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van Dyck CH, Mecca AP, O'Dell RS, Bartlett HH, Diepenbrock NG, Huang Y, Hamby ME, Grundman M, Catalano SM, Caggiano AO, Carson RE. A pilot study to evaluate the effect of CT1812 treatment on synaptic density and other biomarkers in Alzheimer's disease. Alzheimers Res Ther 2024; 16:20. [PMID: 38273408 PMCID: PMC10809445 DOI: 10.1186/s13195-024-01382-2] [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] [Accepted: 01/01/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Effective, disease-modifying therapeutics for the treatment of Alzheimer's disease (AD) remain a large unmet need. Extensive evidence suggests that amyloid beta (Aβ) is central to AD pathophysiology, and Aβ oligomers are among the most toxic forms of Aβ. CT1812 is a novel brain penetrant sigma-2 receptor ligand that interferes with the binding of Aβ oligomers to neurons. Preclinical studies of CT1812 have demonstrated its ability to displace Aβ oligomers from neurons, restore synapses in cell cultures, and improve cognitive measures in mouse models of AD. CT1812 was found to be generally safe and well tolerated in a placebo-controlled phase 1 clinical trial in healthy volunteers and phase 1a/2 clinical trials in patients with mild to moderate dementia due to AD. The unique objective of this study was to incorporate synaptic positron emission tomography (PET) imaging as an outcome measure for CT1812 in AD patients. METHODS The present phase 1/2 study was a randomized, double-blind, placebo-controlled, parallel-group trial conducted in 23 participants with mild to moderate dementia due to AD to primarily evaluate the safety of CT1812 and secondarily its pharmacodynamic effects. Participants received either placebo or 100 mg or 300 mg per day of oral CT1812 for 24 weeks. Pharmacodynamic effects were assessed using the exploratory efficacy endpoints synaptic vesicle glycoprotein 2A (SV2A) PET, fluorodeoxyglucose (FDG) PET, volumetric MRI, cognitive clinical measures, as well as cerebrospinal fluid (CSF) biomarkers of AD pathology and synaptic degeneration. RESULTS No treatment differences relative to placebo were observed in the change from baseline at 24 weeks in either SV2A or FDG PET signal, the cognitive clinical rating scales, or in CSF biomarkers. Composite region volumetric MRI revealed a trend towards tissue preservation in participants treated with either dose of CT1812, and nominally significant differences with both doses of CT1812 compared to placebo were found in the pericentral, prefrontal, and hippocampal cortices. CT1812 was safe and well tolerated. CONCLUSIONS The safety findings of this 24-week study and the observed changes on volumetric MRI with CT1812 support its further clinical development. TRIAL REGISTRATION The clinical trial described in this manuscript is registered at clinicaltrials.gov (NCT03493282).
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Affiliation(s)
- Christopher H van Dyck
- Alzheimer's Disease Research Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Adam P Mecca
- Alzheimer's Disease Research Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ryan S O'Dell
- Alzheimer's Disease Research Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Hugh H Bartlett
- Alzheimer's Disease Research Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nina G Diepenbrock
- Alzheimer's Disease Research Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
| | - Mary E Hamby
- Cognition Therapeutics Inc., Pittsburgh, PA, USA
| | - Michael Grundman
- Global R&D Partners, LLC, San Diego, CA, USA
- Department of Neurosciences, University of California, San Diego, USA
| | | | | | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA
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Silva-Rudberg JA, Salardini E, O'Dell RS, Chen MK, Ra J, Georgelos JK, Morehouse MR, Melino KP, Varma P, Toyonaga T, Nabulsi NB, Huang Y, Carson RE, van Dyck CH, Mecca AP. Assessment of Gray Matter Microstructure and Synaptic Density in Alzheimer's Disease: A Multimodal Imaging Study With DTI and SV2A PET. Am J Geriatr Psychiatry 2024; 32:17-28. [PMID: 37673749 PMCID: PMC10840732 DOI: 10.1016/j.jagp.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/19/2023] [Accepted: 08/05/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE Multimodal imaging techniques have furthered our understanding of how different aspects of Alzheimer's disease (AD) pathology relate to one another. Diffusion tensor imaging (DTI) measures such as mean diffusivity (MD) may be a surrogate measure of the changes in gray matter structure associated with AD. Positron emission tomography (PET) imaging of synaptic vesicle glycoprotein 2A (SV2A) has been used to quantify synaptic loss, which is the major pathological correlate of cognitive impairment in AD. In this study, we investigated the relationship between gray matter microstructure and synaptic density. METHODS DTI was used to measure MD and [11C]UCB-J PET to measure synaptic density in 33 amyloid-positive participants with AD and 17 amyloid-negative cognitively normal (CN) participants aged 50-83. Univariate regression analyses were used to assess the association between synaptic density and MD in both the AD and CN groups. RESULTS Hippocampal MD was inversely associated with hippocampal synaptic density in participants with AD (r = -0.55, p <0.001, df = 31) but not CN (r = 0.13, p = 0.62, df = 15). Exploratory analyses across other regions known to be affected in AD suggested widespread inverse associations between synaptic density and MD in the AD group. CONCLUSION In the setting of AD, an increase in gray matter MD is inversely associated with synaptic density. These co-occurring changes may suggest a link between synaptic loss and gray matter microstructural changes in AD. Imaging studies of gray matter microstructure and synaptic density may allow important insights into AD-related neuropathology.
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Affiliation(s)
- Jason A Silva-Rudberg
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT.
| | - Elaheh Salardini
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Ryan S O'Dell
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Jocelyn Ra
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Jamie K Georgelos
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Mackenzie R Morehouse
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Kaitlyn P Melino
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT
| | - Pradeep Varma
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging (M-KC, PV, TT, NBN, YH, REC), Yale University School of Medicine, New Haven, CT
| | - Christopher H van Dyck
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Neuroscience (CHvD), Yale University School of Medicine, New Haven, CT; Department of Neurology (CHvD), Yale University School of Medicine, New Haven, CT
| | - Adam P Mecca
- Alzheimer's Disease Research Unit (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT; Department of Psychiatry (JAS-R, ES, RSO, JR, JKG, MRM, KPM, CHvD, APM), Yale University School of Medicine, New Haven, CT.
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Ayyubova G. APOE4 is a Risk Factor and Potential Therapeutic Target for Alzheimer's Disease. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2024; 23:342-352. [PMID: 36872358 DOI: 10.2174/1871527322666230303114425] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/20/2022] [Accepted: 01/12/2023] [Indexed: 03/07/2023]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease, the main pathological hallmark of which is the loss of neurons, resulting in cognitive and memory impairments. Sporadic late-onset AD is a prevalent form of the disease and the apolipoprotein E4 (APOE4) genotype is the strongest predictor of the disease development. The structural variations of APOE isoforms affect their roles in synaptic maintenance, lipid trafficking, energy metabolism, inflammatory response, and BBB integrity. In the context of AD, APOE isoforms variously control the key pathological elements of the disease, including Aβ plaque formation, tau aggregation, and neuroinflammation. Taking into consideration the limited number of therapy choices that can alleviate symptoms and have little impact on the AD etiology and progression to date, the precise research strategies guided by apolipoprotein E (APOE) polymorphisms are required to assess the potential risk of age-related cognitive decline in people carrying APOE4 genotype. In this review, we summarize the evidence implicating the significance of APOE isoforms on brain functions in health and pathology with the aim to identify the possible targets that should be addressed to prevent AD manifestation in individuals with the APOE4 genotype and to explore proper treatment strategies.
