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Imbimbo BP, Lista S, Imbimbo C, Nisticò R. Are we close to using Alzheimer blood biomarkers in clinical practice? Neural Regen Res 2024; 19:2583-2585. [PMID: 38808992 DOI: 10.4103/nrr.nrr-d-23-01945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/16/2024] [Indexed: 05/30/2024] Open
Affiliation(s)
- Bruno P Imbimbo
- Department of Research & Development, Chiesi Farmaceutici, Parma, Italy (Imbimbo BP)
| | - Simone Lista
- i+HeALTH Strategic Research Group, Department of Health Sciences, Miguel de Cervantes European University (UEMC), Valladolid, Spain (Lista S)
| | - Camillo Imbimbo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy (Imbimbo C)
| | - Robert Nisticò
- School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy (Nisticò R)
- Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy (Nisticò R)
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2
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Mielke MM, Fowler NR. Alzheimer disease blood biomarkers: considerations for population-level use. Nat Rev Neurol 2024:10.1038/s41582-024-00989-1. [PMID: 38862788 DOI: 10.1038/s41582-024-00989-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/13/2024]
Abstract
In the past 5 years, we have witnessed the first approved Alzheimer disease (AD) disease-modifying therapy and the development of blood-based biomarkers (BBMs) to aid the diagnosis of AD. For many reasons, including accessibility, invasiveness and cost, BBMs are more acceptable and feasible for patients than a lumbar puncture (for cerebrospinal fluid collection) or neuroimaging. However, many questions remain regarding how best to utilize BBMs at the population level. In this Review, we outline the factors that warrant consideration for the widespread implementation and interpretation of AD BBMs. To set the scene, we review the current use of biomarkers, including BBMs, in AD. We go on to describe the characteristics of typical patients with cognitive impairment in primary care, who often differ from the patient populations used in AD BBM research studies. We also consider factors that might affect the interpretation of BBM tests, such as comorbidities, sex and race or ethnicity. We conclude by discussing broader issues such as ethics, patient and provider preference, incidental findings and dealing with indeterminate results and imperfect accuracy in implementing BBMs at the population level.
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Affiliation(s)
- Michelle M Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
| | - Nicole R Fowler
- Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana University Center for Aging Research, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
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Nitrini R. What is "biological Alzheimer's disease"? Dement Neuropsychol 2024; 18:e2024E001. [PMID: 38863570 PMCID: PMC11165693 DOI: 10.1590/1980-5764-dn-2024-e001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 06/13/2024] Open
Affiliation(s)
- Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, São Paulo SP, Brazil
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Tavares-Júnior JWL, Ciurleo GCV, Feitosa EDAAF, Oriá RB, Braga-Neto P. The Clinical Aspects of COVID and Alzheimer's Disease: A Round-Up of Where Things Stand and Are Headed. J Alzheimers Dis 2024:JAD231368. [PMID: 38848177 DOI: 10.3233/jad-231368] [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: 06/09/2024]
Abstract
The link between long COVID-19 and brain/cognitive impairments is concerning and may foster a worrisome worldwide emergence of novel cases of neurodegenerative diseases with aging. This review aims to update the knowledge, crosstalk, and possible intersections between the Post-COVID Syndrome (PCS) and Alzheimer's disease (AD). References included in this review were obtained from PubMed searches conducted between October 2023 and November 2023. PCS is a very heterogenous and poorly understood disease with recent evidence of a possible association with chronic diseases such as AD. However, more scientific data is required to establish the link between PCS and AD.
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Affiliation(s)
| | - Gabriella Cunha Vieira Ciurleo
- Department of Clinical Medicine, Neurology Section, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
- Department of Morphology and Institute of Biomedicine, Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | | | - Reinaldo B Oriá
- Department of Clinical Medicine, Neurology Section, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
- Department of Morphology and Institute of Biomedicine, Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, School of Medicine, Federal University of Ceara, Fortaleza, CE, Brazil
| | - Pedro Braga-Neto
- Department of Clinical Medicine, Neurology Section, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
- Center of Health Sciences, State University of Ceará, Fortaleza, CE, Brazil
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Dombrowski W, Mims A, Kremer I, Cano Desandes P, Rodrigo-Herrero S, Epps F, Snow T, Gutierrez M, Nasta A, Epperly MB, Manaloto K, Hansen JC. Dementia Ideal Care: Ecosystem Map of Best Practices and Care Pathways Enhanced by Technology and Community. J Alzheimers Dis 2024:JAD231491. [PMID: 38848182 DOI: 10.3233/jad-231491] [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: 06/09/2024]
Abstract
Background Globally, much work has been done by nonprofit, private, and academic groups to develop best practices for the care of people living with dementia (PLWD), including Alzheimer's disease. However, these best practices reside in disparate repositories and tend to focus on one phase of the patient journey or one relevant group. Objective To fill this gap, we developed a Dementia Ideal Care Map that everyone in the dementia ecosystem can use as an actionable tool for awareness, policy development, funding, research, training, service delivery, and technology design. The intended audience includes (and not limited to) policymakers, academia, industry, technology developers, health system leaders, clinicians, social service providers, patient advocates, PLWD, their families, and communities at large. Methods A search was conducted for published dementia care best practices and quality measures, which were then summarized in a visual diagram. The draft diagram was analyzed to identify barriers to ideal care. Then, additional processes, services, technologies, and quality measures to overcome those challenges were brainstormed. Feedback was then obtained from experts. Results The Dementia Ideal Care Map summarizes the ecosystem of over 200 best practices, nearly 100 technology enablers, other infrastructure, and enhanced care pathways in one comprehensive diagram. It includes psychosocial interventions, care partner support, community-based organizations; awareness, risk reduction; initial detection, diagnosis, ongoing medical care; governments, payers, health systems, businesses, data, research, and training. Conclusions Dementia Ideal Care Map is a practical tool for planning and coordinating dementia care. This visualized ecosystem approach can be applied to other conditions.
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Affiliation(s)
- Wen Dombrowski
- CATALAIZE, Chicago, IL, USA
- USC Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Adrienne Mims
- Rainmakers Strategic Solutions, Atlanta, GA, USA
- National Committee for Quality Assurance (NCQA), Washington, DC, USA
- NAPA Advisory Council, Washington, DC, USA
| | - Ian Kremer
- Leaders Engaged on Alzheimer's Disease (LEAD Coalition), Washington, DC, USA
| | - Pedro Cano Desandes
- Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT-CERCA), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Silvia Rodrigo-Herrero
- Memory Unit, Department of Neurology, Juan Ramon Jimenez University Hospital, Huelva, Spain
| | - Fayron Epps
- School of Nursing, University of Texas Health Science Center, San Antonio, TX, USA
| | - Teepa Snow
- Positive Approach, LLC, Efland, NC, USA
- Snow Approach, Inc., Hillsborough, NC, USA
| | | | - Anil Nasta
- Roche Diagnostics Corporation, Indianapolis, IN, USA
| | | | - Katrina Manaloto
- Neurotech Collider Lab, University of California, Berkeley, Berkeley, CA, USA
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Zhang B, Zhang C, Wang Y, Cheng L, Wang Y, Qiao Y, Peng D. Associations of liver function with plasma biomarkers for Alzheimer's Disease. Neurol Sci 2024; 45:2625-2631. [PMID: 38177970 DOI: 10.1007/s10072-023-07284-9] [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: 11/07/2023] [Accepted: 12/14/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Blood-based biomarkers for Alzheimer's disease (AD) are promising to be used in clinical settings. The liver is an important degradation organ of the body. Whether liver function affects the levels of AD biomarkers needs to be studied. OBJECTIVE To investigate the associations between liver function and the plasma levels of AD biomarkers. METHODS We conducted an ADNI cohort-based cross-sectional study. Thirteen liver function markers commonly used in clinical settings were analyzed: total protein (TP), albumin (AL), globulin (GL), AL/GL ratio (A/G), total bilirubin (TB), direct bilirubin (DB), indirect bilirubin (IB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), AST/ALT ratio, alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and γ-glutamyltransferase (GGT). Liquid chromatography-tandem mass spectrometry was used to detect the plasma Aβ42 and Aβ40 concentrations. Single Molecule array technique was used to measure the plasma p-tau181 and NfL concentrations. We used linear regression models to analyze the associations between liver function markers and the levels of AD plasma biomarkers. RESULTS ALP was positively associated with the levels of plasma Aβ42 (β = 0.16, P = 0.018) and Aβ40 (β = 0.21, P = 0.004). LDH was positively associated with the levels of plasma p-tau181 (β = 0.09, P = 0.022). While NfL was correlated with multiple liver function markers, including AL, A/G, ALT, AST/ALT, and LDH. CONCLUSION Liver function was associated with the plasma levels of AD biomarkers. It needs to consider the potential influence of liver function on the reference ranges and the interpretation of results for AD biomarkers before clinical use.
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Affiliation(s)
- Bin Zhang
- Department of Neurology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Cheng Zhang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - YuYe Wang
- Department of Neurology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - LeiAn Cheng
- Department of Neurology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Wang
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
| | - YaNan Qiao
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Alexandre-Silva V, Cominetti MR. Unraveling the dual role of ADAM10: Bridging the gap between cancer and Alzheimer's disease. Mech Ageing Dev 2024; 219:111928. [PMID: 38513842 DOI: 10.1016/j.mad.2024.111928] [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: 07/07/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
An inverse association between Alzheimer's disease (AD) and cancer has been proposed. Patients with a cancer history have a decreased risk of developing AD, and AD patients have a reduced cancer incidence, which is not seen in vascular dementia patients. Given this association, common molecular and biological mechanisms that could explain this inverse relationship have been proposed before, such as Peptidylprolyl Cis/Trans Isomerase, NIMA-Interacting 1 (Pin1), Wingless and Int-1 (Wnt), and transformation-related protein 53 (p53)-mediated pathways, along with inflammation and oxidative stress-related proteins. A Disintegrin And Metalloprotease 10 (ADAM10) is a protease responsible for the cleavage of key AD- and cancer-related substrates, and it has inverse roles in those diseases: neuroprotective and disease-promoting, respectively. Thus, herein, we review the relevant literature linking AD and cancer and propose how ADAM10 activity might modulate the inverse association between the diseases. Understanding how this protease mediates those two conditions might raise some considerations in the ADAM10 pharmacological modulation for treating AD and cancer.
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Cantero-Fortiz Y, Cano A, Boada M. Unraveling the Tau Puzzle: A Brief Discussion on Biomarkers in Alzheimer's Disease. J Alzheimers Dis 2024:JAD240055. [PMID: 38848184 DOI: 10.3233/jad-240055] [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: 06/09/2024]
Abstract
This commentary provides an in-depth analysis of a recently published systematic review on 'Biomarkers of Tau Pathology in Alzheimer's Disease', elucidating insights into its implications for the field. This meta-analysis highlights the potential of plasma and CSF p-tau 181/231 as promising, non-invasive, and cost-effective diagnostic tools for patients suffering from AD continuum. The study comprehensively reviews the diagnostic potential of these p-tau isoforms, shedding light on their role in the precision diagnosis of Alzheimer's disease. Here we discuss the significance of these findings and the methodological nuances, emphasizing broader implications for advancing personalized medicine in neurodegenerative disorders.
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Affiliation(s)
- Yahveth Cantero-Fortiz
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
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Chen Y, Zeng X, Diaz JL, Sehrawat A, Lafferty TK, Boslett JJ, Klunk WE, Pascoal TA, Villemagne VL, Cohen AD, Lopez OI, Yates NA, Karikari TK. Effect of blood collection tube containing protease inhibitors on the pre-analytical stability of Alzheimer's disease plasma biomarkers. J Neurochem 2024. [PMID: 38814273 DOI: 10.1111/jnc.16130] [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: 02/27/2024] [Revised: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/31/2024]
Abstract
The reliability of plasma biomarkers of Alzheimer's disease (AD) can be compromised by protease-induced degradation. This can limit the feasibility of conducting plasma biomarker studies in environments that lack the capacity for immediate processing and appropriate storage of blood samples. We hypothesized that blood collection tube supplementation with protease inhibitors can improve the stability of plasma biomarkers at room temperatures (RT). In this study, we conducted a comparative analysis of blood biomarker stability in traditional ethylenediaminetetraacetic acid (EDTA) tubes versus BD™ P100 collection tubes, the latter being coated with a protease inhibitor cocktail. The stability of six plasma AD biomarkers was evaluated over time under RT conditions. We evaluated three experimental approaches. In Approach 1, pooled plasma samples underwent storage at RT for up to 96 h. In Approach 2, plasma samples isolated upfront from whole blood collected into EDTA or P100 tubes were stored at RT for 0 h or 24 h before biomarker measurements. In Approach 3, whole blood samples were collected into paired EDTA and P100 tubes, followed by storage at RT for 0 h or 24 h before isolating the plasma for analyses. Biomarkers were measured with Single Molecule Array (Simoa) and immunoprecipitation-mass spectrometry (IP-MS) assays. Both the IP-MS and Simoa methods revealed that the use of P100 tubes significantly improves the stability of Aβ42 and Aβ40 across all approaches. However, the Aβ42/Aβ40 ratio levels were significantly stabilized only in the IP-MS assay in Approach 3. No significant differences were observed in the levels of plasma p-tau181, GFAP, and NfL for samples collected using either tube type in any of the approaches. Supplementation of blood collection tubes with protease inhibitors could reduce the protease-induced degradation of plasma Aβ42 and Aβ40, and the Aβ42/40 ratio for the IP-MS assay. These findings have crucial implications for preanalytical procedures, particularly in resource-limited settings.
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Affiliation(s)
- Yijun Chen
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xuemei Zeng
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jihui L Diaz
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Anuradha Sehrawat
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tara K Lafferty
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - James J Boslett
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - William E Klunk
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Tharick A Pascoal
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Victor L Villemagne
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Ann D Cohen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Oscar I Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Nathan A Yates
- Department of Chemistry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Thomas K Karikari
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Howe MD, Britton KJ, Joyce HE, Menard W, Emrani S, Kunicki ZJ, Faust MA, Dawson BC, Riddle MC, Huey ED, Janelidze S, Hansson O, Salloway SP. Clinical application of plasma P-tau217 to assess eligibility for amyloid-lowering immunotherapy in memory clinic patients with early Alzheimer's disease. RESEARCH SQUARE 2024:rs.3.rs-3755419. [PMID: 38853872 PMCID: PMC11160917 DOI: 10.21203/rs.3.rs-3755419/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
Background With the approval of disease-modifying treatments (DMTs) for early Alzheimer's disease (AD), there is an increased need for efficient and non-invasive detection methods for cerebral amyloid-β (Aβ) pathology. Current methods, including positron emission tomography (PET) and cerebrospinal fluid (CSF) analysis, are costly and invasive methods that may limit access to new treatments. Plasma tau phosphorylated at threonine-217 (P-tau217) presents a promising alternative, yet optimal cutoffs for treatment eligibility with DMTs like aducanumab require further investigation. This study evaluates the efficacy of one- and two-cutoff strategies for determining DMT eligibility at the Butler Hospital Memory & Aging Program (MAP). Methods In this retrospective, cross-sectional diagnostic cohort study, we first developed P-tau217 cutoffs using site-specific training data and BioFINDER-2, which were then tested in potential DMT candidates from Butler MAP (total n = 150). ROC analysis was used to calculate the area under the curve (AUC) and accuracy of P-tau217 interpretation strategies, using Aβ-PET/CSF testing as the standard of truth. Results Potential DMT candidates at Butler MAP (n = 50), primarily diagnosed with mild cognitive impairment (n = 29 [58%]) or mild dementia (21 [42%]), were predominantly Aβ-positive (38 [76%]), and half (25 [50%]) were subsequently treated with aducanumab. Elevated P-tau217 predicted cerebral Aβ positivity in potential DMT candidates (AUC = 0.97 [0.92-1]), with diagnostic accuracy ranging from 0.88 (0.76-0.95, p = 0.028) to 0.96 (0.86-1, p < .001). When using site-specific cutoffs, a subset of DMT candidates (10%) exhibited borderline P-tau217 (between 0.273 and 0.399 pg/mL) that would have potentially required from confirmatory testing. Conclusions This study, which included participants treated with aducanumab, confirms the utility of one- and two-cutoff strategies for interpreting plasma P-tau217 in assessing DMT eligibility. Using P-tau217 could potentially replace more invasive diagnostic methods, and all aducanumab-treated participants would have been deemed eligible based on P-tau217. However, false positives remain a concern, particularly when applying externally derived cutoffs that exhibited lower specificity which could have led to inappropriate treatment of Aβ-negative participants. Future research should focus on prospective validation of P-tau217 cutoffs to enhance their generalizability and inform standardized treatment decision-making across diverse populations.
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Howe MD, Caruso MR, Manoochehri M, Kunicki ZJ, Emrani S, Rudolph JL, Huey ED, Salloway SP, Oh H. Utility of cerebrovascular imaging biomarkers to detect cerebral amyloidosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.05.28.24308056. [PMID: 38853879 PMCID: PMC11160821 DOI: 10.1101/2024.05.28.24308056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
INTRODUCTION The relationship between cerebrovascular disease (CVD) and amyloid-β (Aβ) in Alzheimer disease (AD) is understudied. We hypothesized that magnetic resonance imaging (MRI)-based CVD biomarkers, including cerebral microbleeds (CMBs), ischemic infarction, and white matter hyperintensities (WMH), would correlate with Aβ positivity on positron emission tomography (Aβ-PET). METHODS We cross-sectionally analyzed data from the Alzheimer's Disease Neuroimaging Initiative (ADNI, N=1,352). Logistic regression was used to calculate odds ratios (ORs), with Aβ-PET positivity as the standard-of-truth. RESULTS Following adjustment, WMH (OR=1.25) and superficial CMBs (OR=1.45) remained positively associated with Aβ-PET positivity (p<.001). Deep CMBs and infarcts exhibited a varied relationship with Aβ-PET in cognitive subgroups. The combined diagnostic model, which included CVD biomarkers and other accessible measures, significantly predicted Aβ-PET (pseudo-R 2 =.41). DISCUSSION The study highlights the translational value of CVD biomarkers in diagnosing AD, and underscores the need for more research on their inclusion in diagnostic criteria. ClinicalTrials.gov: ADNI-2 ( NCT01231971 ), ADNI-3 ( NCT02854033 ).
