1
|
Azargoonjahromi A. Immunotherapy in Alzheimer's disease: focusing on the efficacy of gantenerumab on amyloid-β clearance and cognitive decline. J Pharm Pharmacol 2024:rgae066. [PMID: 38767981 DOI: 10.1093/jpp/rgae066] [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: 01/18/2024] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
Gantenerumab, a human monoclonal antibody (mAb), has been thought of as a potential agent to treat Alzheimer's disease (AD) by specifically targeting regions of the amyloid-β (Aβ) peptide sequence. Aβ protein accumulation in the brain leads to amyloid plaques, causing neuroinflammation, oxidative stress, neuronal damage, and neurotransmitter dysfunction, thereby causing cognitive decline in AD. Gantenerumab involves disrupting Aβ aggregation and promoting the breakdown of larger Aβ aggregates into smaller fragments, which facilitates the action of Aβ-degrading enzymes in the brain, thus slowing down the progression of AD. Moreover, Gantenerumab acts as an opsonin, coating Aβ plaques and enhancing their recognition by immune cells, which, combined with its ability to improve the activity of microglia, makes it an intriguing candidate for promoting Aβ plaque clearance. Indeed, the multifaceted effects of Gantenerumab, including Aβ disaggregation, enhanced immune recognition, and improved microglia activity, may position it as a promising therapeutic approach for AD. Of note, reports suggest that Gantenerumab, albeit its capacity to reduce or eliminate Aβ, has not demonstrated effectiveness in reducing cognitive decline. This review, after providing an overview of immunotherapy approaches that target Aβ in AD, explores the efficacy of Gantenerumab in reducing Aβ levels and cognitive decline.
Collapse
|
2
|
Jagust WJ, Mattay VS, Krainak DM, Wang SJ, Weidner LD, Hofling AA, Koo H, Hsieh P, Kuo PH, Farrar G, Marzella L. Quantitative Brain Amyloid PET. J Nucl Med 2024; 65:670-678. [PMID: 38514082 PMCID: PMC11064834 DOI: 10.2967/jnumed.123.265766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
Since the development of amyloid tracers for PET imaging, there has been interest in quantifying amyloid burden in the brains of patients with Alzheimer disease. Quantitative amyloid PET imaging is poised to become a valuable approach in disease staging, theranostics, monitoring, and as an outcome measure for interventional studies. Yet, there are significant challenges and hurdles to overcome before it can be implemented into widespread clinical practice. On November 17, 2022, the U.S. Food and Drug Administration, Society of Nuclear Medicine and Molecular Imaging, and Medical Imaging and Technology Alliance cosponsored a public workshop comprising experts from academia, industry, and government agencies to discuss the role of quantitative brain amyloid PET imaging in staging, prognosis, and longitudinal assessment of Alzheimer disease. The workshop discussed a range of topics, including available radiopharmaceuticals for amyloid imaging; the methodology, metrics, and analytic validity of quantitative amyloid PET imaging; its use in disease staging, prognosis, and monitoring of progression; and challenges facing the field. This report provides a high-level summary of the presentations and the discussion.