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Affiliation(s)
- Gunel Ayyubova
- Department of Cytology, Embryology and Histology, Azerbaijan Medical University, Baku, Azerbaijan
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O'Dell RS, Higgins-Chen A, Gupta D, Chen MK, Naganawa M, Toyonaga T, Lu Y, Ni G, Chupak A, Zhao W, Salardini E, Nabulsi NB, Huang Y, Arnsten AFT, Carson RE, van Dyck CH, Mecca AP. Principal component analysis of synaptic density measured with [ 11C]UCB-J PET in early Alzheimer's disease. Neuroimage Clin 2023; 39:103457. [PMID: 37422964 PMCID: PMC10338149 DOI: 10.1016/j.nicl.2023.103457] [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: 09/20/2022] [Revised: 05/01/2023] [Accepted: 06/19/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND Synaptic loss is considered an early pathological event and major structural correlate of cognitive impairment in Alzheimer's disease (AD). We used principal component analysis (PCA) to identify regional patterns of covariance in synaptic density using [11C]UCB-J PET and assessed the association between principal components (PC) subject scores with cognitive performance. METHODS [11C]UCB-J binding was measured in 45 amyloid + participants with AD and 19 amyloid- cognitively normal participants aged 55-85. A validated neuropsychological battery assessed performance across five cognitive domains. PCA was applied to the pooled sample using distribution volume ratios (DVR) standardized (z-scored) by region from 42 bilateral regions of interest (ROI). RESULTS Parallel analysis determined three significant PCs explaining 70.2% of the total variance. PC1 was characterized by positive loadings with similar contributions across the majority of ROIs. PC2 was characterized by positive and negative loadings with strongest contributions from subcortical and parietooccipital cortical regions, respectively, while PC3 was characterized by positive and negative loadings with strongest contributions from rostral and caudal cortical regions, respectively. Within the AD group, PC1 subject scores were positively correlated with performance across all cognitive domains (Pearson r = 0.24-0.40, P = 0.06-0.006), PC2 subject scores were inversely correlated with age (Pearson r = -0.45, P = 0.002) and PC3 subject scores were significantly correlated with CDR-sb (Pearson r = 0.46, P = 0.04). No significant correlations were observed between cognitive performance and PC subject scores in CN participants. CONCLUSIONS This data-driven approach defined specific spatial patterns of synaptic density correlated with unique participant characteristics within the AD group. Our findings reinforce synaptic density as a robust biomarker of disease presence and severity in the early stages of AD.
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Affiliation(s)
- Ryan S O'Dell
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA.
| | - Albert Higgins-Chen
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA; Pain Research, Informatics, Multi-morbidities, and Education Center, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Dhruva Gupta
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Gessica Ni
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Anna Chupak
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Wenzhen Zhao
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Elaheh Salardini
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Amy F T Arnsten
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520, USA
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520, USA
| | - Christopher H van Dyck
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA; Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520, USA; Department of Neurology, Yale University School of Medicine, P.O. Box 208018, New Haven, CT 06520, USA
| | - Adam P Mecca
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8(th) Floor, New Haven, CT 06510, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510, USA.
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5
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Snellman A, Ekblad LL, Tuisku J, Koivumäki M, Ashton NJ, Lantero-Rodriguez J, Karikari TK, Helin S, Bucci M, Löyttyniemi E, Parkkola R, Karrasch M, Schöll M, Zetterberg H, Blennow K, Rinne JO. APOE ε4 gene dose effect on imaging and blood biomarkers of neuroinflammation and beta-amyloid in cognitively unimpaired elderly. Alzheimers Res Ther 2023; 15:71. [PMID: 37016464 PMCID: PMC10071691 DOI: 10.1186/s13195-023-01209-6] [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: 09/29/2022] [Accepted: 03/13/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Neuroinflammation, characterized by increased reactivity of microglia and astrocytes in the brain, is known to be present at various stages of the Alzheimer's disease (AD) continuum. However, its presence and relationship with amyloid pathology in cognitively normal at-risk individuals is less clear. Here, we used positron emission tomography (PET) and blood biomarker measurements to examine differences in neuroinflammation and beta-amyloid (Aβ) and their association in cognitively unimpaired homozygotes, heterozygotes, or non-carriers of the APOE ε4 allele, the strongest genetic risk for sporadic AD. METHODS Sixty 60-75-year-old APOE ε4 homozygotes (n = 19), heterozygotes (n = 21), and non-carriers (n = 20) were recruited in collaboration with the local Auria biobank. The participants underwent 11C-PK11195 PET (targeting 18-kDa translocator protein, TSPO), 11C-PiB PET (targeting Aβ), brain MRI, and neuropsychological testing including a preclinical cognitive composite (APCC). 11C-PK11195 distribution volume ratios and 11C-PiB standardized uptake value ratios (SUVRs) were calculated for regions typical for early Aβ accumulation in AD. Blood samples were drawn for measuring plasma glial fibrillary acidic protein (GFAP) and plasma Aβ1-42/1.40. RESULTS In our cognitively unimpaired sample, cortical 11C-PiB-binding increased according to APOE ε4 gene dose (median composite SUVR 1.47 (range 1.38-1.66) in non-carriers, 1.55 (1.43-2.02) in heterozygotes, and 2.13 (1.61-2.83) in homozygotes, P = 0.002). In contrast, cortical composite 11C-PK11195-binding did not differ between the APOE ε4 gene doses (P = 0.27) or between Aβ-positive and Aβ-negative individuals (P = 0.81) and associated with higher Aβ burden only in APOE ε4 homozygotes (Rho = 0.47, P = 0.043). Plasma GFAP concentration correlated with cortical 11C-PiB (Rho = 0.35, P = 0.040), but not 11C-PK11195-binding (Rho = 0.13, P = 0.47) in Aβ-positive individuals. In the total cognitively unimpaired population, both higher composite 11C-PK11195-binding and plasma GFAP were associated with lower hippocampal volume, whereas elevated 11C-PiB-binding was associated with lower APCC scores. CONCLUSIONS Only Aβ burden measured by PET, but not markers of neuroinflammation, differed among cognitively unimpaired elderly with different APOE ε4 gene dose. However, APOE ε4 gene dose seemed to modulate the association between neuroinflammation and Aβ.
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Affiliation(s)
- Anniina Snellman
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.
| | - Laura L Ekblad
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - Jouni Tuisku
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - Mikko Koivumäki
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
- 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
| | - Juan Lantero-Rodriguez
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Thomas K Karikari
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Semi Helin
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
| | - Marco Bucci
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Mira Karrasch
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Michael Schöll
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku University Hospital, Kiinamyllynkatu 4-8, 20520, Turku, Finland
- InFLAMES Research Flagship Center, University of Turku, Turku, Finland
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Lou T, Tao B, Chen M. Relationship of Apolipoprotein E with Alzheimer's Disease and Other Neurological Disorders: An Updated Review. Neuroscience 2023; 514:123-140. [PMID: 36736614 DOI: 10.1016/j.neuroscience.2023.01.032] [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: 06/24/2022] [Revised: 01/21/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
Alzheimer's disease (AD) and other neurodegenerative diseases, for which there is no effective cure, cause great social burden. Apolipoprotein E (APOE) is an important lipid transporter, which has been shown to have a close relationship with AD and other neurological disorders in an increasing number of studies, suggesting its potential as a therapeutic target. In this review, we summarize the recent advances in clinical and basic research on the role of APOE in the pathogenesis of multiple neurological diseases, with an emphasis on the new associations between APOE and AD, and between APOE and depression. The progress of APOE research in Parkinson's disease (PD) and some other neurological diseases is briefly discussed.