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Sosa AL, Brucki SM, Crivelli L, Lopera FJ, Acosta DM, Acosta-Uribe J, Aguilar D, Aguilar-Navarro SG, Allegri RF, Bertolucci PH, Calandri IL, Carrillo MC, Mendez PAC, Cornejo-Olivas M, Custodio N, Damian A, de Souza LC, Duran-Aniotz C, García AM, García-Peña C, Gonzales MM, Grinberg LT, Ibanez AM, Illanes-Manrique MZ, Jack CR, Leon-Salas JM, Llibre-Guerra JJ, Luna-Muñoz J, Matallana D, Miller BL, Naci L, Parra MA, Pericak-Vance M, Piña-Escudero SD, França Resende EDP, Ringman JM, Sevlever G, Slachevsky A, Suemoto CK, Valcour V, Villegas-Lanau A, Yassuda MS, Mahinrad S, Sexton C. Advancements in dementia research, diagnostics, and care in Latin America: Highlights from the 2023 Alzheimer's Association International conference satellite symposium in Mexico City. Alzheimers Dement 2024. [PMID: 38801124 DOI: 10.1002/alz.13850] [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: 12/06/2023] [Accepted: 01/03/2024] [Indexed: 05/29/2024]
Abstract
INTRODUCTION While Latin America (LatAm) is facing an increasing burden of dementia due to the rapid aging of the population, it remains underrepresented in dementia research, diagnostics, and care. METHODS In 2023, the Alzheimer's Association hosted its eighth satellite symposium in Mexico, highlighting emerging dementia research, priorities, and challenges within LatAm. RESULTS Significant initiatives in the region, including intracountry support, showcased their efforts in fostering national and international collaborations; genetic studies unveiled the unique genetic admixture in LatAm; researchers conducting emerging clinical trials discussed ongoing culturally specific interventions; and the urgent need to harmonize practices and studies, improve diagnosis and care, and use affordable biomarkers in the region was highlighted. DISCUSSION The myriad of topics discussed at the 2023 AAIC satellite symposium highlighted the growing research efforts in LatAm, providing valuable insights into dementia biology, genetics, epidemiology, treatment, and care.
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Affiliation(s)
- Ana Luisa Sosa
- Laboratorio de Demencias del Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, CDMX, México
| | - Sonia Md Brucki
- Department of Neurology, Cognitive and Behavioral Group, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Lucia Crivelli
- Department of Cognitive Neurology, Fleni, Buenos Aires, Argentina
| | - Francisco Javier Lopera
- Grupo de Neurociencias (GNA), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Daisy M Acosta
- Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic
| | - Juliana Acosta-Uribe
- Grupo de Neurociencias (GNA), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California Santa Barbara, Santa Barbara, California, USA
| | | | - Sara G Aguilar-Navarro
- Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubiran, México, CDMX, Mexico
| | - Ricardo F Allegri
- Instituto de Neurociencias, Fleni, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa CUC, Barranquilla, Colombia
| | - Paulo Hf Bertolucci
- Neurology & Neurosurgery Department, Escola Paulista de Medicina/UNIFESP, São Paulo, São Paulo, Brazil
| | | | | | | | - Mario Cornejo-Olivas
- Neurogenetics Working Group, Universidad Científica del Sur, Lima, Peru
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
| | - Nilton Custodio
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Andrés Damian
- Departamento de Montevideo, Centro Uruguayo de Imagenología Molecular (CUDIM) and Unidad Académica de Medicina Nuclear e Imagenología Molecular, Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Montevideo, Uruguay
| | - Leonardo Cruz de Souza
- Programa de Pós-Graduação em Neurociências, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
- Departamento de Clínica Médica da Faculdade de Medicina da UFMG, Belo Horizonte, MG, Brazil
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile
| | - Adolfo M García
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
- Cognitive Neuroscience Center, Universidad de San Andrés, Victoria, Provincia de Buenos Aires, Argentina
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | | | - Mitzi M Gonzales
- Department of Neurology, Cedars Sinai Medical Center, Los Angeles, California, USA
- Glenn Biggs Institute, UT Health San Antonio, San Antonio, Texas, USA
| | - Lea T Grinberg
- Department of Neurology and Pathology, University of California San Francisco (UCSF), San Francisco, California, USA
- Department of Pathology, University of Sao Paulo, São Paulo, São Paulo, Brazil
| | - Agustin M Ibanez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
- Global Brain Health Institute (GBHI), University of Trinity Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, and CONICET, Victoria, Argentina
- Trinity College Dublin (TCD), College Green, Dublin, Ireland
| | - Maryenela Zaida Illanes-Manrique
- Neurogenetics Working Group, Universidad Científica del Sur, Lima, Peru
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologicas, Lima, Peru
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
| | | | - Jorge Mario Leon-Salas
- Departamento de Investigación Clínica, Life Science Research Institute, Hospital Clinica Biblica, San José, Costa Rica
| | - Jorge J Llibre-Guerra
- Dominantly Inherited Alzheimer's Network Trials Unit, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine in St.Louis, St. Louis, Missouri, USA
| | - José Luna-Muñoz
- Banco Nacional de Cerebros-UNPHU, Universidad Nacional Pedro Henríquez Ureña, Santo Domingo, Dominican Republic
- National Dementia BioBank, Dirección de Investigación, Innovación y Posgrado, Universidad Politécnica de Pachuca, Zempoala, México
- Federación Mexicana de Alzheimer (FEDMA), México, CDMX, Mexico
| | - Diana Matallana
- Pontificia Universidad Javeriana, Medical School, Aging Institute, Hospital Universitario San Ignacio, Bogotá, Colombia
- Memory and Cognition Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Mental Health Department, Hospital Universitario Fundación Santa Fe, Bogotá, Colombia
| | - Bruce L Miller
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
- Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Lorina Naci
- Global Brain Health Institute (GBHI), University of Trinity Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin, Ireland
| | - Mario A Parra
- Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Margaret Pericak-Vance
- John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA
- Dr. John T Macdonald Foundation, Department of Human Genetics, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Stefanie D Piña-Escudero
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
- Global Brain Health Institute (GBHI), University of Trinity Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Elisa de Paula França Resende
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, California, USA
- Global Brain Health Institute (GBHI), University of Trinity Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Universidade Federal de Minas Gerais, Faculdade de Medicina Ciências Médicas de Minas Gerais, Hospital das Clínicas - EBSERH-UFMG, Belo Horizonte, Brazil
| | - John M Ringman
- Department of Neurology, Alzheimer's Disease Research Center, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | | | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Neurology Department, Hospital del Salvador & Faculty of Medicine, University of Chile, Santiago de Chile, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Program - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago de Chile, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Las Condes, Chile
| | - Claudia Kimie Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil
| | - Victor Valcour
- Department of Neurology, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Andres Villegas-Lanau
- Grupo de Neurociencias (GNA), Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Mônica S Yassuda
- Department of Neurology, Cognitive and Behavioral Group, University of Sao Paulo, São Paulo, São Paulo, Brazil
- Gerontology, School of Arts, Sciences and Humanities, University of Sao Paulo, São Paulo, São Paulo, Brazil
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Gerlach LR, Prabhakaran V, Antuono PG, Granadillo E. The use of an anterior-posterior atrophy index to distinguish Alzheimer's disease from frontotemporal disorders: an automated volumetric MRI Study. Acta Radiol 2024:2841851241254746. [PMID: 38803154 DOI: 10.1177/02841851241254746] [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: 05/29/2024]
Abstract
BACKGROUND Alzheimer's disease (AD) and frontotemporal dementia (FTD) require different treatments. Since clinical presentation can be nuanced, imaging biomarkers aid in diagnosis. Automated software such as Neuroreader (NR) provides volumetric imaging data, and indices between anterior and posterior brain areas have proven useful in distinguishing dementia subtypes in research cohorts. Existing indices are complex and require further validation in clinical settings. PURPOSE To provide initial validation for a simplified anterior-posterior index (API) from NR in distinguishing FTD and AD in a clinical cohort. MATERIAL AND METHODS A retrospective chart review was completed. We derived a simplified API: API = (logVA/VP-μ)/σ where V A is weighted volume of frontal and temporal lobes and V P of parietal and occipital lobes. μ and σ are the mean and standard deviation of logVA/VP computed for AD participants. Receiver operating characteristic (ROC) curves and regression analyses assessed the efficacy of the API versus brain areas in predicting diagnosis of AD versus FTD. RESULTS A total of 39 participants with FTD and 78 participants with AD were included. The API had an excellent performance in distinguishing AD from FTD with an area under the ROC curve of 0.82 and a positive association with diagnostic classification on logistic regression analysis (B = 1.491, P < 0.001). CONCLUSION The API successfully distinguished AD and FTD with excellent performance. The results provide preliminary validation of the API in a clinical setting.
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Affiliation(s)
- Leah R Gerlach
- Medical School, Medical College of Wisconsin, Milwaukee WI, USA
| | - Vivek Prabhakaran
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison WI, USA
| | - Piero G Antuono
- Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Elias Granadillo
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA
- Institute for Clinical and Translational Research, University of Wisconsin - Madison, Madison WI, USA
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14
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Song Y, Kim H, Lee J, Kim K. Oxygen-enriching triphase platform for reliable sensing of femtomolar Alzheimer's neurofilament lights. Biosens Bioelectron 2024; 260:116431. [PMID: 38815462 DOI: 10.1016/j.bios.2024.116431] [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: 04/27/2024] [Revised: 05/21/2024] [Accepted: 05/24/2024] [Indexed: 06/01/2024]
Abstract
Accurate quantification of neurofilament lights (NfLs), a prognostic blood biomarker, is highly required to predict neurodegeneration in the presymptomatic stages of Alzheimer's disease. Here, we report self-oxygen-enriching coral structures with triphase interfaces for the label-free photocathodic detection of NfLs in blood plasma with femtomolar sensitivities and high reliability. In conventional photocathodic immunoassays, the poor solubility and sluggish diffusion rate of the dissolved oxygen serving as electron acceptors have necessitated the incorporation of additional electron acceptors or aeration procedures. To address the challenge, we designed the coral-like copper bismuth oxides (CBO) with robust solid-liquid-air contact boundaries that enrich the interfacial oxygen levels without an external aeration source. By optimally assembling the perfluorododecyltrichlorosilane (FTCS) and platinum (Pt) co-catalysts into the silver-doped CBO (Ag:CBO), the stable solid-liquid-air contact boundaries were formed within the sensor interfaces, which allowed for the abundant supply of air phase oxygen through an air pocket connected to the atmosphere. The Pt/FTCS-Ag:CBO exhibited the stable background signals independent of the dissolved oxygen fluctuations and amplified photocurrent signals by 1.76-fold, which were attributed to the elevated interfacial oxygen levels and 11.15 times-lowered mass transport resistance. Under the illumination of white light-emitting diode, the oxygen-enriching photocathodic sensor composed of Pt/FTCS-Ag:CBO conjugated with NfLs-specific antibodies precisely quantified the NfLs in plasma with a low coefficient of variation (≤2.97%), a high degree of recovery (>97.0%), and a limit of detection of 40.38 fg/mL, which was 140 times lower than the typical photocathodic sensor with diphase interfaces.
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Affiliation(s)
- Yunji Song
- Department of Fiber Convergence Material Engineering, Dankook University, Gyeonggi-Do, 16890, Republic of Korea
| | - Hayeon Kim
- Department of Fiber Convergence Material Engineering, Dankook University, Gyeonggi-Do, 16890, Republic of Korea
| | - Joonseok Lee
- Department of Chemistry, Hanyang University, Seoul, 04763, Republic of Korea.
| | - Kayoung Kim
- Department of Fiber Convergence Material Engineering, Dankook University, Gyeonggi-Do, 16890, Republic of Korea.
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15
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Wei YC, Kung YC, Lin CP, Chen CK, Lin C, Tseng RY, Chen YL, Huang WY, Chen PY, Chong ST, Shyu YC, Chang WC, Yeh CH. White matter alterations and their associations with biomarkers and behavior in subjective cognitive decline individuals: a fixel-based analysis. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2024; 20:12. [PMID: 38778325 PMCID: PMC11110460 DOI: 10.1186/s12993-024-00238-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 05/04/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is an early stage of dementia linked to Alzheimer's disease pathology. White matter changes were found in SCD using diffusion tensor imaging, but there are known limitations in voxel-wise tensor-based methods. Fixel-based analysis (FBA) can help understand changes in white matter fibers and how they relate to neurodegenerative proteins and multidomain behavior data in individuals with SCD. METHODS Healthy adults with normal cognition were recruited in the Northeastern Taiwan Community Medicine Research Cohort in 2018-2022 and divided into SCD and normal control (NC). Participants underwent evaluations to assess cognitive abilities, mental states, physical activity levels, and susceptibility to fatigue. Neurodegenerative proteins were measured using an immunomagnetic reduction technique. Multi-shell diffusion MRI data were collected and analyzed using whole-brain FBA, comparing results between groups and correlating them with multidomain assessments. RESULTS The final enrollment included 33 SCD and 46 NC participants, with no significant differences in age, sex, or education between the groups. SCD had a greater fiber-bundle cross-section than NC (pFWE < 0.05) at bilateral frontal superior longitudinal fasciculus II (SLFII). These white matter changes correlate negatively with plasma Aβ42 level (r = -0.38, p = 0.01) and positively with the AD8 score for subjective cognitive complaints (r = 0.42, p = 0.004) and the Hamilton Anxiety Rating Scale score for the degree of anxiety (Ham-A, r = 0.35, p = 0.019). The dimensional analysis of FBA metrics and blood biomarkers found positive correlations of plasma neurofilament light chain with fiber density at the splenium of corpus callosum (pFWE < 0.05) and with fiber-bundle cross-section at the right thalamus (pFWE < 0.05). Further examination of how SCD grouping interacts between the correlations of FBA metrics and multidomain assessments showed interactions between the fiber density at the corpus callosum with letter-number sequencing cognitive score (pFWE < 0.01) and with fatigue to leisure activities (pFWE < 0.05). CONCLUSION Based on FBA, our investigation suggests white matter structural alterations in SCD. The enlargement of SLFII's fiber cross-section is linked to plasma Aβ42 and neuropsychiatric symptoms, which suggests potential early axonal dystrophy associated with Alzheimer's pathology in SCD. The splenium of the corpus callosum is also a critical region of axonal degeneration and cognitive alteration for SCD.
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Affiliation(s)
- Yi-Chia Wei
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Yi-Chia Kung
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Chih-Ken Chen
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Chemin Lin
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
- Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Rung-Yu Tseng
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, 333, Taiwan
| | - Yao-Liang Chen
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, 333, Taiwan
- Department of Radiology, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Wen-Yi Huang
- Department of Neurology, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
| | - Pin-Yuan Chen
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, 333, Taiwan
- Department of Neurosurgery, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
| | - Shin-Tai Chong
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, 112, Taiwan
| | - Yu-Chiau Shyu
- Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, 204, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, 333, Taiwan
| | - Wei-Chou Chang
- Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, 114, Taiwan
| | - Chun-Hung Yeh
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, 333, Taiwan.
- Department of Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, 333, Taiwan.
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16
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Wang R, Zhan Y, Zhu W, Yang Q, Pei J. Association of soluble TREM2 with Alzheimer's disease and mild cognitive impairment: a systematic review and meta-analysis. Front Aging Neurosci 2024; 16:1407980. [PMID: 38841103 PMCID: PMC11150578 DOI: 10.3389/fnagi.2024.1407980] [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: 03/27/2024] [Accepted: 05/03/2024] [Indexed: 06/07/2024] Open
Abstract
Objective Soluble triggering receptor expressed on myeloid cells 2 (sTREM2) is a potential neuroinflammatory biomarker linked to the pathogenesis of Alzheimer's disease (AD) and mild cognitive impairment (MCI). Previous studies have produced inconsistent results regarding sTREM2 levels in various clinical stages of AD. This study aims to establish the correlation between sTREM2 levels and AD progression through a meta-analysis of sTREM2 levels in cerebrospinal fluid (CSF) and blood. Methods Comprehensive searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Library to identify observational studies reporting CSF and blood sTREM2 levels in AD patients, MCI patients, and healthy controls. A random effects meta-analysis was used to calculate the standardized mean difference (SMD) and 95% confidence intervals (CIs). Results Thirty-six observational studies involving 3,016 AD patients, 3,533 MCI patients, and 4,510 healthy controls were included. CSF sTREM2 levels were significantly higher in both the AD [SMD = 0.28, 95% CI (0.15, 0.41)] and MCI groups [SMD = 0.30, 95% CI (0.13, 0.47)] compared to the healthy control group. However, no significant differences in expression were detected between the AD and MCI groups [SMD = 0.09, 95% CI (-0.09, 0.26)]. Furthermore, increased plasma sTREM2 levels were associated with a higher risk of AD [SMD = 0.42, 95% CI (0.01, 0.83)]. Conclusion CSF sTREM2 levels are positively associated with an increased risk of AD and MCI. Plasma sTREM2 levels were notably higher in the AD group than in the control group and may serve as a promising biomarker for diagnosing AD. However, sTREM2 levels are not effective for distinguishing between different disease stages of AD. Further investigations are needed to explore the longitudinal changes in sTREM2 levels, particularly plasma sTREM2 levels, during AD progression. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024514593.
