetic stimulation (TMS) is a consolidated procedure for the treatment of depression, with several meta-analyses demonstrating its efficacy. Theta-burst stimulation (TBS) is a modification of TMS with similar efficacy and shorter session duration. The geriatric population has many comorbidities and a high prevalence of depression, but few clinical trials are conducted specifically for this age group. TBS could be an option in this population, offering the advantages of few side effects and no pharmacological interactions. Therefore, our aim is to investigate the efficacy of TBS in geriatric depression. Clinical trial registration [https://clinicaltrials.gov/ct2/], identifier [NCT04842929].
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Affiliation(s)
- Leandro Valiengo
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Programa de Fisiopatologia Experimental, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- *Correspondence: Leandro Valiengo,
| | - Bianca S. Pinto
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Kalian A. P. Marinho
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Leonardo A. Santos
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Luara C. Tort
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Rafael G. Benatti
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Bruna B. Teixeira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Cristiane S. Miranda
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Henriette B. Cardeal
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo J. C. Suen
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Julia C. Loureiro
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Renata A. R. Vaughan
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Roberta A. M. P. F. Dini Mattar
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Maíra Lessa
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Pedro S. Oliveira
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Valquíria A. Silva
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
| | - Wagner Farid Gattaz
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - André R. Brunoni
- Interdisciplinary Neuromodulation Service (SIN), Department and Institute of Psychiatry, Hospital das Clínicas HCFMUSP, Faculty of Medicine, Universidade de São Paulo, São Paulo, Brazil
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Orestes Vicente Forlenza
- Laboratório de Neurociências (LIM-27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
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16
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Ashford JW, Schmitt FA, Bergeron MF, Bayley PJ, Clifford JO, Xu Q, Liu X, Zhou X, Kumar V, Buschke H, Dean M, Finkel SI, Hyer L, Perry G. Now is the Time to Improve Cognitive Screening and Assessment for Clinical and Research Advancement. J Alzheimers Dis 2022; 87:305-315. [DOI: 10.3233/jad-220211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Alzheimer’s disease (AD) is the only cause of death ranked in the top ten globally without precise early diagnosis or effective means of prevention or treatment. Further, AD was identified as a pandemic [1] well before COVID-19 was dubbed a 21st century pandemic [2]. And now, with the realization of the prominent secondary impacts of pandemics, there is a growing, widespread recognition of the tremendous magnitude of the impending burden from AD in an aging world population in the coming decades [3]. This appreciation has amplified the growing and pressing need for a new, efficacious, and practical platform to detect and track cognitive decline, beginning in the preliminary (prodromal) phases of the disease, sensitively, accurately, effectively, reliably, efficiently, and remotely [4–7]. Moreover, the parallel necessity of clarifying and understanding risk factors, developing successful prevention strategies [8–17], and discovering and monitoring viable and effective treatments could all benefit from accurate and efficient screening and assessment platforms. Modern recognition of AD [18] as a common affliction of the elderly began in 1968 with a paper by Blessed, Tomlinson, & Roth [19] in which two tests, one a brief assessment of cognitive function and the other a measure of daily function, demonstrated impairment which was associated with the postmortem counts of neurofibrillary tangles, composed mainly of microtubule-associated protein-tau (tau), in the brain, though not to senile plaques, composed mainly of amyloid-β (Aβ). Even in more recent analyses, the tangles correspond with the severity of dementia more than the plaques [20, 21]. Since 1960, a plethora of cognitive tests, paper and pencil [22, 23], simple screening models [24], and computerized [25–27], have been developed to assess the dysfunction associated with AD. However, there has been limited application of Modern Test Theory, which includes Item Characteristic Curve Analysis, used in the technological development of such tools [28–31], along with widespread failure to understand the underlying AD pathological process to guide test development [32, 33]. The lack of such development has likely been a major contributor to the failure of the field to develop timely screening approaches for AD [34, 35], inaccurate assessment of the progression of AD [36], and even now, failure to find an effective approach to stopping AD.
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Affiliation(s)
- J. Wesson Ashford
- War Related Illness and Injury Study Center, VA Palo Alto HCS, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
| | - Frederick A. Schmitt
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- Departments of Neurology, Psychiatry, Neurosurgery, Psychology, Behavioral Science; Sanders-Brown Center on Aging, Spinal Cord & Brain Injury Research Center, University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
| | | | - Peter J. Bayley
- War Related Illness and Injury Study Center, VA Palo Alto HCS, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
| | | | - Qun Xu
- Health Management Center, Department of Neurology, Renji Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaolei Liu
- Department of Neurology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
- Yunnan Provincial Clinical Research Center for Neurological Diseases, Yunnan, China
| | - Xianbo Zhou
- Center for Alzheimer’s Research, Washington Institute of Clinical Research, Vienna, VA, USA
- Zhongze Therapeutics, Shanghai, China
| | | | - Herman Buschke
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- The Saul R. Korey Department of Neurology and Dominick P. Purpura Department of Neuroscience, Lena and Joseph Gluck Distinguished Scholar in Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Margaret Dean
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- Geriatric Division, Internal Medicine, Texas Tech Health Sciences Center, Amarillo, TX, USA
| | - Sanford I. Finkel
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- University of Chicago Medical School, Chicago, IL, USA
| | - Lee Hyer
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- Gateway Behavioral Health, Mercer University, School of Medicine, Savannah, GA, USA
| | - George Perry
- Medical, Scientific, Memory Screening Advisory Board, Alzheimer’s Foundation of American (AFA), New York, USA
- Brain Health Consortium, Department Biology and Chemistry, University of Texas at San Antonio, San Antonio, TX, USA
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