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Affiliation(s)
- Tianwen Lou
- The First Clinical Medical College, Anhui Medical University, Hefei, China; Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Borui Tao
- The First Clinical Medical College, Anhui Medical University, Hefei, China; Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Ming Chen
- Department of Pharmacology, School of Basic Medical Sciences, Anhui Medical University, Hefei, China.
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7
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Mecca AP, O'Dell RS, Sharp ES, Banks ER, Bartlett HH, Zhao W, Lipior S, Diepenbrock NG, Chen M, Naganawa M, Toyonaga T, Nabulsi NB, Vander Wyk BC, Arnsten AFT, Huang Y, Carson RE, van Dyck CH. Synaptic density and cognitive performance in Alzheimer's disease: A PET imaging study with [ 11 C]UCB-J. Alzheimers Dement 2022; 18:2527-2536. [PMID: 35174954 PMCID: PMC9381645 DOI: 10.1002/alz.12582] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/23/2021] [Accepted: 12/12/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION For 30 years synapse loss has been referred to as the major pathological correlate of cognitive impairment in Alzheimer's disease (AD). However, this statement is based on remarkably few patients studied by autopsy or biopsy. With the recent advent of synaptic vesicle glycoprotein 2A (SV2A) positron emission tomography (PET) imaging, we have begun to evaluate the consequences of synaptic alterations in vivo. METHODS We examined the relationship between synaptic density measured by [11 C]UCB-J PET and neuropsychological test performance in 45 participants with early AD. RESULTS Global synaptic density showed a significant positive association with global cognition and performance on five individual cognitive domains in participants with early AD. Synaptic density was a stronger predictor of cognitive performance than gray matter volume. CONCLUSION These results confirm neuropathologic studies demonstrating a significant association between synaptic density and cognitive performance, and suggest that this correlation extends to the early stages of AD.
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Affiliation(s)
- Adam P. Mecca
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Ryan S. O'Dell
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Emily S. Sharp
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of NeurologyYale University School of MedicineNew HavenConnecticutUSA
| | - Emmie R. Banks
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Hugh H. Bartlett
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Wenzhen Zhao
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Sylwia Lipior
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Nina G. Diepenbrock
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
| | - Ming‐Kai Chen
- Department of Radiology and Biomedical ImagingYale University School of MedicineNew HavenConnecticutUSA
| | - Mika Naganawa
- Department of Radiology and Biomedical ImagingYale University School of MedicineNew HavenConnecticutUSA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical ImagingYale University School of MedicineNew HavenConnecticutUSA
| | - Nabeel B. Nabulsi
- Department of Radiology and Biomedical ImagingYale University School of MedicineNew HavenConnecticutUSA
| | | | - Amy F. T. Arnsten
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of NeuroscienceYale University School of MedicineNew HavenConnecticutUSA
| | - Yiyun Huang
- Program on AgingYale University School of MedicineNew HavenConnecticutUSA
| | - Richard E. Carson
- Program on AgingYale University School of MedicineNew HavenConnecticutUSA
| | - Christopher H. van Dyck
- Alzheimer's Disease Research UnitYale University School of MedicineNew HavenConnecticutUSA
- Department of PsychiatryYale University School of MedicineNew HavenConnecticutUSA
- Department of NeurologyYale University School of MedicineNew HavenConnecticutUSA
- Department of NeuroscienceYale University School of MedicineNew HavenConnecticutUSA
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8
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Snellman A, Ekblad LL, Koivumäki M, Lindgrén N, Tuisku J, Perälä M, Kallio L, Lehtonen R, Saunavaara V, Saunavaara J, Oikonen V, Aarnio R, Löyttyniemi E, Parkkola R, Karrasch M, Zetterberg H, Blennow K, Rinne JO. ASIC-E4: Interplay of Beta-Amyloid, Synaptic Density and Neuroinflammation in Cognitively Normal Volunteers With Three Levels of Genetic Risk for Late-Onset Alzheimer's Disease - Study Protocol and Baseline Characteristics. Front Neurol 2022; 13:826423. [PMID: 35222254 PMCID: PMC8863967 DOI: 10.3389/fneur.2022.826423] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/06/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Detailed characterization of early pathophysiological changes in preclinical Alzheimer's disease (AD) is necessary to enable development of correctly targeted and timed disease-modifying treatments. ASIC-E4 study ("Beta-Amyloid, Synaptic loss, Inflammation and Cognition in healthy APOE ε4 carriers") combines state-of-the-art neuroimaging and fluid-based biomarker measurements to study the early interplay of three key pathological features of AD, i.e., beta-amyloid (Aβ) deposition, neuroinflammation and synaptic dysfunction and loss in cognitively normal volunteers with three different levels of genetic (APOE-related) risk for late-onset AD. OBJECTIVE Here, our objective is to describe the study design, used protocols and baseline demographics of the ASIC-E4 study. METHODS/DESIGN ASIC-E4 is a prospective observational multimodal imaging study performed in Turku PET Centre in collaboration with University of Gothenburg. Cognitively normal 60-75-year-old-individuals with known APOE ε4/ε4 genotype were recruited via local Auria Biobank (Turku, Finland). Recruitment of the project has been completed in July 2020 and 63 individuals were enrolled to three study groups (Group 1: APOE ε4/ε4, N = 19; Group 2: APOE ε4/ε3, N = 22; Group 3: APOE ε3/ε3, N = 22). At baseline, all participants will undergo positron emission tomography imaging with tracers targeted against Aβ deposition (11C-PIB), activated glia (11C-PK11195) and synaptic vesicle glycoprotein 2A (11C-UCB-J), two brain magnetic resonance imaging scans, and extensive cognitive testing. In addition, blood samples are collected for various laboratory measurements and blood biomarker analysis and cerebrospinal fluid samples are collected from a subset of participants based on additional voluntary informed consent. To evaluate the predictive value of the early neuroimaging findings, neuropsychological evaluation and blood biomarker measurements will be repeated after a 4-year follow-up period. DISCUSSION Results of the ASIC-E4 project will bridge the gap related to limited knowledge of the synaptic and inflammatory changes and their association with each other and Aβ in "at-risk" individuals. Thorough in vivo characterization of the biomarker profiles in this population will produce valuable information for diagnostic purposes and future drug development, where the field has already started to look beyond Aβ.