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Affiliation(s)
| | | | | | | | - Jian Pei
- Department of Acupuncture, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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17
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Rudolph MD, Sutphen CL, Register TC, Whitlow CT, Solingapuram Sai KK, Hughes TM, Bateman JR, Dage JL, Russ KA, Mielke MM, Craft S, Lockhart SN. Associations among plasma, MRI, and amyloid PET biomarkers of Alzheimer's disease and related dementias and the impact of health-related comorbidities in a community-dwelling cohort. Alzheimers Dement 2024. [PMID: 38747525 DOI: 10.1002/alz.13835] [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: 11/08/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION We evaluated associations between plasma and neuroimaging-derived biomarkers of Alzheimer's disease and related dementias and the impact of health-related comorbidities. METHODS We examined plasma biomarkers (neurofilament light chain, glial fibrillary acidic protein, amyloid beta [Aβ] 42/40, phosphorylated tau 181) and neuroimaging measures of amyloid deposition (Aβ-positron emission tomography [PET]), total brain volume, white matter hyperintensity volume, diffusion-weighted fractional anisotropy, and neurite orientation dispersion and density imaging free water. Participants were adjudicated as cognitively unimpaired (CU; N = 299), mild cognitive impairment (MCI; N = 192), or dementia (DEM; N = 65). Biomarkers were compared across groups stratified by diagnosis, sex, race, and APOE ε4 carrier status. General linear models examined plasma-imaging associations before and after adjusting for demographics (age, sex, race, education), APOE ε4 status, medications, diagnosis, and other factors (estimated glomerular filtration rate [eGFR], body mass index [BMI]). RESULTS Plasma biomarkers differed across diagnostic groups (DEM > MCI > CU), were altered in Aβ-PET-positive individuals, and were associated with poorer brain health and kidney function. DISCUSSION eGFR and BMI did not substantially impact associations between plasma and neuroimaging biomarkers. HIGHLIGHTS Plasma biomarkers differ across diagnostic groups (DEM > MCI > CU) and are altered in Aβ-PET-positive individuals. Altered plasma biomarker levels are associated with poorer brain health and kidney function. Plasma and neuroimaging biomarker associations are largely independent of comorbidities.
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Affiliation(s)
- Marc D Rudolph
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Courtney L Sutphen
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Thomas C Register
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Christopher T Whitlow
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Kiran K Solingapuram Sai
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - James R Bateman
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jeffrey L Dage
- Department Of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kristen A Russ
- Department Of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Michelle M Mielke
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Samuel N Lockhart
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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18
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Galvin JE, Cummings JL, Benea ML, de Moor C, Allegri RF, Atri A, Chertkow H, Paquet C, Porter VR, Ritchie CW, Sikkes SAM, Smith MR, Grassi CM, Rubino I. Generating real-world evidence in Alzheimer's disease: Considerations for establishing a core dataset. Alzheimers Dement 2024. [PMID: 38706421 DOI: 10.1002/alz.13785] [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: 07/11/2023] [Revised: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 05/07/2024]
Abstract
Ongoing assessment of patients with Alzheimer's disease (AD) in postapproval studies is important for mapping disease progression and evaluating real-world treatment effectiveness and safety. However, interpreting outcomes in the real world is challenging owing to variation in data collected across centers and specialties and greater heterogeneity of patients compared with trial participants. Here, we share considerations for observational postapproval studies designed to collect harmonized longitudinal data from individuals with mild cognitive impairment or mild dementia stage of disease who receive therapies targeting the underlying pathological processes of AD in routine practice. This paper considers key study design parameters, including proposed aims and objectives, study populations, approaches to data collection, and measures of cognition, functional abilities, neuropsychiatric status, quality of life, health economics, safety, and drug utilization. Postapproval studies that capture these considerations will be important to provide standardized data on AD treatment effectiveness and safety in real-world settings.
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Affiliation(s)
- James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, Florida, USA
| | - Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | | | | | - Ricardo F Allegri
- Instituto de Investigaciones Neurológicas Fleni, Buenos Aires, Argentina
- Departamento de Neurociencias, Universidad De La Costa (CUC), Barranquilla, Atlántico, Colombia
| | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women's Hospital - Main Campus, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Howard Chertkow
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Claire Paquet
- Université de Paris GHU AP-HP Nord Lariboisière Hospital, Paris, France
| | - Verna R Porter
- Pacific Brain Health Center, Pacific Neuroscience Institute, Santa Monica, California, USA
- Saint John's Cancer Institute, Santa Monica, California, USA
| | | | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Amsterdam University Medical Center, Amsterdam, The Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit (VU) Amsterdam, Amsterdam, The Netherlands
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19
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Kalaria R, Maestre G, Mahinrad S, Acosta DM, Akinyemi RO, Alladi S, Allegri RF, Arshad F, Babalola DO, Baiyewu O, Bak TH, Bellaj T, Brodie-Mends DK, Carrillo MC, Celestin KKM, Damasceno A, de Silva RK, de Silva R, Djibuti M, Dreyer AJ, Ellajosyula R, Farombi TH, Friedland RP, Garza N, Gbessemehlan A, Georgiou EEZ, Govia I, Grinberg LT, Guerchet M, Gugssa SA, Gumikiriza-Onoria JL, Hogervorst E, Hornberger M, Ibanez A, Ihara M, Issac TG, Jönsson L, Karanja WM, Lee JH, Leroi I, Livingston G, Manes FF, Mbakile-Mahlanza L, Miller BL, Musyimi CW, Mutiso VN, Nakasujja N, Ndetei DM, Nightingale S, Novotni G, Nyamayaro P, Nyame S, Ogeng'o JA, Ogunniyi A, de Oliveira MO, Okubadejo NU, Orrell M, Paddick SM, Pericak-Vance MA, Pirtosek Z, Potocnik FCV, Raman R, Rizig M, Rosselli M, Salokhiddinov M, Satizabal CL, Sepulveda-Falla D, Seshadri S, Sexton CE, Skoog I, George-Hyslop PHS, Suemoto CK, Thapa P, Udeh-Momoh CT, Valcour V, Vance JM, Varghese M, Vera JH, Walker RW, Zetterberg H, Zewde YZ, Ismail O. The 2022 symposium on dementia and brain aging in low- and middle-income countries: Highlights on research, diagnosis, care, and impact. Alzheimers Dement 2024. [PMID: 38696263 DOI: 10.1002/alz.13836] [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: 10/31/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 05/04/2024]
Abstract
Two of every three persons living with dementia reside in low- and middle-income countries (LMICs). The projected increase in global dementia rates is expected to affect LMICs disproportionately. However, the majority of global dementia care costs occur in high-income countries (HICs), with dementia research predominantly focusing on HICs. This imbalance necessitates LMIC-focused research to ensure that characterization of dementia accurately reflects the involvement and specificities of diverse populations. Development of effective preventive, diagnostic, and therapeutic approaches for dementia in LMICs requires targeted, personalized, and harmonized efforts. Our article represents timely discussions at the 2022 Symposium on Dementia and Brain Aging in LMICs that identified the foremost opportunities to advance dementia research, differential diagnosis, use of neuropsychometric tools, awareness, and treatment options. We highlight key topics discussed at the meeting and provide future recommendations to foster a more equitable landscape for dementia prevention, diagnosis, care, policy, and management in LMICs. HIGHLIGHTS: Two-thirds of persons with dementia live in LMICs, yet research and costs are skewed toward HICs. LMICs expect dementia prevalence to more than double, accompanied by socioeconomic disparities. The 2022 Symposium on Dementia in LMICs addressed advances in research, diagnosis, prevention, and policy. The Nairobi Declaration urges global action to enhance dementia outcomes in LMICs.
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Affiliation(s)
- Raj Kalaria
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Gladys Maestre
- Departments of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, One W. University Blvd, Brownsville, Texas, USA
| | - Simin Mahinrad
- Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Daisy M Acosta
- Universidad Nacional Pedro Henriquez Urena (UNPHU), Santo Domingo, Dominican Republic
| | - Rufus Olusola Akinyemi
- Neuroscience and Ageing Research Unit, Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ricardo F Allegri
- Fleni Neurological Institute, Buenos Aires, Argentina
- Department of Neurosciences, Universidad de la Costa (CUC), Barranquilla, Colombia
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | | | - Olusegun Baiyewu
- Department of Psychiatry, University of Ibadan, Ibadan, Oyo, Nigeria
| | | | | | | | - Maria C Carrillo
- Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Kaputu-Kalala-Malu Celestin
- Department of Neurology, Centre Neuropsychopathologique (CNPP), Kinshasa University Teaching Hospital, University of Kinshasa, Kinshasa, Republic Democratic of the Congo
| | | | - Ranil Karunamuni de Silva
- Interdisciplinary Centre for Innovation in Biotechnology and Neuroscience, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
- Institute for Combinatorial Advanced Research and Education (KDU-CARE), General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Rohan de Silva
- Reta Lila Weston Institute and Department of Clinical, Movement Neuroscience, UCL Queen Square Institute of Neurology, London, UK
| | - Mamuka Djibuti
- Partnership for Research and Action for Health (PRAH), Tbilisi, Georgia
| | | | - Ratnavalli Ellajosyula
- Cognitive Neurology Clinic, Manipal Hospital, and Annasawmy Mudaliar Hospital, Bengaluru, Karnataka, India
- Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India
| | - Temitope H Farombi
- Tony Anenih Geriatric Center, University College Hospital, Ibadan, Oyo, Nigeria
| | | | - Noe Garza
- Department of Neuroscience and Human Genetics, University of Texas Rio Grande Valley, Harlingen, Texas, USA
| | - Antoine Gbessemehlan
- Inserm U1094, IRD U270, University of Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
- Inserm, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Eliza Eleni-Zacharoula Georgiou
- Department of Psychiatry, Patras University General Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Ishtar Govia
- Caribbean Institute for Health Research, The University of the West Indies, Jamaica, West Indies, Jamaica
- Institute for Global Health, University College London, London, UK
| | - Lea T Grinberg
- Department of Neurology and Pathology, University of California San Francisco, San Francisco, California, USA
- Department of Pathology, University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil
| | - Maëlenn Guerchet
- Inserm U1094, IRD U270, University of Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Seid Ali Gugssa
- Department of Neurology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Eef Hogervorst
- Loughborough University, Loughborough, UK
- Respati University, Yogyakarta, Indonesia
| | | | - Agustin Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Peñalolén, Santiago, Chile
- Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, and National Scientific and Technical Research Council (CONICET), Victoria, Provincia de Buenos Aires, Argentina
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Thomas Gregor Issac
- Centre for Brain Research, Indian Institute of Science (IISc), Bengaluru, Karnataka, India
| | - Linus Jönsson
- Department of Neurobiology, Care Science and Society, section for Neurogeriatrics, Karolinska Institute, Solnavägen, Solna, Sweden
| | - Wambui M Karanja
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Joseph H Lee
- Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Departments of Neurology and Epidemiology, Columbia University, New York, New York, USA
| | - Iracema Leroi
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
| | | | - Facundo Francisco Manes
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Lingani Mbakile-Mahlanza
- Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA
- University of Botswana, Gaborone, Botswana
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco Weill Institute for Neurosciences, San Francisco, California, USA
| | | | - Victoria N Mutiso
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | | | - David M Ndetei
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
- Department of Psychiatry, University of Nairobi, Nairobi, Kenya
- World Psychiatric Association Collaborating Centre for Research and Training, Nairobi, Kenya
| | - Sam Nightingale
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Gabriela Novotni
- University Clinic of Neurology, Medical Faculty University Ss Cyril and Methodius Institute for Alzheimer's Disease and Neuroscience, Skopje, North Macedonia
| | - Primrose Nyamayaro
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Solomon Nyame
- Kintampo Health Research Centre, Ghana Health Service, Hospital Road, Near Kintampo-north Municipal Hospital, Kintampo, Ghana
| | | | | | - Maira Okada de Oliveira
- Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry at Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Cognitive Neurology and Behavioral Unit (GNCC), University of Sao Paulo, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil
| | - Njideka U Okubadejo
- Neurology Unit, Department of Medicine, Faculty of Clinical Sciences, College of Medicine, University of Lagos, Yaba, Lagos, Nigeria
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Stella-Maria Paddick
- Newcastle University, Newcastle upon Tyne, UK
- Gateshead Health NHS Foundation Trust, Sheriff Hill, Tyne and Wear, UK
| | - Margaret A Pericak-Vance
- John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA
- Dr. John T Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Coral Gables, Florida, USA
| | - Zvezdan Pirtosek
- Faculty of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Felix Claude Victor Potocnik
- Old Age Psychiatry Unit, Depth Psychiatry, Stellenbosch University, Western Cape, Stellenbosch Central, Stellenbosch, South Africa
| | - Rema Raman
- Alzheimer's Therapeutic Research Institute, University of Southern California, Los Angeles, California, USA
| | - Mie Rizig
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, UK
| | - Mónica Rosselli
- Department of Psychology, Charles E. Schmidt College of Science, Florida Atlantic University, Boca Raton, Florida, USA
- Florida Alzheimer's Disease Research Center, Gainesville, Florida, USA
| | | | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
- The Framingham Heart Study, Framingham, Massachusetts, USA
| | - Diego Sepulveda-Falla
- Molecular Neuropathology of Alzheimer's Disease, Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases and South Texas ADRC, UT Health San Antonio, San Antonio, Texas, USA
- University of Texas Health Sciences Center, San Antonio, Texas, USA
| | - Claire E Sexton
- Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
| | - Ingmar Skoog
- Institute of Neuroscience and Fysiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter H St George-Hyslop
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
- Cambridge Institute for Medical Research and Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Addenbrookes Biomedical Campus, Trumpington, Cambridge, UK
- Department of Medicine (Neurology), Temerty Faculty of Medicine, University of Toronto, and University Health Network, 27 King's College Cir, Toronto, Ontario, Canada
| | - Claudia Kimie Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, R. da Reitoria, R. Cidade Universitária, São Paulo, Sao Paulo, Brazil
| | - Prekshy Thapa
- Global Brain Health Institute (GBHI), Trinity College Dublin, Lloyd Building Trinity College Dublin, Dublin, Ireland
| | - Chinedu Theresa Udeh-Momoh
- Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA
- FINGERS Brain Health Institute, c/o Stockholms Sjukhem, Stockholm, Sweden
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
- Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institute, Solnavägen, Solna, Sweden
- Imarisha Centre for Brain health and Aging, Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Jeffery M Vance
- John P Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Coral Gables, Florida, USA
| | - Mathew Varghese
- St. John's Medical College, Sarjapur - Marathahalli Rd, beside Bank Of Baroda, John Nagar, Koramangala, Bengaluru, Karnataka, India
| | - Jaime H Vera
- Department of Global Health and Infection, Brighton and Sussex Medical School, Brighton, UK
| | - Richard W Walker
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, Queen Square, London, UK
- UK Dementia Research Institute at UCL, University College London, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Yared Z Zewde
- Department of Neurology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ozama Ismail
- Division of Medical and Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
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20
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DeMarco ML, Algeciras‐Schimnich A, Budelier MM. Blood tests for Alzheimer's disease: The impact of disease prevalence on test performance. Alzheimers Dement 2024; 20:3661-3663. [PMID: 38447004 PMCID: PMC11095438 DOI: 10.1002/alz.13762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/31/2024] [Indexed: 03/08/2024]
Affiliation(s)
- Mari L. DeMarco
- Department of Pathology and Laboratory MedicineSt. Paul's HospitalProvidence Health CareVancouverBritish ColumbiaCanada
- Department of Pathology and Laboratory MedicineUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | - Melissa M. Budelier
- TriCore Reference LaboratoriesAlbuquerqueNew MexicoUSA
- Department of PathologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
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21
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Dark HE, Duggan MR, Walker KA. Plasma biomarkers for Alzheimer's and related dementias: A review and outlook for clinical neuropsychology. Arch Clin Neuropsychol 2024; 39:313-324. [PMID: 38520383 DOI: 10.1093/arclin/acae019] [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: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/25/2024] Open
Abstract
Recent technological advances have improved the sensitivity and specificity of blood-based biomarkers for Alzheimer's disease and related dementias. Accurate quantification of amyloid-ß peptide, phosphorylated tau (pTau) isoforms, as well as markers of neurodegeneration (neurofilament light chain [NfL]) and neuro-immune activation (glial fibrillary acidic protein [GFAP] and chitinase-3-like protein 1 [YKL-40]) in blood has allowed researchers to characterize neurobiological processes at scale in a cost-effective and minimally invasive manner. Although currently used primarily for research purposes, these blood-based biomarkers have the potential to be highly impactful in the clinical setting - aiding in diagnosis, predicting disease risk, and monitoring disease progression. Whereas plasma NfL has shown promise as a non-specific marker of neuronal injury, plasma pTau181, pTau217, pTau231, and GFAP have demonstrated desirable levels of sensitivity and specificity for identification of individuals with Alzheimer's disease pathology and Alzheimer's dementia. In this forward looking review, we (i) provide an overview of the most commonly used blood-based biomarkers for Alzheimer's disease and related dementias, (ii) discuss how comorbid medical conditions, demographic, and genetic factors can inform the interpretation of these biomarkers, (iii) describe ongoing efforts to move blood-based biomarkers into the clinic, and (iv) highlight the central role that clinical neuropsychologists may play in contextualizing and communicating blood-based biomarker results for patients.
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Affiliation(s)
- Heather E Dark
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Michael R Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
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22
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Bouteloup V, Pellegrin I, Dubois B, Chene G, Planche V, Dufouil C. Explaining the Variability of Alzheimer Disease Fluid Biomarker Concentrations in Memory Clinic Patients Without Dementia. Neurology 2024; 102:e209219. [PMID: 38527237 DOI: 10.1212/wnl.0000000000209219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 01/02/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Patients' comorbidities can affect Alzheimer disease (AD) blood biomarker concentrations. Because a limited number of factors have been explored to date, our aim was to assess the proportion of the variance in fluid biomarker levels explained by the clinical features of AD and by a large number of non-AD-related factors. METHODS MEMENTO enrolled 2,323 individuals with cognitive complaints or mild cognitive impairment in 26 French memory clinics. Baseline evaluation included clinical and neuropsychological assessments, brain MRI, amyloid-PET, CSF (optional), and blood sampling. Blood biomarker levels were determined using the Simoa-HDX analyzer. We performed linear regression analysis of the clinical features of AD (cognition, AD genetic risk score, and brain atrophy) to model biomarker concentrations. Next, we added covariates among routine biological tests, inflammatory markers, demographic and behavioral determinants, treatments, comorbidities, and preanalytical sample handling in final models using both stepwise selection processes and least absolute shrinkage and selection operator (LASSO). RESULTS In total, 2,257 participants were included in the analysis (median age 71.7, 61.8% women, 55.2% with high educational levels). For blood biomarkers, the proportion of variance explained by clinical features of AD was 13.7% for neurofilaments (NfL), 11.4% for p181-tau, 3.0% for Aβ-42/40, and 1.4% for total-tau. In final models accounting for non-AD-related factors, the variance was mainly explained by age, routine biological tests, inflammatory markers, and preanalytical sample handling. In CSF, the proportion of variance explained by clinical features of AD was 24.8% for NfL, 22.3% for Aβ-42/40, 19.8% for total-tau, and 17.2% for p181-tau. In contrast to blood biomarkers, the largest proportion of variance was explained by cognition after adjustment for covariates. The covariates that explained the largest proportion of variance were also the most frequently selected with LASSO. The performance of blood biomarkers for predicting A+ and T+ status (PET or CSF) remained unchanged after controlling for drivers of variance. DISCUSSION This comprehensive analysis demonstrated that the variance in AD blood biomarker concentrations was mainly explained by age, with minor contributions from cognition, brain atrophy, and genetics, conversely to CSF measures. These results challenge the use of blood biomarkers as isolated stand-alone biomarkers for AD.
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Affiliation(s)
- Vincent Bouteloup
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
| | - Isabelle Pellegrin
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
| | - Bruno Dubois
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
| | - Genevieve Chene
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
| | - Vincent Planche
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
| | - Carole Dufouil
- From the Univ. Bordeaux (V.B., G.C., C.D.), Inserm, Bordeaux Population Health, UMR1219, Bordeaux; CIC 1401 EC (V.B., G.C., C.D.), Pôle Santé Publique, CHU de Bordeaux; Laboratory of Immunology and Immunogenetics (I.P.), Resources Biological Center (CRB), CHU Bordeaux; Univ. Bordeaux (I.P.), CNRS, ImmunoConcEpT, UMR 5164, Bordeaux; Alzheimer Research Center IM2A (B.D.), Salpêtrière Hospital, AP-HP, Sorbonne University, Paris; Univ. Bordeaux (V.P.), CNRS, Institut des Maladies Neuroégénératives, UMR 5293, Bordeaux; Pôle de Neurosciences Cliniques (V.P.), Centre Mémoire de Ressources et de Recherche, CHU Bordeaux, France
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23
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Calluy E, Beaudart C, Alokail MS, Al-Daghri NM, Bruyère O, Reginster JY, Cavalier E, Ladang A. Confounding factors of the expression of mTBI biomarkers, S100B, GFAP and UCH-L1 in an aging population. Clin Chem Lab Med 2024; 0:cclm-2024-0194. [PMID: 38643415 DOI: 10.1515/cclm-2024-0194] [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: 09/15/2023] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVES To evaluate some confounding factors that influence the concentrations of S100 calcium binding protein B (S100B), glial fibrillary acidic protein (GFAP), and ubiquitin carboxyl-terminal hydrolase L-1 (UCH-L1) in older individuals. Indeed, recent guidelines have proposed the combined use of S100B and the "GFAP-UCH-L1" mTBI test to rule out mild traumatic brain injuries (mTBI). As older adults are the most at risk of mTBI, it is particularly important to understand the confounding factors of those mTBI rule-out biomarkers in aging population. METHODS The protein S100B and the "GFAP and UCH-L1" mTBI test were measured using Liaison XL (Diasorin) and Alinity I (Abbott), respectively, in 330 and 341 individuals with non-suspected mTBI from the SarcoPhAge cohort. RESULTS S100B, GFAP and UCH-L1 were all significantly correlated with renal function whereas alcohol consumption, Geriatric Depression Score (GDS), smoking habits and anticoagulant intake were not associated with any of these three biomarkers. Body mass index (BMI) and age were associated with GFAP and UCH-L1 expression while sex and mini-mental state examination (MMSE) were only associated with GFAP. According to the manufacturer's cut-offs for mTBI rule-out, only 5.5 % of participants were positive for S100B whereas 66.9 % were positive for the "GFAP-UCH-L1" mTBI test. All positive "GFAP-UCH-L1" mTBI tests were GFAP+/UCH-L1-. Among individuals with cystatin C>1.55 mg/L, 25 % were positive for S100B while 90 % were positive for the mTBI test. CONCLUSIONS Our data show that confounding factors have different impacts on the positivity rate of the "GFAP-UCH-L1" mTBI test compared to S100B.
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Affiliation(s)
- Emma Calluy
- Clinical Chemistry Department, CHU de Liège, University of Liège, Liège, Belgium
| | - Charlotte Beaudart
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Clinical Pharmacology and Toxicology Research Unit (URPC), NARILIS, Department of Biomedical Sciences, Faculty of Medicine, University of Namur, Namur, Belgium
| | - Majed S Alokail
- Protein Research Chair, Biochemistry Department, 37850 College of Science, KSU , Riyadh, Kingdom of Saudi Arabia
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, 37850 College of Science, KSU , Riyadh, Kingdom of Saudi Arabia
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Department of Sport and Rehabilitation Sciences, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Protein Research Chair, Biochemistry Department, 37850 College of Science, KSU , Riyadh, Kingdom of Saudi Arabia
| | - Etienne Cavalier
- Clinical Chemistry Department, CHU de Liège, University of Liège, Liège, Belgium
| | - Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, University of Liège, Liège, Belgium
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Pelegrini LNDC, da Silva VA, Grigoli MM, Vatanabe IP, Manzine PR, Cominetti MR. Plasma ADAM10 Levels and Their Association with Alzheimer's Disease Diagnosis in Older Adults with Fewer Years of Formal Education. Dement Geriatr Cogn Disord 2024:1-9. [PMID: 38583419 DOI: 10.1159/000538630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Low educational attainment is a potential risk factor for Alzheimer's disease (AD) development. Alpha-secretase ADAM10 plays a central role in AD pathology, attenuating the formation of beta-amyloid peptides and, therefore, their aggregation into senile plaques. This study seeks to investigate ADAM10 as a blood-based biomarker in mild cognitive impairment (MCI) and AD in a diverse group of community-dwelling older adults, focusing on those with limited educational attainment. METHODS Participants were recruited from public health services. Cognition was evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination - Revised (ACE-R) batteries. Blood samples were collected to analyze plasma ADAM10 levels. A logistic regression was conducted to verify the influence of plasma ADAM10 on the AD diagnosis. RESULTS Significant differences in age, years of education, prescribed medications, and cognitive test scores were found between the MCI and AD groups. Regarding cognitive performance, both ACE-R and MMSE scores displayed significant differences between groups, with post hoc analyses highlighting these distinctions, particularly between AD and cognitively unimpaired individuals. Elevated plasma ADAM10 levels were associated with a 4.5-fold increase in the likelihood of a diagnosis of MCI and a 5.9-fold increase in the likelihood of a diagnosis of AD. These findings suggest ADAM10 levels in plasma as a valuable biomarker for assessing cognitive status in older individuals with low education attainment. CONCLUSION This study underscores the potential utility of plasma ADAM10 levels as a blood-based biomarker for cognitive status, especially in individuals with low educational backgrounds, shedding light on their relevance in AD development and diagnosis.
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Affiliation(s)
| | | | | | - Izabela Pereira Vatanabe
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Pharmaceutical Sciences Faculty, University of São Paulo, São Paulo, Brazil
| | | | - Marcia Regina Cominetti
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil,
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland,
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25
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Zhang Q, Li F, Wei M, Wang M, Wang L, Han Y, Jiang J. Prediction of Cognitive Progression Due to Alzheimer's Disease in Normal Participants Based on Individual Default Mode Network Metabolic Connectivity Strength. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00104-6. [PMID: 38631552 DOI: 10.1016/j.bpsc.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/11/2024] [Accepted: 04/05/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Predicting cognitive decline among individuals in the aging population who are already amyloid-β (Aβ) positive or tau positive poses clinical challenges. In Alzheimer's disease research, intra-default mode network (DMN) connections play a pivotal role in diagnosis. In this article, we propose metabolic connectivity within the DMN as a supplementary biomarker to the Aβ, pathological tau, and neurodegeneration framework. METHODS Extracting data from 1292 participants in the Alzheimer's Disease Neuroimaging Initiative, we collected paired T1-weighted structural magnetic resonance imaging and 18F-labeled-fluorodeoxyglucose positron emission computed tomography scans. Individual metabolic DMN networks were constructed, and metabolic connectivity (MC) strength in the DMN was assessed. In the cognitively unimpaired group, the Cox model identified cognitively unimpaired (MC+), high-risk participants, with Kaplan-Meier survival analyses and hazard ratios revealing the strength of MC's predictive performance. Spearman correlation analyses explored relationships between MC strength, and Aβ, pathological tau, neurodegeneration biomarkers, and clinical scales. DMN standard uptake value ratio (SUVR) provided comparative insights in the analyses. RESULTS Both MC strength and SUVR exhibited gradual declines with cognitive deterioration, displaying significant intergroup differences. Survival analyses indicated enhanced Aβ and tau prediction with both metrics, with MC strength outperforming SUVR. Combined MC strength and Aβ yielded optimal predictive performance (hazard ratio = 9.29), followed by MC strength and tau (hazard ratio = 8.92). Generally, the strength of MC's correlations with Aβ, pathological tau, and neurodegeneration biomarkers exceeded SUVR. CONCLUSIONS Individuals with normal cognition and disrupted DMN metabolic connectivity face an elevated risk of cognitive decline linked to Aβ that precedes metabolic issues.
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Affiliation(s)
- Qi Zhang
- School of Communication & Information Engineering, Shanghai University, Shanghai, China; School of Life Sciences, Shanghai University, Shanghai, China
| | - Fangjie Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Wei
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China
| | - Min Wang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Luyao Wang
- School of Life Sciences, Shanghai University, Shanghai, China
| | - Ying Han
- Department of Neurology, XuanWu Hospital of Capital Medical University, Beijing, China; School of Biomedical Engineering, Hainan University, Haikou, China; Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; National Clinical Research Center for Geriatric Diseases, Beijing, China.
| | - Jiehui Jiang
- School of Life Sciences, Shanghai University, Shanghai, China.
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Lu Y, Pike JR, Hoogeveen R, Walker K, Raffield L, Selvin E, Avery C, Engel S, Mielke MM, Garcia T, Heiss G, Palta P. Nonalcoholic Fatty Liver Disease and Longitudinal Change in Imaging and Plasma Biomarkers of Alzheimer Disease and Vascular Pathology. Neurology 2024; 102:e209203. [PMID: 38471046 PMCID: PMC11033987 DOI: 10.1212/wnl.0000000000209203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/23/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Prospective measures of plasma and cerebral MRI biomarkers of Alzheimer disease (AD) and vascular neuropathology provide an opportunity to investigate possible mechanisms linking liver disease and dementia. We aimed to quantify the association of midlife nonalcoholic fatty liver disease (NAFLD) with change in plasma and brain MRI biomarkers of AD and vascular neuropathology. METHODS We included participants from the Atherosclerosis Risk in Communities Study with brain MRI measurements of white matter hyperintensity (WMH) volume and temporal-parietal lobe cortical thickness meta region of interest (ROI) at up to 2 different visits, in 2011-13 and 2016-19, and plasma biomarkers of β-amyloid (Aβ)42:40, phosphorylated tau at threonine 181, and neurofilament light (NfL) were measured up to 3 times in 1993-95, 2011-13, and 2016-19. NAFLD was categorized using the fatty liver index in 1990-92. Multivariate linear regression was performed for associations between midlife NAFLD and change in plasma and brain MRI biomarkers of AD and vascular neuropathology. The primary models adjusted for demographics, Apolipoprotein E, alcohol use, and kidney function. RESULTS Among 1,706 participants (mean age 56 years, 62% female, 28% Black), midlife NAFLD vs no NAFLD was associated with greater late-life WMH volume (difference per SD 0.19, 95% CI 0.06-0.31) and faster late-life WMH increase over 6 years (difference in annual change, SD 0.28, 95% CI 0.05-0.51), suggesting accumulating vascular pathology. Midlife NAFLD vs no NAFLD was also associated with AD biomarkers in midlife (lower Aβ42:40 [SD -0.21, 95% CI -0.39 to -0.04] measured in 1993-95) and late life (lower Aβ42:40 [SD -0.13, 95% CI -0.23 to -0.03] and lower temporal-parietal lobe cortical thickness meta ROI [SD -0.16, 95% CI -0.28 to -0.05] measured in 2011-13). Although midlife NfL was lower in individuals with vs without midlife NAFLD, those with NAFLD exhibited a faster rate of NfL increase that accelerated over time. DISCUSSION Midlife NAFLD shows associations with AD and accumulating vascular pathology, revealing potential pathways linking liver function to dementia. Plasma biomarkers of neuropathology and neuronal injury may serve as easily measurable and dynamic indicators for monitoring the impacts of impaired liver function on brain health.
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Affiliation(s)
- Yifei Lu
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - James R Pike
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ron Hoogeveen
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Keenan Walker
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Laura Raffield
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Elizabeth Selvin
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Christy Avery
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Stephanie Engel
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Michelle M Mielke
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Tanya Garcia
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Gerardo Heiss
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
| | - Priya Palta
- From the Departments of Epidemiology (Y.L., C.A., S.E., G.H.) and Biostatistics (T.G.), Gillings School of Global Public Health and Departments of Genetics (L.R.) and Neurology (P.P.), School of Medicine, University of North Carolina at Chapel Hill, NC; Department of Epidemiology (J.R.P., E.S.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine (R.H.), Baylor College of Medicine, Houston, TX; Laboratory of Behavioral Neuroscience (K.W.), National Institute on Aging, Bethesda, MD; and Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC
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Gonzalez-Ortiz F, Kirsebom BE, Contador J, Tanley JE, Selnes P, Gísladóttir B, Pålhaugen L, Suhr Hemminghyth M, Jarholm J, Skogseth R, Bråthen G, Grøndtvedt G, Bjørnerud A, Tecelao S, Waterloo K, Aarsland D, Fernández-Lebrero A, García-Escobar G, Navalpotro-Gómez I, Turton M, Hesthamar A, Kac PR, Nilsson J, Luchsinger J, Hayden KM, Harrison P, Puig-Pijoan A, Zetterberg H, Hughes TM, Suárez-Calvet M, Karikari TK, Fladby T, Blennow K. Plasma brain-derived tau is an amyloid-associated neurodegeneration biomarker in Alzheimer's disease. Nat Commun 2024; 15:2908. [PMID: 38575616 PMCID: PMC10995141 DOI: 10.1038/s41467-024-47286-5] [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: 08/09/2023] [Accepted: 03/26/2024] [Indexed: 04/06/2024] Open
Abstract
Staging amyloid-beta (Aβ) pathophysiology according to the intensity of neurodegeneration could identify individuals at risk for cognitive decline in Alzheimer's disease (AD). In blood, phosphorylated tau (p-tau) associates with Aβ pathophysiology but an AD-type neurodegeneration biomarker has been lacking. In this multicenter study (n = 1076), we show that brain-derived tau (BD-tau) in blood increases according to concomitant Aβ ("A") and neurodegeneration ("N") abnormalities (determined using cerebrospinal fluid biomarkers); We used blood-based A/N biomarkers to profile the participants in this study; individuals with blood-based p-tau+/BD-tau+ profiles had the fastest cognitive decline and atrophy rates, irrespective of the baseline cognitive status. Furthermore, BD-tau showed no or much weaker correlations with age, renal function, other comorbidities/risk factors and self-identified race/ethnicity, compared with other blood biomarkers. Here we show that blood-based BD-tau is a biomarker for identifying Aβ-positive individuals at risk of short-term cognitive decline and atrophy, with implications for clinical trials and implementation of anti-Aβ therapies.