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Affiliation(s)
- Anniina Snellman
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Laura L. Ekblad
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Mikko Koivumäki
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Noora Lindgrén
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Jouni Tuisku
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Merja Perälä
- Auria Biobank, Turku University Hospital, University of Turku, Turku, Finland
| | - Lila Kallio
- Auria Biobank, Turku University Hospital, University of Turku, Turku, Finland
| | - Riina Lehtonen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Virva Saunavaara
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Jani Saunavaara
- Department of Medical Physics, Turku University Hospital, Turku, Finland
| | - Vesa Oikonen
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Richard Aarnio
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, Turku University Hospital, University of Turku, Turku, Finland
| | - Mira Karrasch
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - 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, London, United Kingdom
- UK Dementia Research Institute at UCL, London, United Kingdom
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | - 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
| | - Juha O. Rinne
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
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9
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Jeremic D, Jiménez-Díaz L, Navarro-López JD. Past, present and future of therapeutic strategies against amyloid-β peptides in Alzheimer's disease: a systematic review. Ageing Res Rev 2021; 72:101496. [PMID: 34687956 DOI: 10.1016/j.arr.2021.101496] [Citation(s) in RCA: 106] [Impact Index Per Article: 35.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 09/30/2021] [Accepted: 10/18/2021] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is the most prevalent neurodegenerative disease in ageing, affecting around 46 million people worldwide but few treatments are currently available. The etiology of AD is still puzzling, and new drugs development and clinical trials have high failure rates. Urgent outline of an integral (multi-target) and effective treatment of AD is needed. Accumulation of amyloid-β (Aβ) peptides is considered one of the fundamental neuropathological pillars of the disease, and its dyshomeostasis has shown a crucial role in AD onset. Therefore, many amyloid-targeted therapies have been investigated. Here, we will systematically review recent (from 2014) investigational, follow-up and review studies focused on anti-amyloid strategies to summarize and analyze their current clinical potential. Combination of anti-Aβ therapies with new developing early detection biomarkers and other therapeutic agents acting on early functional AD changes will be highlighted in this review. Near-term approval seems likely for several drugs acting against Aβ, with recent FDA approval of a monoclonal anti-Aβ oligomers antibody -aducanumab- raising hopes and controversies. We conclude that, development of oligomer-epitope specific Aβ treatment and implementation of multiple improved biomarkers and risk prediction methods allowing early detection, together with therapies acting on other factors such as hyperexcitability in early AD, could be the key to slowing this global pandemic.
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10
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Souto JJ, Silva GM, Almeida NL, Shoshina II, Santos NA, Fernandes TP. Age-related episodic memory decline and the role of amyloid-β: a systematic review. Dement Neuropsychol 2021; 15:299-313. [PMID: 34630918 PMCID: PMC8485646 DOI: 10.1590/1980-57642021dn15-030002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 02/22/2021] [Indexed: 12/25/2022] Open
Abstract
Aging has been associated with the functional decline of episodic memory (EM). Unanswered questions are whether the decline of EM occurs even during healthy aging and whether this decline is related to amyloid-β (Aβ) deposition in the hippocampus. Objective The main purpose of this study was to investigate data on the relationship between the age-related EM decline and Aβ deposition. Methods We searched the Cochrane, MEDLINE, Scopus, and Web of Science databases and reference lists of retrieved articles that were published in the past 10 years. The initial literature search identified 517 studies. After screening the title, abstract, key words, and reference lists, 56 studies met the inclusion criteria. Results The overall results revealed that increases in Aβ are related to lower hippocampal volume and worse performance on EM tests. The results of this systematic review revealed that high levels of Aβ may be related to EM deficits and the progression to Alzheimer's disease. Conclusions We discussed the strengths and pitfalls of various tests and techniques used for investigating EM and Aβ deposition, methodological issues, and potential directions for future research.
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Affiliation(s)
- Jandirlly Julianna Souto
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Gabriella Medeiros Silva
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Natalia Leandro Almeida
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | | | - Natanael Antonio Santos
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
| | - Thiago Paiva Fernandes
- Department of Psychology, Universidade Federal da Paraíba - João Pessoa, PB, Brazil.,Perception, Neuroscience and Behaviour Laboratory, Universidade Federal da Paraíba - João Pessoa, Brazil
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11
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Chen MK, Mecca AP, Naganawa M, Gallezot JD, Toyonaga T, Mondal J, Finnema SJ, Lin SF, O’Dell RS, McDonald JW, Michalak HR, Vander Wyk B, Nabulsi NB, Huang Y, Arnsten AFT, van Dyck CH, Carson RE. Comparison of [ 11C]UCB-J and [ 18F]FDG PET in Alzheimer's disease: A tracer kinetic modeling study. J Cereb Blood Flow Metab 2021; 41:2395-2409. [PMID: 33757318 PMCID: PMC8393289 DOI: 10.1177/0271678x211004312] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/29/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022]
Abstract
[11C]UCB-J PET for synaptic vesicle glycoprotein 2 A (SV2A) has been proposed as a suitable marker for synaptic density in Alzheimer's disease (AD). We compared [11C]UCB-J binding for synaptic density and [18F]FDG uptake for metabolism (correlated with neuronal activity) in 14 AD and 11 cognitively normal (CN) participants. We assessed both absolute and relative outcome measures in brain regions of interest, i.e., K1 or R1 for [11C]UCB-J perfusion, VT (volume of distribution) or DVR to cerebellum for [11C]UCB-J binding to SV2A; and Ki or KiR to cerebellum for [18F]FDG metabolism. [11C]UCB-J binding and [18F]FDG metabolism showed a similar magnitude of reduction in the medial temporal lobe of AD -compared to CN participants. However, the magnitude of reduction of [11C]UCB-J binding in neocortical regions was less than that observed with [18F]FDG metabolism. Inter-tracer correlations were also higher in the medial temporal regions between synaptic density and metabolism, with lower correlations in neocortical regions. [11C]UCB-J perfusion showed a similar pattern to [18F]FDG metabolism, with high inter-tracer regional correlations. In summary, we conducted the first in vivo PET imaging of synaptic density and metabolism in the same AD participants and reported a concordant reduction in medial temporal regions but a discordant reduction in neocortical regions.
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Affiliation(s)
- Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Adam P Mecca
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jean-Dominique Gallezot
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jayanta Mondal
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Sjoerd J Finnema
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Shu-fei Lin
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Ryan S O’Dell
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Julia W McDonald
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Hannah R Michalak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Brent Vander Wyk
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Amy FT Arnsten
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
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12
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Mecca AP, Rogers K, Jacobs Z, McDonald JW, Michalak HR, DellaGioia N, Zhao W, Hillmer AT, Nabulsi N, Lim K, Ropchan J, Huang Y, Matuskey D, Esterlis I, Carson RE, van Dyck CH. Effect of age on brain metabotropic glutamate receptor subtype 5 measured with [ 18F]FPEB PET. Neuroimage 2021; 238:118217. [PMID: 34052464 PMCID: PMC8378132 DOI: 10.1016/j.neuroimage.2021.118217] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 04/08/2021] [Accepted: 05/26/2021] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Metabotropic glutamate receptor subtype 5 (mGluR5) is integral to the brain glutamatergic system and cognitive function. This study investigated whether aging is associated with decreased brain mGluR5 availability. METHODS Cognitively normal participants (n = 45), aged 18 to 84 years, underwent [18F]FPEB positron emission tomography scans to quantify brain mGluR5. Distribution volume (VT) was computed using a venous or arterial input function and equilibrium modeling from 90 to 120 min. In the primary analysis, the association between age and VT in the hippocampus and association cortex was evaluated using a linear mixed model. Exploratory analyses assessed the association between age and VT in multiple brain regions. The contribution of gray matter tissue alterations and partial volume effects to associations with age was also examined. RESULTS In the primary analysis, older age was associated with lower [18F]FPEB binding to mGluR5 (P = 0.026), whereas this association was not significant after gray matter masking or partial volume correction to account for age-related tissue loss. Post hoc analyses revealed an age-related decline in mGluR5 availability in the hippocampus of 4.5% per decade (P = 0.007) and a non-significant trend in the association cortex (P = 0.085). An exploratory analysis of multiple brain regions revealed broader inverse associations of age with mGluR5 availability, but not after partial volume correction. CONCLUSION Reductions in mGluR5 availability with age appear to be largely mediated by tissue loss. Quantification of [18F]FPEB binding to mGluR5 may expand our understanding of age-related molecular changes and the relationship with brain tissue loss.
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Affiliation(s)
- Adam P Mecca
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
| | - Kelly Rogers
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Zachary Jacobs
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Julia W McDonald
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Hannah R Michalak
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nicole DellaGioia
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Wenzhen Zhao
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ansel T Hillmer
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Nabeel Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Keunpoong Lim
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Jim Ropchan
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - David Matuskey
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA; Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
| | - Irina Esterlis
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher H van Dyck
- Alzheimer's Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT, 06514, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
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13
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Partial volume correction analysis for 11C-UCB-J PET studies of Alzheimer's disease. Neuroimage 2021; 238:118248. [PMID: 34119639 PMCID: PMC8454285 DOI: 10.1016/j.neuroimage.2021.118248] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/30/2021] [Accepted: 06/06/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose: 11C-UCB-J PET imaging, targeting synaptic vesicle glycoprotein 2A (SV2A), has been shown to be a useful indicator of synaptic density in Alzheimer’s disease (AD). For SV2A imaging, a decrease in apparent tracer uptake is often due to the combination of gray-matter (GM) atrophy and SV2A decrease in the remaining tissue. Our aim is to reveal the true SV2A change by performing partial volume correction (PVC). Methods: We performed two PVC algorithms, Müller-Gärtner (MG) and ‘iterative Yang’ (IY), on 17 AD participants and 11 cognitive normal (CN) participants using the brain-dedicated HRRT scanner. Distribution volume VT, the rate constant K1, binding potential BPND (centrum semiovale as reference region), and tissue volume were compared. Results: In most regions, both PVC algorithms reduced the between-group differences. Alternatively, in hippocampus, IY increased the significance of between-group differences while MG reduced it (VT, BPND and K1 group differences: uncorrected: 20%, 27%, 17%; MG: 18%, 22%, 14%; IY: 22%, 28%, 17%). The group difference in hippocampal volume (10%) was substantially smaller than any PET measures. MG increased GM binding values to a greater extent than IY due to differences in algorithm assumptions. Conclusion: 11C-UCB-J binding is significantly reduced in AD hippocampus, but PVC is important to adjust for significant volume reduction. After correction, PET measures are substantially more sensitive to group differences than volumetric MRI measures. Assumptions of each PVC algorithm are important and should be carefully examined and validated. For 11C-UCB-J, the less stringent assumptions of IY support its use as a PVC algorithm over MG.
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14
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Kurose S, Kubota M, Takahata K, Yamamoto Y, Fujiwara H, Kimura Y, Ito H, Takeuchi H, Mimura M, Suhara T, Higuchi M. Relationship between regional gray matter volumes and dopamine D 2 receptor and transporter in living human brains. Hum Brain Mapp 2021; 42:4048-4058. [PMID: 34014611 PMCID: PMC8288088 DOI: 10.1002/hbm.25538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/24/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022] Open
Abstract
Although striatal dopamine neurotransmission is believed to be functionally linked to the formation of the corticostriatal network, there has been little evidence for this regulatory process in the human brain and its disruptions in neuropsychiatric disorders. Here, we aimed to investigate associations of striatal dopamine transporter (DAT) and D2 receptor availabilities with gray matter (GM) volumes in healthy humans. Positron emission tomography images of D2 receptor (n = 34) and DAT (n = 17) captured with the specific radioligands [11C]raclopride and [18F]FE‐PE2I, respectively, were acquired along with T1‐weighted magnetic resonance imaging data in our previous studies, and were re‐analyzed in this work. We quantified the binding potentials (BPND) of these radioligands in the limbic, executive, and sensorimotor functional subregions of the striatum. Correlations between the radioligand BPND and regional GM volume were then examined by voxel‐based morphometry. In line with the functional and anatomical connectivity, [11C]raclopride BPND in the limbic striatum was positively correlated with volumes of the uncal/parahippocampal gyrus and adjacent temporal areas. Similarly, we found positive correlations between the BPND of this radioligand in the executive striatum and volumes of the prefrontal cortices and their adjacent areas as well as between the BPND in the sensorimotor striatum and volumes of the somatosensory and supplementary motor areas. By contrast, no significant correlation was found between [18F]FE‐PE2I BPND and regional GM volumes. Our results suggest unique structural and functional corticostriatal associations involving D2 receptor in healthy humans, which might be partially independent of the nigrostriatal pathway reflected by striatal DAT.
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Affiliation(s)
- Shin Kurose
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Manabu Kubota
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keisuke Takahata
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Yasuharu Yamamoto
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Hironobu Fujiwara
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasuyuki Kimura
- Department of Clinical and Experimental Neuroimaging, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroshi Ito
- Department of Radiology and Nuclear Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hiroyoshi Takeuchi
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Suhara
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Makoto Higuchi
- Department of Functional Brain Imaging, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
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15
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O’Dell RS, Mecca AP, Chen MK, Naganawa M, Toyonaga T, Lu Y, Godek TA, Harris JE, Bartlett HH, Banks ER, Kominek VL, Zhao W, Nabulsi NB, Ropchan J, Ye Y, Vander Wyk BC, Huang Y, Arnsten AFT, Carson RE, van Dyck CH. Association of Aβ deposition and regional synaptic density in early Alzheimer's disease: a PET imaging study with [ 11C]UCB-J. Alzheimers Res Ther 2021; 13:11. [PMID: 33402201 PMCID: PMC7786921 DOI: 10.1186/s13195-020-00742-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/07/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND Attempts to associate amyloid-β (Aβ) pathogenesis with synaptic loss in Alzheimer's disease (AD) have thus far been limited to small numbers of postmortem studies. Aβ plaque burden is not well-correlated with indices of clinical severity or neurodegeneration-at least in the dementia stage-as deposition of Aβ reaches a ceiling. In this study, we examined in vivo the association between fibrillar Aβ deposition and synaptic density in early AD using positron emission tomography (PET). We hypothesized that global Aβ deposition would be more strongly inversely associated with hippocampal synaptic density in participants with amnestic mild cognitive impairment (aMCI; a stage of continued Aβ accumulation) compared to those with dementia (a stage of relative Aβ plateau). METHODS We measured SV2A binding ([11C]UCB-J) and Aβ deposition ([11C]PiB) in 14 participants with aMCI due to AD and 24 participants with mild AD dementia. Distribution volume ratios (DVR) with a cerebellar reference region were calculated for both tracers to investigate the association between global Aβ deposition and SV2A binding in hippocampus. Exploratory analyses examined correlations between both global and regional Aβ deposition and SV2A binding across a broad range of brain regions using both ROI- and surface-based approaches. RESULTS We observed a significant inverse association between global Aβ deposition and hippocampal SV2A binding in participants with aMCI (r = - 0.55, P = 0.04), but not mild dementia (r = 0.05, P = 0.82; difference statistically significant by Fisher z = - 1.80, P = 0.04). Exploratory analyses across other ROIs and whole brain analyses demonstrated no broad or consistent associations between global Aβ deposition and regional SV2A binding in either diagnostic group. ROI-based analyses of the association between regional Aβ deposition and SV2A binding also revealed no consistent pattern but suggested a "paradoxical" positive association between local Aβ deposition and SV2A binding in the hippocampus. CONCLUSIONS Our findings lend support to a model in which fibrillar Aβ is still accumulating in the early stages of clinical disease but approaching a relative plateau, a point at which Aβ may uncouple from neurodegenerative processes including synaptic loss. Future research should investigate the relationship between Aβ deposition and synaptic loss in larger cohorts beginning preclinically and followed longitudinally in conjunction with other biomarkers.