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Affiliation(s)
- Fernando Gonzalez-Ortiz
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.
| | - Bjørn-Eivind Kirsebom
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - José Contador
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
| | - Jordan E Tanley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | | | - Lene Pålhaugen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Mathilde Suhr Hemminghyth
- Research Group for Age-Related Medicine, Haugesund Hospital, Haugesund, Norway
- Department of Neuropsychology, Haugesund Hospital, Haugesund, Norway
- Department of Clinical Medicine (K1), University of Bergen, Bergen, Norway
| | - Jonas Jarholm
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Ragnhild Skogseth
- Department of Geriatric Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
- Department of Clinical Sciences, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Geir Bråthen
- Department of Neurology and Clinical Neurophysiology, University Hospital of Trondheim, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gøril Grøndtvedt
- Department of Neurology and Clinical Neurophysiology, University Hospital of Trondheim, Trondheim, Norway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Atle Bjørnerud
- Department of Physics, University of Oslo, Oslo, Norway
- Unit for Computational Radiology and Artificial Intelligence, Oslo University hospital, Oslo, Norway
- Department of Psychology, Faculty for Social Sciences, University of Oslo, Oslo, Norway
| | - Sandra Tecelao
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Knut Waterloo
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
- Department of Psychology, Faculty of Health Sciences, The Arctic University of Norway, Tromsø, Norway
| | - Dag Aarsland
- Department of Old Age Psychiatry. Institute of psychiatry, Psychology and Neuroscience King's College London, London, UK
- Centre for Age-Related Diseases, University Hospital Stavanger, Stavanger, Norway
| | - Aida Fernández-Lebrero
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, 08003, Spain
- ERA-Net on Cardiovascular Diseases (ERA-CVD) consortium, Barcelona, Spain
| | - Greta García-Escobar
- Hospital del Mar Research Institute, Barcelona, Spain
- ERA-Net on Cardiovascular Diseases (ERA-CVD) consortium, Barcelona, Spain
| | - Irene Navalpotro-Gómez
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
- ERA-Net on Cardiovascular Diseases (ERA-CVD) consortium, Barcelona, Spain
| | - Michael Turton
- Bioventix Plc, 7 Romans Business Park, East Street, Farnham, Surrey, GU9 7SX, UK
| | - Agnes Hesthamar
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Przemyslaw R Kac
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Johanna Nilsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Jose Luchsinger
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M Hayden
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Peter Harrison
- Bioventix Plc, 7 Romans Business Park, East Street, Farnham, Surrey, GU9 7SX, UK
| | - Albert Puig-Pijoan
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- ERA-Net on Cardiovascular Diseases (ERA-CVD) consortium, Barcelona, Spain
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Research Institute, Barcelona, Spain
- Cognitive Decline and Movement Disorders Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tormod Fladby
- Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
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Chen A, Shea D, Daggett V. Performance of SOBA-AD blood test in discriminating Alzheimer's disease patients from cognitively unimpaired controls in two independent cohorts. Sci Rep 2024; 14:7946. [PMID: 38575622 PMCID: PMC10995183 DOI: 10.1038/s41598-024-57107-w] [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: 01/02/2024] [Accepted: 03/14/2024] [Indexed: 04/06/2024] Open
Abstract
Amyloid-beta (Aβ) toxic oligomers are critical early players in the molecular pathology of Alzheimer's disease (AD). We have developed a Soluble Oligomer Binding Assay (SOBA-AD) for detection of these Aβ oligomers that contain α-sheet secondary structure that discriminates plasma samples from patients on the AD continuum from non-AD controls. We tested 265 plasma samples from two independent cohorts to investigate the performance of SOBA-AD. Testing was performed at two different sites, with different personnel, reagents, and instrumentation. Across two cohorts, SOBA-AD discriminated AD patients from cognitively unimpaired (CU) subjects with 100% sensitivity, > 95% specificity, and > 98% area under the curve (AUC) (95% CI 0.95-1.00). A SOBA-AD positive readout, reflecting α-sheet toxic oligomer burden, was found in AD patients, and not in controls, providing separation of the two populations, aside from 5 SOBA-AD positive controls. Based on an earlier SOBA-AD study, the Aβ oligomers detected in these CU subjects may represent preclinical cases of AD. The results presented here support the value of SOBA-AD as a promising blood-based tool for the detection and confirmation of AD.
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Affiliation(s)
- Amy Chen
- AltPep Corporation, 1150 Eastlake Avenue N, Suite 800, Seattle, WA, 98109, USA
| | - Dylan Shea
- AltPep Corporation, 1150 Eastlake Avenue N, Suite 800, Seattle, WA, 98109, USA
- University of Washington, Box 355610, Seattle, WA, 98195-5610, USA
| | - Valerie Daggett
- AltPep Corporation, 1150 Eastlake Avenue N, Suite 800, Seattle, WA, 98109, USA.
- University of Washington, Box 355610, Seattle, WA, 98195-5610, USA.
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Chong JR, Chai YL, Yam ATY, Hilal S, Vrooman H, Venketasubramanian N, Blennow K, Zetterberg H, Ashton NJ, Chen CP, Lai MKP. Association of plasma GFAP with elevated brain amyloid is dependent on severity of white matter lesions in an Asian cognitively impaired cohort. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12576. [PMID: 38605996 PMCID: PMC11007806 DOI: 10.1002/dad2.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/25/2024] [Accepted: 03/01/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION While elevated blood glial fibrillary acidic protein (GFAP) has been associated with brain amyloid pathology, whether this association occurs in populations with high cerebral small vessel disease (CSVD) concomitance remains unclear. METHODS Using a Singapore-based cohort of cognitively impaired subjects, we assessed associations between plasma GFAP and neuroimaging measures of brain amyloid and CSVD, including white matter hyperintensities (WMH). We also examined the diagnostic performance of plasma GFAP in detecting brain amyloid beta positivity (Aβ+). RESULTS When stratified by WMH status, elevated brain amyloid was associated with higher plasma GFAP only in the WMH- group (β = 0.383; P < 0.001). The diagnostic performance of plasma GFAP in identifying Aβ+ was significantly higher in the WMH- group (area under the curve [AUC] = 0.896) than in the WMH+ group (AUC = 0.712, P = 0.008). DISCUSSION The biomarker utility of plasma GFAP in detecting brain amyloid pathology is dependent on the severity of concomitant WMH. Highlight Glial fibrillary acidic protein (GFAP)'s association with brain amyloid is unclear in populations with high cerebral small vessel disease (CSVD).Plasma GFAP was measured in a cohort with CSVD and brain amyloid.Plasma GFAP was better in detecting amyloid in patients with low CSVD versus high CSVD.Biomarker utility of GFAP in detecting brain amyloid depends on the severity of CSVD.
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Affiliation(s)
- Joyce R. Chong
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
| | - Yuek Ling Chai
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
| | - Amelia T. Y. Yam
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
| | - Saima Hilal
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
- Saw Swee Hock School of Public HealthNational University of Singapore and National University Health SystemKent RidgeSingapore
- Department of Radiology and Nuclear MedicineErasmus Medical CenterRotterdamthe Netherlands
| | - Henri Vrooman
- Department of Radiology and Nuclear MedicineErasmus Medical CenterRotterdamthe Netherlands
| | | | - Kaj Blennow
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGöteborgSweden
| | - Henrik Zetterberg
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGöteborgSweden
- Department of Neurodegenerative DiseaseThe UCL Queen Square Institute of NeurologyLondonUK
| | - Nicholas J. Ashton
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGöteborgSweden
| | - Christopher P. Chen
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
| | - Mitchell K. P. Lai
- Department of PharmacologyYong Loo Lin School of MedicineNational University of SingaporeKent RidgeSingapore
- Memory, Aging and Cognition CentreNational University Health SystemsKent RidgeSingapore
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Ortega‐Cruz D, Bress KS, Gazula H, Rabano A, Iglesias JE, Strange BA. Three-dimensional histology reveals dissociable human hippocampal long-axis gradients of Alzheimer's pathology. Alzheimers Dement 2024; 20:2606-2619. [PMID: 38369763 PMCID: PMC11032559 DOI: 10.1002/alz.13695] [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: 08/04/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 02/20/2024]
Abstract
INTRODUCTION Three-dimensional (3D) histology analyses are essential to overcome sampling variability and understand pathological differences beyond the dissection axis. We present Path2MR, the first pipeline allowing 3D reconstruction of sparse human histology without a magnetic resonance imaging (MRI) reference. We implemented Path2MR with post-mortem hippocampal sections to explore pathology gradients in Alzheimer's disease. METHODS Blockface photographs of brain hemisphere slices are used for 3D reconstruction, from which an MRI-like image is generated using machine learning. Histology sections are aligned to the reconstructed hemisphere and subsequently to an atlas in standard space. RESULTS Path2MR successfully registered histological sections to their anatomic position along the hippocampal longitudinal axis. Combined with histopathology quantification, we found an expected peak of tau pathology at the anterior end of the hippocampus, whereas amyloid-beta (Aβ) displayed a quadratic anterior-posterior distribution. CONCLUSION Path2MR, which enables 3D histology using any brain bank data set, revealed significant differences along the hippocampus between tau and Aβ. HIGHLIGHTS Path2MR enables three-dimensional (3D) brain reconstruction from blockface dissection photographs. This pipeline does not require dense specimen sampling or a subject-specific magnetic resonance (MR) image. Anatomically consistent mapping of hippocampal sections was obtained with Path2MR. Our analyses revealed an anterior-posterior gradient of hippocampal tau pathology. In contrast, the peak of amyloid-beta (Aβ) deposition was closer to the hippocampal body.
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Affiliation(s)
- Diana Ortega‐Cruz
- Laboratory for Clinical Neuroscience, Center for Biomedical TechnologyUniversidad Politécnica de Madrid, IdISSCMadridSpain
- Alzheimer's Disease Research UnitCIEN Foundation, Queen Sofia Foundation Alzheimer CenterMadridSpain
| | - Kimberly S. Bress
- Alzheimer's Disease Research UnitCIEN Foundation, Queen Sofia Foundation Alzheimer CenterMadridSpain
- Present address:
Vanderbilt University School of MedicineNashvilleTennesseeUSA
| | - Harshvardhan Gazula
- Martinos Center for Biomedical ImagingMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
| | - Alberto Rabano
- Alzheimer's Disease Research UnitCIEN Foundation, Queen Sofia Foundation Alzheimer CenterMadridSpain
| | - Juan Eugenio Iglesias
- Martinos Center for Biomedical ImagingMassachusetts General Hospital and Harvard Medical SchoolBostonMassachusettsUSA
- Computer Science and Artificial Intelligence LaboratoryMassachusetts Institute of TechnologyBostonMassachusettsUSA
- Centre for Medical Image ComputingUniversity College LondonLondonUK
| | - Bryan A. Strange
- Laboratory for Clinical Neuroscience, Center for Biomedical TechnologyUniversidad Politécnica de Madrid, IdISSCMadridSpain
- Alzheimer's Disease Research UnitCIEN Foundation, Queen Sofia Foundation Alzheimer CenterMadridSpain
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Barthélemy NR, Salvadó G, Schindler SE, He Y, Janelidze S, Collij LE, Saef B, Henson RL, Chen CD, Gordon BA, Li Y, La Joie R, Benzinger TLS, Morris JC, Mattsson-Carlgren N, Palmqvist S, Ossenkoppele R, Rabinovici GD, Stomrud E, Bateman RJ, Hansson O. Highly accurate blood test for Alzheimer's disease is similar or superior to clinical cerebrospinal fluid tests. Nat Med 2024; 30:1085-1095. [PMID: 38382645 PMCID: PMC11031399 DOI: 10.1038/s41591-024-02869-z] [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: 10/24/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024]
Abstract
With the emergence of Alzheimer's disease (AD) disease-modifying therapies, identifying patients who could benefit from these treatments becomes critical. In this study, we evaluated whether a precise blood test could perform as well as established cerebrospinal fluid (CSF) tests in detecting amyloid-β (Aβ) plaques and tau tangles. Plasma %p-tau217 (ratio of phosporylated-tau217 to non-phosphorylated tau) was analyzed by mass spectrometry in the Swedish BioFINDER-2 cohort (n = 1,422) and the US Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC) cohort (n = 337). Matched CSF samples were analyzed with clinically used and FDA-approved automated immunoassays for Aβ42/40 and p-tau181/Aβ42. The primary and secondary outcomes were detection of brain Aβ or tau pathology, respectively, using positron emission tomography (PET) imaging as the reference standard. Main analyses were focused on individuals with cognitive impairment (mild cognitive impairment and mild dementia), which is the target population for available disease-modifying treatments. Plasma %p-tau217 was clinically equivalent to FDA-approved CSF tests in classifying Aβ PET status, with an area under the curve (AUC) for both between 0.95 and 0.97. Plasma %p-tau217 was generally superior to CSF tests in classification of tau-PET with AUCs of 0.95-0.98. In cognitively impaired subcohorts (BioFINDER-2: n = 720; Knight ADRC: n = 50), plasma %p-tau217 had an accuracy, a positive predictive value and a negative predictive value of 89-90% for Aβ PET and 87-88% for tau PET status, which was clinically equivalent to CSF tests, further improving to 95% using a two-cutoffs approach. Blood plasma %p-tau217 demonstrated performance that was clinically equivalent or superior to clinically used FDA-approved CSF tests in the detection of AD pathology. Use of high-performance blood tests in clinical practice can improve access to accurate AD diagnosis and AD-specific treatments.
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Affiliation(s)
- Nicolas R Barthélemy
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, MO, USA
| | - Yingxin He
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
| | - Lyduine E Collij
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
| | - Benjamin Saef
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel L Henson
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Charles D Chen
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Renaud La Joie
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, MO, USA
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, Amsterdam, The Netherlands
| | - 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 Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Tracy Family Stable Isotope Labeling Quantitation (SILQ) Center, Washington University School of Medicine, St. Louis, MO, USA.
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University School of Medicine, St. Louis, MO, USA.
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Malmö, Sweden.
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Zhong H, Zhou X, Uhm H, Jiang Y, Cao H, Chen Y, Mak TTW, Lo RMN, Wong BWY, Cheng EYL, Mok KY, Chan ALT, Kwok TCY, Mok VCT, Ip FCF, Hardy J, Fu AKY, Ip NY. Using blood transcriptome analysis for Alzheimer's disease diagnosis and patient stratification. Alzheimers Dement 2024; 20:2469-2484. [PMID: 38323937 PMCID: PMC11032555 DOI: 10.1002/alz.13691] [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: 08/03/2023] [Revised: 10/03/2023] [Accepted: 10/11/2023] [Indexed: 02/08/2024]
Abstract
INTRODUCTION Blood protein biomarkers demonstrate potential for Alzheimer's disease (AD) diagnosis. Limited studies examine the molecular changes in AD blood cells. METHODS Bulk RNA-sequencing of blood cells was performed on AD patients of Chinese descent (n = 214 and 26 in the discovery and validation cohorts, respectively) with normal controls (n = 208 and 38 in the discovery and validation cohorts, respectively). Weighted gene co-expression network analysis (WGCNA) and deconvolution analysis identified AD-associated gene modules and blood cell types. Regression and unsupervised clustering analysis identified AD-associated genes, gene modules, cell types, and established AD classification models. RESULTS WGCNA on differentially expressed genes revealed 15 gene modules, with 6 accurately classifying AD (areas under the receiver operating characteristics curve [auROCs] > 0.90). These modules stratified AD patients into subgroups with distinct disease states. Cell-type deconvolution analysis identified specific blood cell types potentially associated with AD pathogenesis. DISCUSSION This study highlights the potential of blood transcriptome for AD diagnosis, patient stratification, and mechanistic studies. HIGHLIGHTS We comprehensively analyze the blood transcriptomes of a well-characterized Alzheimer's disease cohort to identify genes, gene modules, pathways, and specific blood cells associated with the disease. Blood transcriptome analysis accurately classifies and stratifies patients with Alzheimer's disease, with some gene modules achieving classification accuracy comparable to that of the plasma ATN biomarkers. Immune-associated pathways and immune cells, such as neutrophils, have potential roles in the pathogenesis and progression of Alzheimer's disease.
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Affiliation(s)
- Huan Zhong
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
| | - Xiaopu Zhou
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Hyebin Uhm
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
| | - Yuanbing Jiang
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
| | - Han Cao
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
| | - Yu Chen
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
- The Brain Cognition and Brain Disease InstituteShenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen–Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research InstitutionsShenzhenGuangdongChina
| | - Tiffany T. W. Mak
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
| | - Ronnie Ming Nok Lo
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
| | - Bonnie Wing Yan Wong
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
| | - Elaine Yee Ling Cheng
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
| | - Kin Y. Mok
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
| | | | - Timothy C. Y. Kwok
- Therese Pei Fong Chow Research Centre for Prevention of DementiaDivision of GeriatricsDepartment of Medicine and TherapeuticsThe Chinese University of Hong KongHKSARChina
| | - Vincent C. T. Mok
- Lau Tat‐chuen Research Centre of Brain Degenerative Diseases in ChineseTherese Pei Fong Chow Research Centre for Prevention of DementiaGerald Choa Neuroscience InstituteLi Ka Shing Institute of Health SciencesDivision of NeurologyDepartment of Medicine and TherapeuticsThe Chinese University of Hong KongHKSARChina
| | - Fanny C. F. Ip
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - John Hardy
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Department of Neurodegenerative DiseaseUCL Institute of NeurologyLondonUK
- Institute for Advanced StudyThe Hong Kong University of Science and TechnologyHKSARChina
| | - Amy K. Y. Fu
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Nancy Y. Ip
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience and Molecular Neuroscience CenterThe Hong Kong University of Science and TechnologyHKSARChina
- Hong Kong Center for Neurodegenerative DiseasesInnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
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Sarto J, Esteller-Gauxax D, Tort-Merino A, Guillén N, Pérez-Millan A, Falgàs N, Borrego-Écija S, Fernández-Villullas G, Bosch B, Juncà-Parella J, Antonell A, Naranjo L, Ruiz-García R, Augé JM, Sánchez-Valle R, Lladó A, Balasa M. Impact of demographics and comorbid conditions on plasma biomarkers concentrations and their diagnostic accuracy in a memory clinic cohort. J Neurol 2024; 271:1973-1984. [PMID: 38151575 DOI: 10.1007/s00415-023-12153-8] [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: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/29/2023]
Abstract
Plasma biomarkers have emerged as promising tools for identifying amyloid beta (Aβ) pathology. Before implementation in routine clinical practice, confounding factors modifying their concentration beyond neurodegenerative diseases should be identified. We studied the association of a comprehensive list of demographics, comorbidities, medication and laboratory parameters with plasma p-tau181, glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) on a prospective memory clinic cohort and studied their impact on diagnostic accuracy for discriminating CSF/amyloid PET-defined Aβ status. Three hundred sixty patients (mean age 66.5 years, 55% females, 53% Aβ positive) were included. Sex, age and Aβ status-adjusted models showed that only estimated glomerular filtration rate (eGFR, standardized β -0.115 [-0.192 to -0.035], p = 0.005) was associated with p-tau181 levels, although with a much smaller effect than Aβ status (0.685 [0.607-0.763], p < 0.001). Age, sex, body mass index (BMI), Charlson comorbidity index (CCI) and eGFR significantly modified GFAP concentration. Age, blood volume (BV) and eGFR were associated with NfL levels. p-tau181 predicted Aβ status with 87% sensitivity and specificity with no relevant increase in diagnostic performance by adding any of the confounding factors. Using two cut-offs, plasma p-tau181 could have spared 62% of amyloid-PET/CSF testing. Excluding patients with chronic kidney disease did not change the proposed cut-offs nor the diagnostic performance. In conclusion, in a memory clinic cohort, age, sex, eGFR, BMI, BV and CCI slightly modified plasma p-tau181, GFAP and NfL concentrations but their impact on the diagnostic accuracy of plasma biomarkers for Aβ status discrimination was minimal.
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Affiliation(s)
- Jordi Sarto
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Diana Esteller-Gauxax
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Adrià Tort-Merino
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Núria Guillén
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Agnès Pérez-Millan
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Neus Falgàs
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Sergi Borrego-Écija
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Guadalupe Fernández-Villullas
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Beatriz Bosch
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Jordi Juncà-Parella
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Anna Antonell
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
| | - Laura Naranjo
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Ruiz-García
- Immunology Service, Biomedical Diagnostic Center, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Josep María Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Raquel Sánchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Albert Lladó
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Mircea Balasa
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Fundació de Recerca Clínic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Villaroel 170, 08036, Barcelona, Spain.
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Mattke S, Tang Y, Hanson M. Expected wait times for access to a disease-modifying Alzheimer's treatment in England: A modelling study. J Health Serv Res Policy 2024; 29:69-75. [PMID: 37931615 DOI: 10.1177/13558196231211141] [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] [Indexed: 11/08/2023]
Abstract
OBJECTIVES We previously analysed the preparedness to deliver a disease-modifying Alzheimer's treatment in the United Kingdom and predicted substantial wait times. This study updates the prediction for the National Health Service (NHS) in England, using an improved model and newer data. METHODS We reviewed published data on capacity for diagnosis of cognitive impairment combined with expert input and constructed a model for wait times to access from 2023 to 2043. The model tracks patients from initial evaluation in primary care, cognitive testing by a dementia specialist, confirmatory biomarker testing with positron emission tomography (PET) scans or examination of cerebrospinal fluid and infusion delivery. Capacity for specialist visits and PET scans are assumed to be capacity constrained, and cerebrospinal fluid testing and infusion delivery to be scalable. RESULTS Capacity constraints were projected to result in substantial wait times: patients referred to specialists based on a brief cognitive test, which is the current standard of care, would expect an overall initial wait times of 56 months in 2023, increasing to 129 months in 2029 and then falling slowly to around 100 months. Use of a blood test for the confirmation of Alzheimer's pathology as an additional triage step, would reduce wait times to around 17 to 25 months. DISCUSSION The NHS England lacks capacity to provide timely access to a disease-modifying treatment, which is estimated to result in significant wait times and potentially avoidable disease progression. Better diagnostic tools at initial evaluation may reduce delays.
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Affiliation(s)
- Soeren Mattke
- University of Southern California, Los Angeles, CA, United States
| | - Yu Tang
- University of Southern California, Los Angeles, CA, United States
| | - Mark Hanson
- University of Southern California, Los Angeles, CA, United States
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35
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Shan C, Zhang C, Zhang C. The Role of IL-6 in Neurodegenerative Disorders. Neurochem Res 2024; 49:834-846. [PMID: 38227113 DOI: 10.1007/s11064-023-04085-6] [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: 10/11/2023] [Revised: 11/26/2023] [Accepted: 12/08/2023] [Indexed: 01/17/2024]
Abstract
"Neurodegenerative disorder" is an umbrella term for a group of fatal progressive neurological illnesses characterized by neuronal loss and inflammation. Interleukin-6 (IL-6), a pleiotropic cytokine, significantly affects the activities of nerve cells and plays a pivotal role in neuroinflammation. Furthermore, as high levels of IL-6 have been frequently observed in association with several neurodegenerative disorders, it may potentially be used as a biomarker for the progression and prognosis of these diseases. This review summarizes the production and function of IL-6 as well as its downstream signaling pathways. Moreover, we make a comprehensive review on the roles of IL-6 in neurodegenerative disorders and its potential clinical application.
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Affiliation(s)
- Chen Shan
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, People's Republic of China
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Chao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, People's Republic of China.
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
| | - Chuanbao Zhang
- National Center for Clinical Laboratories, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing Hospital/National Center of Gerontology, Beijing, People's Republic of China.
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
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Therriault J, Ashton NJ, Pola I, Triana-Baltzer G, Brum WS, Di Molfetta G, Arslan B, Rahmouni N, Tissot C, Servaes S, Stevenson J, Macedo AC, Pascoal TA, Kolb HC, Jeromin A, Blennow K, Zetterberg H, Rosa-Neto P, Benedet AL. Comparison of two plasma p-tau217 assays to detect and monitor Alzheimer's pathology. EBioMedicine 2024; 102:105046. [PMID: 38471397 PMCID: PMC10943661 DOI: 10.1016/j.ebiom.2024.105046] [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: 09/14/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Blood-based biomarkers of Alzheimer's disease (AD) have become increasingly important as scalable tools for diagnosis and determining clinical trial eligibility. P-tau217 is the most promising due to its excellent sensitivity and specificity for AD-related pathological changes. METHODS We compared the performance of two commercially available plasma p-tau217 assays (ALZpath p-tau217 and Janssen p-tau217+) in 294 individuals cross-sectionally. Correlations with amyloid PET and tau PET were assessed, and Receiver Operating Characteristic (ROC) analyses evaluated both p-tau217 assays for identifying AD pathology. FINDINGS Both plasma p-tau217 assays were strongly associated with amyloid and tau PET. Furthermore, both plasma p-tau217 assays identified individuals with AD vs other neurodegenerative diseases (ALZpath AUC = 0.95; Janssen AUC = 0.96). Additionally, plasma p-tau217 concentrations rose with AD severity and their annual changes correlated with tau PET annual change. INTERPRETATION Both p-tau217 assays had excellent diagnostic performance for AD. Our study supports the future clinical use of commercially-available assays for p-tau217. FUNDING This research is supported by the Weston Brain Institute, Canadian Institutes of Health Research (CIHR), Canadian Consortium on Neurodegeneration in Aging, the Alzheimer's Association, Brain Canada Foundation, the Fonds de Recherche du Québec - Santé and the Colin J. Adair Charitable Foundation.
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Affiliation(s)
- Joseph Therriault
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Nicholas James Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden; Wallenberg Centre for Molecular Medicine, University of Gothenburg, Gothenburg 6 431 41, Sweden; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London SE5 9RT, UK; NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London SE5 8AF, UK
| | - Ilaria Pola
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden
| | | | - Wagner Scheeren Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden
| | - Burak Arslan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden
| | - Nesrine Rahmouni
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Cecile Tissot
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Stijn Servaes
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Jenna Stevenson
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Arthur Cassa Macedo
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Tharick Ali Pascoal
- Department of Neurology and Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh 15213, USA
| | | | | | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 6 431 41, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden; Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 6 431 41, Sweden; Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK; UK Dementia Research Institute at UCL, London SE5 9RT, UK; Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong 1512, China; Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53792, USA
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, Le Centre Intégré Universitaire de Santé et de Services Sociaux (CIUSSS) de l'Ouest-de-l'Île-de-Montréal, Montréal, Québec H4H 1R3, Canada; Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec H3A 2B4, Canada
| | - Andrea Lessa Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Mölndal 6 431 41, Sweden.
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Carrillo MC, Mahinrad S. Navigating complexities of racial disparities in Alzheimer disease biomarkers. Nat Rev Neurol 2024; 20:205-206. [PMID: 38263247 DOI: 10.1038/s41582-024-00930-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
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Bellomo G, Bayoumy S, Megaro A, Toja A, Nardi G, Gaetani L, Blujdea ER, Paolini Paoletti F, Wojdaƚa AL, Chiasserini D, van der Flier WM, Verberk IMW, Teunissen C, Parnetti L. Fully automated measurement of plasma Aβ42/40 and p-tau181: Analytical robustness and concordance with cerebrospinal fluid profile along the Alzheimer's disease continuum in two independent cohorts. Alzheimers Dement 2024; 20:2453-2468. [PMID: 38323780 PMCID: PMC11032583 DOI: 10.1002/alz.13687] [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: 10/02/2023] [Revised: 11/30/2023] [Accepted: 12/16/2023] [Indexed: 02/08/2024]
Abstract
INTRODUCTION For routine clinical implementation of Alzheimer's disease (AD) plasma biomarkers, fully automated random-access platforms are crucial to ensure reproducible measurements. We aimed to perform an analytical validation and to establish cutoffs for AD plasma biomarkers measured with Lumipulse. METHODS Two cohorts were included. UNIPG: n = 450 paired cerebrospinal fluid (CSF)/plasma samples from subjects along the AD-continuum, subjects affected by other neurodegenerative diseases, and controls with known CSF profile; AMS: n = 40 plasma samples from AD and n = 40 controls. Plasma amyloid β (Aβ)42, Aβ40, and p-tau181 were measured with Lumipulse. We evaluated analytical and diagnostic performance. RESULTS Lumipulse assays showed high analytical performance. Plasma p-tau181 levels accurately reflected CSF A+/T+ profile in AD-dementia and mild cognitive impairment (MCI)-AD, but not in asymptomatic-AD. Plasma and CSF Aβ42/40 values were concordant across clinical AD stages. Cutoffs and probability-based models performed satisfactorily in both cohorts. DISCUSSION The identified cutoffs and probability-based models represent a significant step toward plasma AD molecular diagnosis.
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Affiliation(s)
- Giovanni Bellomo
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Sherif Bayoumy
- Neurochemistry LaboratoryDepartment of Laboratory MedicineAmsterdam Neuroscience, Amsterdam UMCAmsterdamThe Netherlands
| | - Alfredo Megaro
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Andrea Toja
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Giovanna Nardi
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Lorenzo Gaetani
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Elena R. Blujdea
- Neurochemistry LaboratoryDepartment of Laboratory MedicineAmsterdam Neuroscience, Amsterdam UMCAmsterdamThe Netherlands
| | - Federico Paolini Paoletti
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Anna Lidia Wojdaƚa
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Davide Chiasserini
- Section of BiochemistryDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
| | - Wiesje M. van der Flier
- Alzheimer CenterDepartment of NeurologyVrije Universiteit Amsterdam, Amsterdam UMCAmsterdamThe Netherlands
- Department of Epidemiology and Data ScienceVrije Universiteit AmsterdamAmsterdam UMCAmsterdamThe Netherlands
| | - Inge M. W. Verberk
- Neurochemistry LaboratoryDepartment of Laboratory MedicineAmsterdam Neuroscience, Amsterdam UMCAmsterdamThe Netherlands
| | - Charlotte Teunissen
- Neurochemistry LaboratoryDepartment of Laboratory MedicineAmsterdam Neuroscience, Amsterdam UMCAmsterdamThe Netherlands
| | - Lucilla Parnetti
- Center for Memory DisturbancesLab of Clinical NeurochemistrySection of NeurologyDepartment of Medicine and SurgeryUniversity of PerugiaPerugiaItaly
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Colvee-Martin H, Parra JR, Gonzalez GA, Barker W, Duara R. Neuropathology, Neuroimaging, and Fluid Biomarkers in Alzheimer's Disease. Diagnostics (Basel) 2024; 14:704. [PMID: 38611617 PMCID: PMC11012058 DOI: 10.3390/diagnostics14070704] [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: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/17/2024] [Indexed: 04/14/2024] Open
Abstract
An improved understanding of the pathobiology of Alzheimer's disease (AD) should lead ultimately to an earlier and more accurate diagnosis of AD, providing the opportunity to intervene earlier in the disease process and to improve outcomes. The known hallmarks of Alzheimer's disease include amyloid-β plaques and neurofibrillary tau tangles. It is now clear that an imbalance between production and clearance of the amyloid beta protein and related Aβ peptides, especially Aβ42, is a very early, initiating factor in Alzheimer's disease (AD) pathogenesis, leading to aggregates of hyperphosphorylation and misfolded tau protein, inflammation, and neurodegeneration. In this article, we review how the AD diagnostic process has been transformed in recent decades by our ability to measure these various elements of the pathological cascade through the use of imaging and fluid biomarkers. The more recently developed plasma biomarkers, especially phosphorylated-tau217 (p-tau217), have utility for screening and diagnosis of the earliest stages of AD. These biomarkers can also be used to measure target engagement by disease-modifying therapies and the response to treatment.
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Affiliation(s)
- Helena Colvee-Martin
- Wien Center for Alzheimer’s Disease & Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA; (H.C.-M.); (W.B.)
| | - Juan Rayo Parra
- Human & Molecular Genetics, Florida International University, Miami, FL 33199, USA; (J.R.P.); (G.A.G.)
| | - Gabriel Antonio Gonzalez
- Human & Molecular Genetics, Florida International University, Miami, FL 33199, USA; (J.R.P.); (G.A.G.)
| | - Warren Barker
- Wien Center for Alzheimer’s Disease & Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA; (H.C.-M.); (W.B.)
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease & Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA; (H.C.-M.); (W.B.)
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Silva-Spínola A, Leitão MJ, Nadal A, Le Bastard N, Santana I, Baldeiras I. Exploring the potential of fully automated LUMIPULSE G plasma assays for detecting Alzheimer's disease pathology. Alzheimers Res Ther 2024; 16:51. [PMID: 38454502 PMCID: PMC10918996 DOI: 10.1186/s13195-024-01397-9] [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: 07/25/2023] [Accepted: 01/26/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND LUMIPULSE G-automated immunoassays represent a widely used method for the quantification of Alzheimer's disease (AD) biomarkers in the cerebrospinal fluid (CSF). Less invasive blood-based markers confer a promising tool for AD diagnosis at prodromal stages (mild cognitive impairment (MCI)). Highly sensitive assays for the quantification of amyloid-beta (Aβ) and phosphorylated Tau-181 (p-Tau181) in the blood are showing promising results. In this study, we evaluated the clinical performance of the recently available fully automated LUMIPULSE plasma marker assays for detecting brain AD pathology and for predicting progression from MCI to AD dementia stage. METHODS A retrospective exploratory cohort of 138 individuals (22 neurological controls [NC], 72 MCI, and 44 AD dementia patients) was included. Data regarding baseline CSF concentrations of Aβ42, Aβ40, t-Tau, and p-Tau181 was available and used to establish the presence of AD brain pathology. Baseline Aβ42, Aβ40, and p-Tau181 concentrations were determined in stored plasma samples using high-throughput fully automated LUMIPULSE assays. Progression from MCI to AD dementia was evaluated during follow-up (mean 6.4 ± 2.5 years). Moreover, a prospective validation cohort of 72 individuals with memory complaints underwent AD biomarker quantification, closely mirroring typical clinical practice. This cohort aimed to confirm the study's main findings. RESULTS In the exploratory cohort, correlations between CSF and plasma were moderate for p-Tau181 (ρ = 0.61, p < 0.001) and weak for Aβ42/Aβ40 ratio (ρ = 0.39, p < 0.001). Plasma p-Tau181 and p-Tau181/Aβ42 concentrations were significantly increased while Aβ42/Aβ40 was significantly decreased (p < 0.001) in patients with AD dementia and prodromal AD, as well as in individuals with CSF abnormal amyloid concentrations (A +). Plasma p-Tau181 showed a robust performance in differentiating patients clinically diagnosed as AD (AUC = 0.89; 95% CI 0.83-0.94); A + vs. A - (AUC = 0.84, 95% CI 0.77-0.91) and also in predicting conversion to AD dementia in MCI patients (AUC = 0.89, 95% CI 0.81-0.96). When tested in the validation cohort, plasma p-Tau181 displayed 83.3% of the overall percentage of agreement according to amyloid status. CONCLUSIONS Our results show that the measurement of p-Tau181 in plasma has great potential as a non-invasive prognostic screening tool for implementation in a clinical setting.
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Affiliation(s)
- Anuschka Silva-Spínola
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.
- Centre for Informatics and Systems, Department of Informatics Engineering, University of Coimbra, Coimbra, Portugal.