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Affiliation(s)
- Ryan S. O’Dell
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Adam P. Mecca
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Tyler A. Godek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Joanna E. Harris
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Hugh H. Bartlett
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Emmie R. Banks
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Victoria L. Kominek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Wenzhen Zhao
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
| | - Nabeel B. Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Jim Ropchan
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Yunpeng Ye
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Brent C. Vander Wyk
- Program on Aging, Yale University School of Medicine, P.O. Box 207900, New Haven, CT 06520 USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Amy F. T. Arnsten
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520 USA
| | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, P.O. Box 208048, New Haven, CT 06520 USA
| | - Christopher H. van Dyck
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, 300 George Street, New Haven, CT 06510 USA
- Department of Neuroscience, Yale University School of Medicine, P.O. Box 208001, New Haven, CT 06520 USA
- Department of Neurology, Yale University School of Medicine, P.O. Box 208018, New Haven, CT 06520 USA
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16
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Leocadi M, Canu E, Calderaro D, Corbetta D, Filippi M, Agosta F. An update on magnetic resonance imaging markers in AD. Ther Adv Neurol Disord 2020; 13:1756286420947986. [PMID: 33747128 PMCID: PMC7903819 DOI: 10.1177/1756286420947986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/09/2020] [Indexed: 12/22/2022] Open
Abstract
The purpose of the present review is to provide an update of the available recent scientific literature on the use of magnetic resonance imaging (MRI) in Alzheimer's disease (AD). MRI is playing an increasingly important role in the characterization of the AD signatures, which can be useful in both the diagnostic process and monitoring of disease progression. Furthermore, this technique is unique in assessing brain structure and function and provides a deep understanding of in vivo evolution of cerebral pathology. In the reviewing process, we established a priori criteria and we thoroughly searched the very recent scientific literature (January 2018-March 2020) for relevant articles on this topic. In summary, we selected 73 articles out of 1654 publications retrieved from PubMed. Based on this selection, this review summarizes the recent application of MRI in clinical trials, defining the predementia stages of AD, the clinical utility of MRI, proposal of novel biomarkers and brain regions of interest, and assessing the relationship between MRI and cognitive features, risk and protective factors of AD. Finally, the value of a multiparametric approach in clinical and preclinical stages of AD is discussed.
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Affiliation(s)
- Michela Leocadi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Calderaro
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Davide Corbetta
- Laboratory of Movement Analysis, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, Neurology and Neurophysiology Units, IRCCS San Raffaele Scientific Institute, and Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, and Vita-Salute San Raffaele University, Via Olgettina 60, Milan 20132, Italy
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17
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Chew H, Solomon VA, Fonteh AN. Involvement of Lipids in Alzheimer's Disease Pathology and Potential Therapies. Front Physiol 2020; 11:598. [PMID: 32581851 PMCID: PMC7296164 DOI: 10.3389/fphys.2020.00598] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022] Open
Abstract
Lipids constitute the bulk of the dry mass of the brain and have been associated with healthy function as well as the most common pathological conditions of the brain. Demographic factors, genetics, and lifestyles are the major factors that influence lipid metabolism and are also the key components of lipid disruption in Alzheimer's disease (AD). Additionally, the most common genetic risk factor of AD, APOE ϵ4 genotype, is involved in lipid transport and metabolism. We propose that lipids are at the center of Alzheimer's disease pathology based on their involvement in the blood-brain barrier function, amyloid precursor protein (APP) processing, myelination, membrane remodeling, receptor signaling, inflammation, oxidation, and energy balance. Under healthy conditions, lipid homeostasis bestows a balanced cellular environment that enables the proper functioning of brain cells. However, under pathological conditions, dyshomeostasis of brain lipid composition can result in disturbed BBB, abnormal processing of APP, dysfunction in endocytosis/exocytosis/autophagocytosis, altered myelination, disturbed signaling, unbalanced energy metabolism, and enhanced inflammation. These lipid disturbances may contribute to abnormalities in brain function that are the hallmark of AD. The wide variance of lipid disturbances associated with brain function suggest that AD pathology may present as a complex interaction between several metabolic pathways that are augmented by risk factors such as age, genetics, and lifestyles. Herewith, we examine factors that influence brain lipid composition, review the association of lipids with all known facets of AD pathology, and offer pointers for potential therapies that target lipid pathways.
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Affiliation(s)
- Hannah Chew
- Huntington Medical Research Institutes, Pasadena, CA, United States
- University of California, Los Angeles, Los Angeles, CA, United States
| | | | - Alfred N. Fonteh
- Huntington Medical Research Institutes, Pasadena, CA, United States
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18
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Influence of apolipoprotein-E genotype on brain amyloid load and longitudinal trajectories. Neurobiol Aging 2020; 94:111-120. [PMID: 32603776 DOI: 10.1016/j.neurobiolaging.2020.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 05/21/2020] [Accepted: 05/23/2020] [Indexed: 12/23/2022]
Abstract
To characterize the influence of apolipoprotein-E (APOE) genotype on cerebral Aβ load and longitudinal Aβ trajectories, [11C]Pittsburgh compound-B (PiB) positron emission tomography (PET) imaging was used to assess amyloid load in a clinically heterogeneous cohort of 428 elderly participants with known APOE genotype. Serial [11C]PiB data and a repeated measures model were used to model amyloid trajectories in a subset of 235 participants classified on the basis of APOE genotype. We found that APOE-ε4 was associated with increased Aβ burden and an earlier age of onset of Aβ positivity, whereas APOE-ε2 appeared to have modest protective effects against Aβ. APOE class did not predict rates of Aβ accumulation. The present study suggests that APOE modifies Alzheimer's disease risk through a direct influence on amyloidogenic processes, which manifests as an earlier age of onset of Aβ positivity, although it is likely that other genetic, environmental, and lifestyle factors are important.
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19
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Mecca AP, Chen MK, O'Dell RS, Naganawa M, Toyonaga T, Godek TA, Harris JE, Bartlett HH, Zhao W, Nabulsi NB, Wyk BCV, Varma P, Arnsten AFT, Huang Y, Carson RE, van Dyck CH. In vivo measurement of widespread synaptic loss in Alzheimer's disease with SV2A PET. Alzheimers Dement 2020; 16:974-982. [PMID: 32400950 PMCID: PMC7383876 DOI: 10.1002/alz.12097] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 02/18/2020] [Accepted: 03/02/2020] [Indexed: 12/18/2022]
Abstract
Introduction Synaptic loss is a robust and consistent pathology in Alzheimer's disease (AD) and the major structural correlate of cognitive impairment. Positron emission tomography (PET) imaging of synaptic vesicle glycoprotein 2A (SV2A) has emerged as a promising biomarker of synaptic density. Methods We measured SV2A binding in 34 participants with early AD and 19 cognitively normal (CN) participants using [11C]UCB‐J PET and a cerebellar reference region for calculation of the distribution volume ratio. Results We observed widespread reductions of SV2A binding in medial temporal and neocortical brain regions in early AD compared to CN participants. These reductions were largely maintained after correction for volume loss and were more extensive than decreases in gray matter volume. Conclusion We were able to measure widespread synaptic loss due to AD using [11C]UCB‐J PET. Future studies will continue to evaluate the utility of SV2A PET for tracking AD progression and for monitoring potential therapies.