- Neurochemistry Laboratory, Neurology Department, Coimbra University Hospital, Praceta Mota Pinto, 3004-561, Coimbra, Portugal.
| | - Maria João Leitão
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Neurochemistry Laboratory, Neurology Department, Coimbra University Hospital, Praceta Mota Pinto, 3004-561, Coimbra, Portugal
| | | | | | - Isabel Santana
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Neurology Department, Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal
| | - Inês Baldeiras
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
- Neurochemistry Laboratory, Neurology Department, Coimbra University Hospital, Praceta Mota Pinto, 3004-561, Coimbra, Portugal
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Chen Y, Zeng X, Lee J, Sehrawat A, Lafferty TK, Boslett JJ, Klunk WE, Pascoal TA, Villemagne VL, Cohen AD, Lopez O, Yates NA, Karikari TK. Effect of blood collection tube containing protease inhibitors on the pre-analytical stability of Alzheimer's disease plasma biomarkers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.05.24303504. [PMID: 38496591 PMCID: PMC10942510 DOI: 10.1101/2024.03.05.24303504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
INTRODUCTION The reliability of plasma Alzheimer's disease (AD) biomarkers can be compromised by protease-induced degradation. This limits the feasibility of conducting plasma biomarker studies in environments that lack the capacity for immediate processing and appropriate storage of blood samples. We hypothesized that blood collection tube supplementation with protease inhibitors can improve the stability of plasma biomarkers at room temperatures (RT). This study conducted a comparative analysis of blood biomarker stability in traditional ethylenediaminetetraacetic acid (EDTA) tubes versus BD™ P100 collection tubes, the latter being coated with a protease inhibitor cocktail. The stability of six plasma AD biomarkers was evaluated over time under RT conditions. METHODS We evaluated three experimental approaches. In Approach 1, pooled plasma samples underwent storage at RT for up to 96 hours. In Approach 2, plasma samples isolated upfront from whole blood collected into EDTA or P100 tubes were stored at RT for 0h or 24h before biomarker measurements. In Approach 3, whole blood samples were collected into paired EDTA or P100 tubes, followed by storage at RT for 0h or 24h before isolating the plasma for analyses. Biomarkers were measured with Single Molecule Array (Simoa) and immunoprecipitation-mass spectrometry (IP-MS) assays. RESULTS Both the IP-MS and Simoa methods revealed that the use of P100 tubes significantly improved the stability of Aβ42 and Aβ40 across all approaches. Additionally, the Aβ42/Aβ40 ratio levels were significantly stabilized only in the IP-MS assay in Approach 3. No significant differences were observed in the levels of plasma p-tau181, GFAP, and NfL for samples collected using either tube type in any of the approaches. CONCLUSION Supplementation of blood collection tubes with protease inhibitors could reduce the protease-induced degradation of plasma Aβ42 and Aβ40, and the Aβ ratio for IP-MS assay. This has crucial implications for preanalytical procedures, particularly in resource-limited settings.
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Nihashi T, Sakurai K, Kato T, Kimura Y, Ito K, Nakamura A, Terasawa T. Blood levels of glial fibrillary acidic protein for predicting clinical progression to Alzheimer's disease in adults without dementia: a systematic review and meta-analysis protocol. Diagn Progn Res 2024; 8:4. [PMID: 38439065 PMCID: PMC10913586 DOI: 10.1186/s41512-024-00167-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/02/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND There is urgent clinical need to identify reliable prognostic biomarkers that predict the progression of dementia symptoms in individuals with early-phase Alzheimer's disease (AD) especially given the research on and predicted applications of amyloid-beta (Aβ)-directed immunotherapies to remove Aβ from the brain. Cross-sectional studies have reported higher levels of cerebrospinal fluid and blood glial fibrillary acidic protein (GFAP) in individuals with AD-associated dementia than in cognitively unimpaired individuals. Further, recent longitudinal studies have assessed the prognostic potential of baseline blood GFAP levels as a predictor of future cognitive decline in cognitively unimpaired individuals and in those with mild cognitive impairment (MCI) due to AD. In this systematic review and meta-analysis, we propose analyzing longitudinal studies on blood GFAP levels to predict future cognitive decline. METHODS This study will include prospective and retrospective cohort studies that assessed blood GFAP levels as a prognostic factor and any prediction models that incorporated blood GFAP levels in cognitively unimpaired individuals or those with MCI. The primary outcome will be conversion to MCI or AD in cognitively unimpaired individuals or conversion to AD in individuals with MCI. Articles from PubMed and Embase will be extracted up to December 31, 2023, without language restrictions. An independent dual screening of abstracts and potentially eligible full-text reports will be conducted. Data will be dual-extracted using the CHeck list for critical appraisal, data extraction for systematic Reviews of prediction Modeling Studies (CHARMS)-prognostic factor, and CHARMS checklists, and we will dual-rate the risk of bias and applicability using the Quality In Prognosis Studies and Prediction Study Risk-of-Bias Assessment tools. We will qualitatively synthesize the study data, participants, index biomarkers, predictive model characteristics, and clinical outcomes. If appropriate, random-effects meta-analyses will be performed to obtain summary estimates. Finally, we will assess the body of evidence using the Grading of Recommendation, Assessment, Development, and Evaluation Approach. DISCUSSION This systematic review and meta-analysis will comprehensively evaluate and synthesize existing evidence on blood GFAP levels for prognosticating presymptomatic individuals and those with MCI to help advance risk-stratified treatment strategies for early-phase AD. TRIAL REGISTRATION PROSPERO CRD42023481200.
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Affiliation(s)
- Takashi Nihashi
- Department of Radiology, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
| | - Keita Sakurai
- Department of Radiology, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Takashi Kato
- Department of Radiology, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Yasuyuki Kimura
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Kengo Ito
- National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Akinori Nakamura
- Department of Biomarker Research, National Center for Geriatrics and Gerontology, 7-430 Morioka-cho, Obu, Aichi, 474-8511, Japan
- Department of Clinical and Experimental Neuroimaging, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Teruhiko Terasawa
- Section of General Internal Medicine, Department of Emergency Medicine and General Internal Medicine, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-Cho, Toyoake, Aichi, 470-1192, Japan.
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De Meyer S, Blujdea ER, Schaeverbeke J, Reinartz M, Luckett ES, Adamczuk K, Van Laere K, Dupont P, Teunissen CE, Vandenberghe R, Poesen K. Longitudinal associations of serum biomarkers with early cognitive, amyloid and grey matter changes. Brain 2024; 147:936-948. [PMID: 37787146 DOI: 10.1093/brain/awad330] [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: 04/01/2023] [Revised: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 10/04/2023] Open
Abstract
Blood-based biomarkers have been extensively evaluated for their diagnostic potential in Alzheimer's disease. However, their relative prognostic and monitoring capabilities for cognitive decline, amyloid-β (Aβ) accumulation and grey matter loss in cognitively unimpaired elderly require further investigation over extended time periods. This prospective cohort study in cognitively unimpaired elderly [n = 185, mean age (range) = 69 (53-84) years, 48% female] examined the prognostic and monitoring capabilities of glial fibrillary acidic protein (GFAP), neurofilament light (NfL), Aβ1-42/Aβ1-40 and phosphorylated tau (pTau)181 through their quantification in serum. All participants underwent baseline Aβ-PET, MRI and blood sampling as well as 2-yearly cognitive testing. A subset additionally underwent Aβ-PET (n = 109), MRI (n = 106) and blood sampling (n = 110) during follow-up [median time interval (range) = 6.1 (1.3-11.0) years]. Matching plasma measurements were available for Aβ1-42/Aβ1-40 and pTau181 (both n = 140). Linear mixed-effects models showed that high serum GFAP and NfL predicted future cognitive decline in memory (βGFAP×Time = -0.021, PFDR = 0.007 and βNfL×Time = -0.031, PFDR = 0.002) and language (βGFAP×Time = -0.021, PFDR = 0.002 and βNfL×Time = -0.018, PFDR = 0.03) domains. Low serum Aβ1-42/Aβ1-40 equally but independently predicted memory decline (βAβ1-42/Aβ1-40×Time = -0.024, PFDR = 0.02). Whole-brain voxelwise analyses revealed that low Aβ1-42/Aβ1-40 predicted Aβ accumulation within the precuneus and frontal regions, high GFAP and NfL predicted grey matter loss within hippocampal regions and low Aβ1-42/Aβ1-40 predicted grey matter loss in lateral temporal regions. Serum GFAP, NfL and pTau181 increased over time, while Aβ1-42/Aβ1-40 decreased only in Aβ-PET-negative elderly. NfL increases associated with declining memory (βNfLchange×Time = -0.030, PFDR = 0.006) and language (βNfLchange×Time = -0.021, PFDR = 0.02) function and serum Aβ1-42/Aβ1-40 decreases associated with declining language function (βAβ1-42/Aβ1-40×Time = -0.020, PFDR = 0.04). GFAP increases associated with Aβ accumulation within the precuneus and NfL increases associated with grey matter loss. Baseline and longitudinal serum pTau181 only associated with Aβ accumulation in restricted occipital regions. In head-to-head comparisons, serum outperformed plasma Aβ1-42/Aβ1-40 (ΔAUC = 0.10, PDeLong, FDR = 0.04), while both plasma and serum pTau181 demonstrated poor performance to detect asymptomatic Aβ-PET positivity (AUC = 0.55 and 0.63, respectively). However, when measured with a more phospho-specific assay, plasma pTau181 detected Aβ-positivity with high performance (AUC = 0.82, PDeLong, FDR < 0.007). In conclusion, serum GFAP, NfL and Aβ1-42/Aβ1-40 are valuable prognostic and/or monitoring tools in asymptomatic stages providing complementary information in a time- and pathology-dependent manner.
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Affiliation(s)
- Steffi De Meyer
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Elena R Blujdea
- Neurochemistry Laboratory, Amsterdam UMC, 1081 HZ Amsterdam, The Netherlands
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Mariska Reinartz
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Emma S Luckett
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
| | - Katarzyna Adamczuk
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
| | - Koen Van Laere
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
- Nuclear Medicine and Molecular Imaging, Department of Imaging and Pathology, KU Leuven, 3000 Leuven, Belgium
- Division of Nuclear Medicine, UZ Leuven, 3000 Leuven, Belgium
| | - Patrick Dupont
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
| | | | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
- Department of Neurology, UZ Leuven, 3000 Leuven, Belgium
| | - Koen Poesen
- Laboratory for Molecular Neurobiomarker Research, Department of Neurosciences, KU Leuven, 3000 Leuven, Belgium
- Alzheimer Research Centre, Leuven Brain Institute (LBI), KU Leuven, 3000 Leuven, Belgium
- Department of Laboratory Medicine, UZ Leuven, 3000 Leuven, Belgium
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Jiang Y, Uhm H, Ip FC, Ouyang L, Lo RMN, Cheng EYL, Cao X, Tan CMC, Law BCH, Ortiz‐Romero P, Puig‐Pijoan A, Fernández‐Lebrero A, Contador J, Mok KY, Hardy J, Kwok TCY, Mok VCT, Suárez‐Calvet M, Zetterberg H, Fu AKY, Ip NY. A blood-based multi-pathway biomarker assay for early detection and staging of Alzheimer's disease across ethnic groups. Alzheimers Dement 2024; 20:2000-2015. [PMID: 38183344 PMCID: PMC10984431 DOI: 10.1002/alz.13676] [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: 10/05/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Existing blood-based biomarkers for Alzheimer's disease (AD) mainly focus on its pathological features. However, studies on blood-based biomarkers associated with other biological processes for a comprehensive evaluation of AD status are limited. METHODS We developed a blood-based, multiplex biomarker assay for AD that measures the levels of 21 proteins involved in multiple biological pathways. We evaluated the assay's performance for classifying AD and indicating AD-related endophenotypes in three independent cohorts from Chinese or European-descent populations. RESULTS The 21-protein assay accurately classified AD (area under the receiver operating characteristic curve [AUC] = 0.9407 to 0.9867) and mild cognitive impairment (MCI; AUC = 0.8434 to 0.8945) while also indicating brain amyloid pathology. Moreover, the assay simultaneously evaluated the changes of five biological processes in individuals and revealed the ethnic-specific dysregulations of biological processes upon AD progression. DISCUSSION This study demonstrated the utility of a blood-based, multi-pathway biomarker assay for early screening and staging of AD, providing insights for patient stratification and precision medicine. HIGHLIGHTS The authors developed a blood-based biomarker assay for Alzheimer's disease. The 21-protein assay classifies AD/MCI and indicates brain amyloid pathology. The 21-protein assay can simultaneously assess activities of five biological processes. Ethnic-specific dysregulations of biological processes in AD were revealed.
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Affiliation(s)
- Yuanbing Jiang
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
| | - Hyebin Uhm
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
| | - Fanny C. Ip
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Li Ouyang
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Ronnie M. N. Lo
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Elaine Y. L. Cheng
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Xiaoyun Cao
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Clara M. C. Tan
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Brian C. H. Law
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
| | - Paula Ortiz‐Romero
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
| | - Albert Puig‐Pijoan
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- Medicine DepartmentUniversitat Autònoma de BarcelonaBarcelonaSpain
- ERA‐Net on Cardiovascular Diseases (ERA‐CVD) ConsortiumBarcelonaSpain
| | - Aida Fernández‐Lebrero
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- ERA‐Net on Cardiovascular Diseases (ERA‐CVD) ConsortiumBarcelonaSpain
- Department of Medicine and Life SciencesUniversitat Pompeu FabraBarcelonaSpain
| | - José Contador
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
| | - Kin Y. Mok
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
| | - John Hardy
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
- UK Dementia Research InstituteUniversity College LondonLondonUK
| | - Timothy C. Y. Kwok
- Therese Pei Fong Chow Research Centre for Prevention of DementiaDivision of GeriatricsDepartment of Medicine and TherapeuticsThe Chinese University of Hong Kong, ShatinHKSARChina
| | - Vincent C. T. Mok
- Lau Tat‐chuen Research Centre of Brain Degenerative Diseases in ChineseGerald Choa Neuroscience InstituteLui Che Woo Institute of Innovative MedicineLi Ka Shing Institute of Health SciencesDivision of NeurologyDepartment of Medicine and TherapeuticsThe Chinese University of Hong Kong, ShatinHKSARChina
| | - Marc Suárez‐Calvet
- Barcelonaβeta Brain Research Center (BBRC)Pasqual Maragall FoundationBarcelonaSpain
- Hospital del Mar Research InstituteBarcelonaSpain
- Cognitive Decline Unit, Department of NeurologyHospital Del MarBarcelonaSpain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES)MadridSpain
| | - Henrik Zetterberg
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Department of Neurodegenerative DiseaseQueen Square Institute of NeurologyUniversity College LondonLondonUK
- UK Dementia Research InstituteUniversity College LondonLondonUK
- Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiologythe Sahlgrenska Academy at the University of GothenburgGothenburgSweden
- Clinical Neurochemistry LaboratorySahlgrenska University HospitalMölndalSweden
- Wisconsin Alzheimer's Disease Research CenterUniversity of Wisconsin School of Medicine and Public HealthUniversity of Wisconsin‐MadisonMadisonWisconsinUSA
| | - Amy K. Y. Fu
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
| | - Nancy Y. Ip
- Division of Life ScienceState Key Laboratory of Molecular Neuroscience, Molecular Neuroscience CenterThe Hong Kong University of Science and Technology, Clear Water Bay, KowloonHKSARChina
- Hong Kong Center for Neurodegenerative Diseases, InnoHKHKSARChina
- Guangdong Provincial Key Laboratory of Brain ScienceDisease and Drug DevelopmentHKUST Shenzhen Research InstituteShenzhenGuangdongChina
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Tsoy E, La Joie R, VandeVrede L, Rojas JC, Yballa C, Chan B, Lago AL, Rodriguez A, Goode CA, Erlhoff SJ, Tee BL, Windon C, Lanata S, Kramer JH, Miller BL, Dilworth‐Anderson P, Boxer AL, Rabinovici GD, Possin KL. Scalable plasma and digital cognitive markers for diagnosis and prognosis of Alzheimer's disease and related dementias. Alzheimers Dement 2024; 20:2089-2101. [PMID: 38224278 PMCID: PMC10942726 DOI: 10.1002/alz.13686] [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: 09/01/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION With emergence of disease-modifying therapies, efficient diagnostic pathways are critically needed to identify treatment candidates, evaluate disease severity, and support prognosis. A combination of plasma biomarkers and brief digital cognitive assessments could provide a scalable alternative to current diagnostic work-up. METHODS We examined the accuracy of plasma biomarkers and a 10-minute supervised tablet-based cognitive assessment (Tablet-based Cognitive Assessment Tool Brain Health Assessment [TabCAT-BHA]) in predicting amyloid β positive (Aβ+) status on positron emission tomography (PET), concurrent disease severity, and functional decline in 309 older adults with subjective cognitive impairment (n = 49), mild cognitive impairment (n = 159), and dementia (n = 101). RESULTS Combination of plasma pTau181, Aβ42/40, neurofilament light (NfL), and TabCAT-BHA was optimal for predicting Aβ-PET positivity (AUC = 0.962). Whereas NfL and TabCAT-BHA optimally predicted concurrent disease severity, combining these with pTau181 and glial fibrillary acidic protein was most accurate in predicting functional decline. DISCUSSION Combinations of plasma and digital cognitive markers show promise for scalable diagnosis and prognosis of ADRD. HIGHLIGHTS The need for cost-efficient diagnostic and prognostic markers of AD is urgent. Plasma and digital cognitive markers provide complementary diagnostic contributions. Combination of these markers holds promise for scalable diagnosis and prognosis. Future validation in community cohorts is needed to inform clinical implementation.
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Affiliation(s)
- Elena Tsoy
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Renaud La Joie
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lawren VandeVrede
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Julio C. Rojas
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Claire Yballa
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Brandon Chan
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Argentina Lario Lago
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Anne‐Marie Rodriguez
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Collette A. Goode
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Sabrina J. Erlhoff
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Boon Lead Tee
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Charles Windon
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Serggio Lanata
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Bruce L. Miller
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Peggye Dilworth‐Anderson
- Department of Health Policy and ManagementGillings School of Global Public HealthUniversity of North Carolina Chapel HillChapel HillCaliforniaUSA
| | - Adam L. Boxer
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Gil D. Rabinovici
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Katherine L. Possin
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Global Brain Health InstituteUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Frisoni GB, Festari C, Massa F, Cotta Ramusino M, Orini S, Aarsland D, Agosta F, Babiloni C, Borroni B, Cappa SF, Frederiksen KS, Froelich L, Garibotto V, Haliassos A, Jessen F, Kamondi A, Kessels RP, Morbelli SD, O'Brien JT, Otto M, Perret-Liaudet A, Pizzini FB, Vandenbulcke M, Vanninen R, Verhey F, Vernooij MW, Yousry T, Boada Rovira M, Dubois B, Georges J, Hansson O, Ritchie CW, Scheltens P, van der Flier WM, Nobili F. European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders. Lancet Neurol 2024; 23:302-312. [PMID: 38365381 DOI: 10.1016/s1474-4422(23)00447-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 02/18/2024]
Abstract
The recent commercialisation of the first disease-modifying drugs for Alzheimer's disease emphasises the need for consensus recommendations on the rational use of biomarkers to diagnose people with suspected neurocognitive disorders in memory clinics. Most available recommendations and guidelines are either disease-centred or biomarker-centred. A European multidisciplinary taskforce consisting of 22 experts from 11 European scientific societies set out to define the first patient-centred diagnostic workflow that aims to prioritise testing for available biomarkers in individuals attending memory clinics. After an extensive literature review, we used a Delphi consensus procedure to identify 11 clinical syndromes, based on clinical history and examination, neuropsychology, blood tests, structural imaging, and, in some cases, EEG. We recommend first-line and, if needed, second-line testing for biomarkers according to the patient's clinical profile and the results of previous biomarker findings. This diagnostic workflow will promote consistency in the diagnosis of neurocognitive disorders across European countries.
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Affiliation(s)
- Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland; Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology and Dementia Research Center (DRC), IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Orini
- Alzheimer's Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Dag Aarsland
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway; UK Dementia Research Institute, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele of Cassino, Cassino, Italy
| | - Barbara Borroni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Continuity of Care and Frailty, ASST Spedali Civili, Brescia, Italy
| | - Stefano F Cappa
- Centro Ricerca sulle Demenze, IRCCS Mondino Foundation, Pavia, Italy; University Institute for Advanced Studies (IUSS), Pavia, Italy
| | - Kristian S Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | | | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Anita Kamondi
- National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary; Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Roy Pc Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands; Radboud UMC Alzheimer Center and Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands; Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Silvia D Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Markus Otto
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Francesca B Pizzini
- Department of Diagnostic and Public Health, Verona University Hospital, Verona University, Verona, Italy
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Ritva Vanninen
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology-Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology and Department of Radiology and Nuclear Medicine Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Tarek Yousry
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Mercè Boada Rovira
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Bruno Dubois
- Institut de La Mémoire et de La Maladie d'Alzheimer, Neurology Department, Salpêtrière Hospital, Assistance Publique-Hôpital de Paris, Paris, France; Sorbonne University, Paris, France
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, UK; Brain Health Scotland, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands; Amsterdam Neuroscience-Neurodegeneration, Amsterdam, Netherlands; Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Netherlands
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Mazzeo S, Ingannato A, Giacomucci G, Bagnoli S, Cavaliere A, Moschini V, Balestrini J, Morinelli C, Galdo G, Emiliani F, Piazzesi D, Crucitti C, Frigerio D, Polito C, Berti V, Padiglioni S, Sorbi S, Nacmias B, Bessi V. The role of plasma neurofilament light chain and glial fibrillary acidic protein in subjective cognitive decline and mild cognitive impairment. Neurol Sci 2024; 45:1031-1039. [PMID: 37723371 PMCID: PMC10857957 DOI: 10.1007/s10072-023-07065-4] [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: 06/28/2023] [Accepted: 09/06/2023] [Indexed: 09/20/2023]
Abstract
INTRODUCTION AND AIM NfL and GFAP are promising blood-based biomarkers for Alzheimer's disease. However, few studies have explored plasma GFAP in the prodromal and preclinical stages of AD. In our cross-sectional study, our aim is to investigate the role of these biomarkers in the earliest stages of AD. MATERIALS AND METHODS We enrolled 40 patients (11 SCD, 21 MCI, 8 AD dementia). All patients underwent neurological and neuropsychological examinations, analysis of CSF biomarkers (Aβ42, Aβ42/Aβ40, p-tau, t-tau), Apolipoprotein E (APOE) genotype analysis and measurement of plasma GFAP and NfL concentrations. Patients were categorized according to the ATN system as follows: normal AD biomarkers (NB), carriers of non-Alzheimer's pathology (non-AD), prodromal AD, or AD with dementia (AD-D). RESULTS GFAP was lower in NB compared to prodromal AD (p = 0.003, d = 1.463) and AD-D (p = 0.002, d = 1.695). NfL was lower in NB patients than in AD-D (p = 0.011, d = 1.474). NfL demonstrated fair accuracy (AUC = 0.718) in differentiating between NB and prodromal AD, with a cut-off value of 11.65 pg/mL. GFAP showed excellent accuracy in differentiating NB from prodromal AD (AUC = 0.901) with a cut-off level of 198.13 pg/mL. CONCLUSIONS GFAP exhibited excellent accuracy in distinguishing patients with normal CSF biomarkers from those with prodromal AD. Our results support the use of this peripheral biomarker for detecting AD in patients with subjective and objective cognitive decline.
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Affiliation(s)
- Salvatore Mazzeo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Assunta Ingannato
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Giulia Giacomucci
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Silvia Bagnoli
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Arianna Cavaliere
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Valentina Moschini
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Juri Balestrini
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Carmen Morinelli
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Giulia Galdo
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Filippo Emiliani
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Diletta Piazzesi
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Chiara Crucitti
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | - Daniele Frigerio
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
| | | | - Valentina Berti
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, 50134, Florence, Italy
| | - Sonia Padiglioni
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- Regional Referral Centre for Relational Criticalities- 50139, Tuscany Region, Italy
| | - Sandro Sorbi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | - Benedetta Nacmias
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy.
- IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy.
| | - Valentina Bessi
- Department of Neuroscience, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
- Research and Innovation Centre for Dementia-CRIDEM, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
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Sanchez E, Wilkinson T, Coughlan G, Mirza S, Baril A, Ramirez J, Binns MA, Black SE, Borrie M, Dilliott AA, Dixon RA, Dowlatshahi D, Farhan S, Finger E, Fischer CE, Frank A, Freedman M, Goncalves RA, Grimes DA, Hassan A, Hegele RA, Kumar S, Lang AE, Marras C, McLaughlin PM, Orange JB, Pasternak SH, Pollock BG, Rajji TK, Roberts AC, Robinson JF, Rogaeva E, Sahlas DJ, Saposnik G, Strong MJ, Swartz RH, Tang‐Wai DF, Tartaglia MC, Troyer AK, Kvartsberg H, Zetterberg H, Munoz DP, Masellis M. Association of plasma biomarkers with cognition, cognitive decline, and daily function across and within neurodegenerative diseases: Results from the Ontario Neurodegenerative Disease Research Initiative. Alzheimers Dement 2024; 20:1753-1770. [PMID: 38105605 PMCID: PMC10984487 DOI: 10.1002/alz.13560] [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: 06/29/2023] [Revised: 10/02/2023] [Accepted: 10/29/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION We investigated whether novel plasma biomarkers are associated with cognition, cognitive decline, and functional independence in activities of daily living across and within neurodegenerative diseases. METHODS Glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), phosphorylated tau (p-tau)181 and amyloid beta (Aβ)42/40 were measured using ultra-sensitive Simoa immunoassays in 44 healthy controls and 480 participants diagnosed with Alzheimer's disease/mild cognitive impairment (AD/MCI), Parkinson's disease (PD), frontotemporal dementia (FTD) spectrum disorders, or cerebrovascular disease (CVD). RESULTS GFAP, NfL, and/or p-tau181 were elevated among all diseases compared to controls, and were broadly associated with worse baseline cognitive performance, greater cognitive decline, and/or lower functional independence. While GFAP, NfL, and p-tau181 were highly predictive across diseases, p-tau181 was more specific to the AD/MCI cohort. Sparse associations were found in the FTD and CVD cohorts and for Aβ42/40 . DISCUSSION GFAP, NfL, and p-tau181 are valuable predictors of cognition and function across common neurodegenerative diseases, and may be useful in specialized clinics and clinical trials.
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49
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Sexton CE, Bitan G, Bowles KR, Brys M, Buée L, Maina MB, Clelland CD, Cohen AD, Crary JF, Dage JL, Diaz K, Frost B, Gan L, Goate AM, Golbe LI, Hansson O, Karch CM, Kolb HC, La Joie R, Lee SE, Matallana D, Miller BL, Onyike CU, Quiroz YT, Rexach JE, Rohrer JD, Rommel A, Sadri‐Vakili G, Schindler SE, Schneider JA, Sperling RA, Teunissen CE, Weninger SC, Worley SL, Zheng H, Carrillo MC. Novel avenues of tau research. Alzheimers Dement 2024; 20:2240-2261. [PMID: 38170841 PMCID: PMC10984447 DOI: 10.1002/alz.13533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION The pace of innovation has accelerated in virtually every area of tau research in just the past few years. METHODS In February 2022, leading international tau experts convened to share selected highlights of this work during Tau 2022, the second international tau conference co-organized and co-sponsored by the Alzheimer's Association, CurePSP, and the Rainwater Charitable Foundation. RESULTS Representing academia, industry, and the philanthropic sector, presenters joined more than 1700 registered attendees from 59 countries, spanning six continents, to share recent advances and exciting new directions in tau research. DISCUSSION The virtual meeting provided an opportunity to foster cross-sector collaboration and partnerships as well as a forum for updating colleagues on research-advancing tools and programs that are steadily moving the field forward.
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Affiliation(s)
| | - Gal Bitan
- Department of NeurologyDavid Geffen School of MedicineBrain Research InstituteMolecular Biology InstituteUniversity of California Los Angeles (UCLA)Los AngelesCaliforniaUSA
| | - Kathryn R. Bowles
- UK Dementia Research Institute at the University of EdinburghCentre for Discovery Brain SciencesUniversity of EdinburghEdinburghUK
| | | | - Luc Buée
- Univ LilleInsermCHU‐LilleLille Neuroscience and CognitionLabEx DISTALZPlace de VerdunLilleFrance
| | - Mahmoud Bukar Maina
- Sussex NeuroscienceSchool of Life SciencesUniversity of SussexFalmerUK
- Biomedical Science Research and Training CentreYobe State UniversityDamaturuNigeria
| | - Claire D. Clelland
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Ann D. Cohen
- University of PittsburghSchool of MedicineDepartment of Psychiatry and Alzheimer's disease Research CenterPittsburghPennsylvaniaUSA
| | - John F. Crary
- Departments of PathologyNeuroscience, and Artificial Intelligence & Human HealthIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Jeffrey L. Dage
- Department of NeurologyIndiana University School of MedicineIndianapolisIndianaUSA
| | | | - Bess Frost
- Sam & Ann Barshop Institute for Longevity & Aging Studies Glenn Biggs Institute for Alzheimer's & Neurodegenerative Disorders Department of Cell Systems and Anatomy University of Texas Health San AntonioSan AntonioTexasUSA
| | - Li Gan
- Helen and Robert Appel Alzheimer Disease Research InstituteFeil Family Brain and Mind Research InstituteWeill Cornell MedicineNew YorkNew YorkUSA
| | - Alison M Goate
- Department of Genetics & Genomic SciencesRonald M. Loeb Center for Alzheimer's diseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Lawrence I. Golbe
- CurePSPIncNew YorkNew YorkUSA
- Rutgers Robert Wood Johnson Medical SchoolNew BrunswickNew JerseyUSA
| | - Oskar Hansson
- Clinical Memory Research UnitDepartment of Clinical Sciences MalmöLund UniversityLundSweden
| | - Celeste M. Karch
- Department of PsychiatryWashington University in St. LouisSt. LouisMissouriUSA
| | | | - Renaud La Joie
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Suzee E. Lee
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Diana Matallana
- Aging InstituteNeuroscience ProgramPsychiatry DepartmentSchool of MedicinePontificia Universidad JaverianaBogotáColombia
- Mental Health DepartmentHospital Universitario Fundaciòn Santa FeBogotaColombia
| | - Bruce L. Miller
- Memory and Aging CenterDepartment of NeurologyWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Chiadi U. Onyike
- Division of Geriatric Psychiatry and NeuropsychiatryJohns Hopkins University School of MedicineBaltimoreBaltimoreMarylandUSA
| | - Yakeel T. Quiroz
- Departments of Psychiatry and NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jessica E. Rexach
- Program in NeurogeneticsDepartment of NeurologyDavid Geffen School of MedicineUniversity of CaliforniaLos AngelesCaliforniaUSA
| | - Jonathan D. Rohrer
- Department of Neurodegenerative DiseaseDementia Research CentreUniversity College London Institute of Neurology, Queen SquareLondonUK
| | - Amy Rommel
- Rainwater Charitable FoundationFort WorthTexasUSA
| | - Ghazaleh Sadri‐Vakili
- Sean M. Healey &AMG Center for ALS at Mass GeneralMassachusetts General HospitalBostonMassachusettsUSA
| | - Suzanne E. Schindler
- Department of NeurologyWashington University School of MedicineSt. LouisMissouriUSA
| | | | - Reisa A. Sperling
- Center for Alzheimer Research and TreatmentBrigham and Women's HospitalMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Charlotte E. Teunissen
- Neurochemistry LaboratoryClinical Chemistry departmentAmsterdam NeuroscienceProgram NeurodegenerationAmsterdam University Medical CentersVrije Universiteit AmsterdamAmsterdamThe Netherlands
| | | | | | - Hui Zheng
- Huffington Center on AgingBaylor College of MedicineHoustonTexasUSA
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Lantero-Rodriguez J, Salvadó G, Snellman A, Montoliu-Gaya L, Brum WS, Benedet AL, Mattsson-Carlgren N, Tideman P, Janelidze S, Palmqvist S, Stomrud E, Ashton NJ, Zetterberg H, Blennow K, Hansson O. Plasma N-terminal containing tau fragments (NTA-tau): a biomarker of tau deposition in Alzheimer's Disease. Mol Neurodegener 2024; 19:19. [PMID: 38365825 PMCID: PMC10874032 DOI: 10.1186/s13024-024-00707-x] [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: 05/26/2023] [Accepted: 01/30/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Novel phosphorylated-tau (p-tau) blood biomarkers (e.g., p-tau181, p-tau217 or p-tau231), are highly specific for Alzheimer's disease (AD), and can track amyloid-β (Aβ) and tau pathology. However, because these biomarkers are strongly associated with the emergence of Aβ pathology, it is difficult to determine the contribution of insoluble tau aggregates to the plasma p-tau signal in blood. Therefore, there remains a need for a biomarker capable of specifically tracking insoluble tau accumulation in brain. METHODS NTA is a novel ultrasensitive assay targeting N-terminal containing tau fragments (NTA-tau) in cerebrospinal fluid (CSF) and plasma, which is elevated in AD. Using two well-characterized research cohorts (BioFINDER-2, n = 1,294, and BioFINDER-1, n = 932), we investigated the association between plasma NTA-tau levels and disease progression in AD, including tau accumulation, brain atrophy and cognitive decline. RESULTS We demonstrate that plasma NTA-tau increases across the AD continuum¸ especially during late stages, and displays a moderate-to-strong association with tau-PET (β = 0.54, p < 0.001) in Aβ-positive participants, while weak with Aβ-PET (β = 0.28, p < 0.001). Unlike plasma p-tau181, GFAP, NfL and t-tau, tau pathology determined with tau-PET is the most prominent contributor to NTA-tau variance (52.5% of total R2), while having very low contribution from Aβ pathology measured with CSF Aβ42/40 (4.3%). High baseline NTA-tau levels are predictive of tau-PET accumulation (R2 = 0.27), steeper atrophy (R2 ≥ 0.18) and steeper cognitive decline (R2 ≥ 0.27) in participants within the AD continuum. Plasma NTA-tau levels significantly increase over time in Aβ positive cognitively unimpaired (βstd = 0.16) and impaired (βstd = 0.18) at baseline compared to their Aβ negative counterparts. Finally, longitudinal increases in plasma NTA-tau levels were associated with steeper longitudinal decreases in cortical thickness (R2 = 0.21) and cognition (R2 = 0.20). CONCLUSION Our results indicate that plasma NTA-tau levels increase across the AD continuum, especially during mid-to-late AD stages, and it is closely associated with in vivo tau tangle deposition in AD and its downstream effects. Moreover, this novel biomarker has potential as a cost-effective and easily accessible tool for monitoring disease progression and cognitive decline in clinical settings, and as an outcome measure in clinical trials which also need to assess the downstream effects of successful Aβ removal.
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Affiliation(s)
- Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden.
| | - Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Anniina Snellman
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
- Turku PET Centre, University of Turku, Turku University Hospital, Turku, Finland
| | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
| | - Wagner S Brum
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Andrea L Benedet
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Department of Neurology, Skåne University Hospital, Lund, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden
| | - Pontus Tideman
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, 20502, Malmö, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, 20502, Malmö, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Old Age Psychiatry, Maurice Wohl Clinical Neuroscience Institute, King's College London, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley NHS Foundation, London, UK
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at the University of Gothenburg, House V3/SU, 43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, 20502, Malmö, Sweden.
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