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Affiliation(s)
- Adam P Mecca
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut.,Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Ryan S O'Dell
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Tyler A Godek
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Joanna E Harris
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Hugh H Bartlett
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Wenzhen Zhao
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Brent C Vander Wyk
- Program on Aging, Yale University School of Medicine, New Haven, Connecticut
| | - Pradeep Varma
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Amy F T Arnsten
- Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher H van Dyck
- Alzheimer's Disease Research Unit, Yale University School of Medicine, New Haven, Connecticut.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.,Department of Neuroscience, Yale University School of Medicine, New Haven, Connecticut.,Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
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20
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Shinto L, Lahna D, Murchison CF, Dodge H, Hagen K, David J, Kaye J, Quinn JF, Wall R, Silbert LC. Oxidized Products of Omega-6 and Omega-3 Long Chain Fatty Acids Are Associated with Increased White Matter Hyperintensity and Poorer Executive Function Performance in a Cohort of Cognitively Normal Hypertensive Older Adults. J Alzheimers Dis 2020; 74:65-77. [DOI: 10.3233/jad-191197] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Lynne Shinto
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - David Lahna
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Charles F. Murchison
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Kirsten Hagen
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Jason David
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
| | - Jeffrey Kaye
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, USA
| | - Joseph F. Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, USA
| | - Rachel Wall
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, USA
| | - Lisa C. Silbert
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, Veterans Affairs Medical Center, Portland, OR, USA
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21
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Mecca AP, McDonald JW, Michalak HR, Godek TA, Harris JE, Pugh EA, Kemp EC, Chen MK, Salardini A, Nabulsi NB, Lim K, Huang Y, Carson RE, Strittmatter SM, van Dyck CH. PET imaging of mGluR5 in Alzheimer's disease. Alzheimers Res Ther 2020; 12:15. [PMID: 31954399 PMCID: PMC6969979 DOI: 10.1186/s13195-020-0582-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 01/05/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Metabotropic glutamate subtype 5 receptors (mGluR5) modulate synaptic transmission and may constitute an important therapeutic target in Alzheimer's disease (AD) by mediating the synaptotoxic action of amyloid-β oligomers. We utilized the positron emission tomography (PET) radioligand [18F]FPEB to investigate mGluR5 binding in early AD. METHODS Sixteen individuals with amnestic mild cognitive impairment (MCI) due to AD or mild AD dementia who were positive for brain amyloid were compared to 15 cognitively normal (CN) participants who were negative for brain amyloid. Diagnostic groups were well balanced for age, sex, and education. Dynamic PET scans were acquired for 60 min, starting at 60 min after the initial administration of up to 185 MBq of [18F]FPEB using a bolus-plus-constant-infusion method (Kbol = 190 min). Equilibrium modeling with a cerebellum reference region was used to estimate [18F]FPEB binding (BPND) to mGluR5. Analyses were performed with and without corrections for gray matter atrophy and partial volume effects. RESULTS Linear mixed model analysis demonstrated a significant effect of group (p = 0.011) and the group × region interaction (p = 0.0049) on BPND. Post hoc comparisons revealed a significant reduction (43%) in mGluR5 binding in the hippocampus of AD (BPND = 0.76 ± 0.41) compared to CN (BPND = 1.34 ± 0.58, p = 0.003, unpaired t test) participants, and a nonsignificant trend for a reduction in a composite association cortical region in AD (BPND = 1.57 ± 0.25) compared to CN (BPND = 1.86 ± 0.63, p = 0.093) participants. Exploratory analyses suggested additional mGluR5 reductions in the entorhinal cortex and parahippocampal gyrus in the AD group. In the overall sample, hippocampal mGluR5 binding was associated with episodic memory scores and global function. CONCLUSIONS [18F]FPEB-PET revealed reductions in hippocampal mGluR5 binding in early AD. Quantification of mGluR5 binding in AD may expand our understanding of AD pathogenesis and accelerate the development of novel biomarkers and treatments.
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Affiliation(s)
- Adam P. Mecca
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Julia W. McDonald
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Hannah R. Michalak
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Tyler A. Godek
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Joanna E. Harris
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Erika A. Pugh
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Emily C. Kemp
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
| | - Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT USA
| | - Arash Salardini
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
| | - Nabeel B. Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT USA
| | - Keunpoong Lim
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT USA
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT USA
| | - Richard E. Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT USA
| | - Stephen M. Strittmatter
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
- CNNR Program, Yale University School of Medicine, 295 Congress Avenue, Ste 431-435, New Haven, CT USA
| | - Christopher H. van Dyck
- Alzheimer’s Disease Research Unit, Yale University School of Medicine, One Church Street, 8th Floor, New Haven, CT 06510 USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT USA
- Department of Neuroscience, Yale University School of Medicine, New Haven, CT USA
- Department of Neurology, Yale University School of Medicine, New Haven, CT USA
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22
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Chen MK, Mecca AP, Naganawa M, Finnema SJ, Toyonaga T, Lin SF, Najafzadeh S, Ropchan J, Lu Y, McDonald JW, Michalak HR, Nabulsi NB, Arnsten AFT, Huang Y, Carson RE, van Dyck CH. Assessing Synaptic Density in Alzheimer Disease With Synaptic Vesicle Glycoprotein 2A Positron Emission Tomographic Imaging. JAMA Neurol 2019; 75:1215-1224. [PMID: 30014145 DOI: 10.1001/jamaneurol.2018.1836] [Citation(s) in RCA: 277] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Importance Synaptic loss is well established as the major structural correlate of cognitive impairment in Alzheimer disease (AD). The ability to measure synaptic density in vivo could accelerate the development of disease-modifying treatments for AD. Synaptic vesicle glycoprotein 2A is an essential vesicle membrane protein expressed in virtually all synapses and could serve as a suitable target for synaptic density. Objective To compare hippocampal synaptic vesicle glycoprotein 2A (SV2A) binding in participants with AD and cognitively normal participants using positron emission tomographic (PET) imaging. Design, Setting, and Participants This cross-sectional study recruited 10 participants with AD and 11 participants who were cognitively normal between November 2015 and June 2017. We hypothesized a reduction in hippocampal SV2A binding in AD, based on the early degeneration of entorhinal cortical cell projections to the hippocampus (via the perforant path) and hippocampal SV2A reductions that had been observed in postmortem studies. Participants underwent high-resolution PET scanning with ((R)-1-((3-(11C-methyl-11C)pyridin-4-yl)methyl)-4-(3,4,5-trifluorophenyl)pyrrolidin-2-one), a compound more commonly known as 11C-UCB-J, for SV2A. They also underwent high-resolution PET scanning with carbon 11-labeled Pittsburgh Compound B (11C-PiB) for β-amyloid, magnetic resonance imaging, and cognitive and neurologic evaluation. Main Outcomes and Measures Outcomes were 11C-UCB-J-specific binding (binding potential [BPND]) via PET imaging in brain regions of interest in participants with AD and participants who were cognitively normal. Results Ten participants with AD (5 male and 5 female; mean [SD] age, 72.7 [6.3] years; 10 [100%] β-amyloid positive) were compared with 11 participants who were cognitively normal (5 male and 6 female; mean [SD] age, 72.9 [8.7] years; 11 [100%] β-amyloid negative). Participants with AD spanned the disease stages from amnestic mild cognitive impairment (n = 5) to mild dementia (n = 5). Participants with AD had significant reduction in hippocampal SV2A specific binding (41%) compared with cognitively normal participants, as assessed by 11C-UCB-J-PET BPND (cognitively normal participants: mean [SD] BPND, 1.47 [0.37]; participants with AD: 0.87 [0.50]; P = .005). These reductions remained significant after correction for atrophy (ie, partial volume correction; participants who were cognitively normal: mean [SD], 2.71 [0.46]; participants with AD: 2.15 [0.55]; P = .02). Hippocampal SV2A-specific binding BPND was correlated with a composite episodic memory score in the overall sample (R = 0.56; P = .01). Conclusions and Relevance To our knowledge, this is the first study to investigate synaptic density in vivo in AD using 11C-UCB-J-PET imaging. This approach may provide a direct measure of synaptic density, and it therefore holds promise as an in vivo biomarker for AD and as an outcome measure for trials of disease-modifying therapies, particularly those targeted at the preservation and restoration of synapses.
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Affiliation(s)
- Ming-Kai Chen
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Adam P Mecca
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Mika Naganawa
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Sjoerd J Finnema
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Takuya Toyonaga
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Shu-Fei Lin
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Soheila Najafzadeh
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Jim Ropchan
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Yihuan Lu
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Julia W McDonald
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Hannah R Michalak
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Nabeel B Nabulsi
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Amy F T Arnsten
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Yiyun Huang
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
| | - Richard E Carson
- Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut
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AD molecular: Molecular imaging of Alzheimer's disease: PET imaging of neurotransmitter systems. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019. [PMID: 31481161 DOI: 10.1016/bs.pmbts.2019.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Current understanding of Alzheimer's disease (AD) pathogenesis relies on the observed accumulations of amyloid β and phosphorylated tau aggregates that are thought to play key roles in initiating or propagating disease. However, other processes including changes in synaptic proteins and neurotransmitter loss have been suggested as important etiologies or contributors. Positron emission tomography (PET) imaging allows in vivo investigations of molecular changes associated with AD. PET imaging with multiple radiotracers can be used in combination with other modalities such as magnetic resonance imaging (MRI), and with assessments of cognition and neuropsychiatric symptoms to investigate the molecular underpinnings of AD. Studies of synaptic protein changes may improve the understanding of disease mechanisms and provide valuable markers of disease progression and therapeutic efficacy. This chapter will illustrate the importance of in vivo molecular imaging in the study of AD with a specific emphasis on PET and radioligands for several non-amyloid targets.
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Zimmermann J, Alain C, Butler C. Impaired memory-guided attention in asymptomatic APOE4 carriers. Sci Rep 2019; 9:8138. [PMID: 31148578 PMCID: PMC6544654 DOI: 10.1038/s41598-019-44471-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 05/15/2019] [Indexed: 11/29/2022] Open
Abstract
Attention and memory may be impaired in individuals at-risk for Alzheimer's disease (AD), though standard cognitive assessments typically study the two in parallel. In reality, attention and memory interact to facilitate information processing, and thus a more integrative approach is required. Here, we used a novel auditory paradigm to assess how long-term memory for auditory scenes facilitates detection of an auditory target in asymptomatic carriers of Apolipoprotein E4 (APOE4), the principle risk gene for late-onset AD. We tested 60 healthy middle-aged adults with varying doses of APOE4 - 20 APOE4 homozygotes (E4/E4), 20 heterozygotes (E3/E4) and 20 non-carriers (E3/E3) - to determine effect on memory-guided attention. While explicit memory was unaffected by genotype, APOE4 dose significantly impaired memory-guided attention. A relationship between explicit memory and memory-guided attention was observed in non-carriers, but this correlation was not significant in E3/E4 and E4/E4 carriers, suggesting that APOE4 carriers rely less on explicit memory to facilitate attention. Since memory-guided attention declined with age in APOE4 homozygotes, this impairment may reflect early disease rather than being a life-long trait. In sum, asymptomatic individuals at increased genetic risk of AD show an age-dependent decline in attention-memory interaction when memory alone is not impaired.
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Affiliation(s)
- Jacqueline Zimmermann
- Department of Psychology, University of Toronto M5S 3G3 and Rotman Research Institute, Baycrest Centre, M6A 2E1, Toronto, Canada.
| | - Claude Alain
- Department of Psychology, University of Toronto M5S 3G3 and Rotman Research Institute, Baycrest Centre, M6A 2E1, Toronto, Canada
| | - Chris Butler
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, OX3 9DU, Oxford, UK
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Paranjpe MD, Chen X, Liu M, Paranjpe I, Leal JP, Wang R, Pomper MG, Wong DF, Benzinger TLS, Zhou Y. The effect of ApoE ε4 on longitudinal brain region-specific glucose metabolism in patients with mild cognitive impairment: a FDG-PET study. NEUROIMAGE-CLINICAL 2019; 22:101795. [PMID: 30991617 PMCID: PMC6449776 DOI: 10.1016/j.nicl.2019.101795] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 03/12/2019] [Accepted: 03/24/2019] [Indexed: 11/02/2022]
Abstract
While the ApoE ε4 allele is a known risk factor for mild cognitive impairment (MCI) and Alzheimer's disease, brain region specific effects remain elusive. In this study, we investigate whether the ApoE ε4 allele exhibits brain region specific effects in longitudinal glucose uptake among patients with MCI from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Preprocessed FDG PET images, MRIs, and demographic information were downloaded from the ADNI database. An iterative reblurred Van Cittertiteration method was used for partial volume correction (PVC) on all PET images. Structural MRIs were used for PET spatial normalization and region of interest (ROI) definition in standard space. Longitudinal changes in ROI FDG standardized uptake value ratio (SUVR) relative to cerebellum in 24 ApoE ε4 carriers and 24 age-matched ApoE ε4 non-carriers were measured for up to 84-months (median 72 months, SD = 11.2 months) and compared using a generalized linear mixed effects model controlling for gender, education, baseline age, and follow-up period. Additionally, voxelwise analysis was performed by implementing a paired t-test comparing matched baseline and 72 month FDG SUVR images in ApoE carriers and non-carriers separately. Results with PVC were compared with ones from non-PVC based analysis. After applying PVC, the superior fontal, parietal, lateral temporal, medial temporal, caudate, thalamus, and post-cingulate, and amygdala regions had greater longitudinal decreases in FDG uptake in ApoE ε4 carriers with MCI compared to non-carriers with MCI. Similar forebrain and limbic clusters were found through voxelwise analysis. Compared to the PVC based analysis, fewer significant ApoE-associated regions and clusters were found in the non-PVC based PET analysis. Our findings suggest that the ApoE ε4 genotype is associated with a longitudinal decline in glucose uptake in 8 forebrain and limbic brain regions in the context of MCI. In conclusion, this 84-months longitudinal FDG PET study demonstrates a novel ApoE ε4-associated brain-region specific glucose metabolism pattern in patients with MCI. Partial volume correction improved FDG PET quantification.
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Affiliation(s)
- Manish D Paranjpe
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Xueqi Chen
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Min Liu
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Ishan Paranjpe
- Icahn School of Medicine at Mount Sinai, NY, New York, United States
| | - Jeffrey P Leal
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Rongfu Wang
- Department of Nuclear Medicine, Peking University First Hospital, Beijing, China
| | - Martin G Pomper
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Dean F Wong
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States
| | - Yun Zhou
- The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States; Department of Nuclear Medicine, Peking University First Hospital, Beijing, China; Mallinckrodt Institute of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, United States.
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