Collapse
Affiliation(s)
| | - Venkata S Mattay
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland;
| | - Daniel M Krainak
- Division of Radiological Imaging and Radiation Therapy Devices, Office of Radiological Health, Office of Product Evaluation and Quality, Centers for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland
| | - Sue-Jane Wang
- Division of Biometrics I, Office of Biostatistics, Office of Translational Sciences, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Lora D Weidner
- Division of Radiological Imaging and Radiation Therapy Devices, Office of Radiological Health, Office of Product Evaluation and Quality, Centers for Devices and Radiological Health, Food and Drug Administration, Silver Spring, Maryland
| | - A Alex Hofling
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | - Hayoung Koo
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| | | | | | | | - Libero Marzella
- Division of Imaging and Radiation Medicine, Office of Specialty Medicine, Office of New Drugs, Center of Drug Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland
| |
Collapse
|
3
|
Meyer MR, Kirmess KM, Eastwood S, Wente‐Roth TL, Irvin F, Holubasch MS, Venkatesh V, Fogelman I, Monane M, Hanna L, Rabinovici GD, Siegel BA, Whitmer RA, Apgar C, Bateman RJ, Holtzman DM, Irizarry M, Verbel D, Sachdev P, Ito S, Contois J, Yarasheski KE, Braunstein JB, Verghese PB, West T. Clinical validation of the PrecivityAD2 blood test: A mass spectrometry-based test with algorithm combining %p-tau217 and Aβ42/40 ratio to identify presence of brain amyloid. Alzheimers Dement 2024; 20:3179-3192. [PMID: 38491912 PMCID: PMC11095426 DOI: 10.1002/alz.13764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 01/25/2024] [Accepted: 01/31/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND With the availability of disease-modifying therapies for Alzheimer's disease (AD), it is important for clinicians to have tests to aid in AD diagnosis, especially when the presence of amyloid pathology is a criterion for receiving treatment. METHODS High-throughput, mass spectrometry-based assays were used to measure %p-tau217 and amyloid beta (Aβ)42/40 ratio in blood samples from 583 individuals with suspected AD (53% positron emission tomography [PET] positive by Centiloid > 25). An algorithm (PrecivityAD2 test) was developed using these plasma biomarkers to identify brain amyloidosis by PET. RESULTS The area under the receiver operating characteristic curve (AUC-ROC) for %p-tau217 (0.94) was statistically significantly higher than that for p-tau217 concentration (0.91). The AUC-ROC for the PrecivityAD2 test output, the Amyloid Probability Score 2, was 0.94, yielding 88% agreement with amyloid PET. Diagnostic performance of the APS2 was similar by ethnicity, sex, age, and apoE4 status. DISCUSSION The PrecivityAD2 blood test showed strong clinical validity, with excellent agreement with brain amyloidosis by PET.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | - Lucy Hanna
- Center for Statistical SciencesBrown University School of Public HealthProvidenceRhode IslandUSA
| | | | | | | | - Charles Apgar
- American College of RadiologyPhiladelphiaPennsylvaniaUSA
| | | | | | | | | | | | | | | | | | | | | | - Tim West
- C2N DiagnosticsSt. LouisMissouriUSA
| |
Collapse
|
4
|
Ishibashi K, Kurihara M, Toyohara J, Ishii K, Iwata A. Pitfalls of Amyloid-Beta PET: Comparisons With 18 F-MK-6240 and 18 F-THK5351 PET. Clin Nucl Med 2024; 49:319-321. [PMID: 38363815 DOI: 10.1097/rlu.0000000000005097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
ABSTRACT We present 3 patients as pitfalls of amyloid-beta (Aβ) PET, who underwent 11 C-PiB (Aβ), 18 F-MK-6240 (Alzheimer disease [AD]-tau), and 18 F-THK5351 (astrogliosis) PET examinations. Despite negligible or tiny Aβ pathology, patients 1 and 2 were diagnosed with AD as the cause of symptoms. Despite widespread Aβ pathology, patient 3 was not diagnosed with AD as the cause of symptoms. However, if we had only conducted Aβ PET, patients 1 and 2 might not have been diagnosed with AD, whereas patient 3 might have been diagnosed with AD. Hence, both Aβ and AD-tau assessments are necessary to relate clinical symptoms to AD pathology.
Collapse
Affiliation(s)
| | - Masanori Kurihara
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | | | | | - Atsushi Iwata
- Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
5
|
De Strooper B, Karran E. New precision medicine avenues to the prevention of Alzheimer's disease from insights into the structure and function of γ-secretases. EMBO J 2024; 43:887-903. [PMID: 38396302 PMCID: PMC10943082 DOI: 10.1038/s44318-024-00057-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 01/20/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Two phase-III clinical trials with anti-amyloid peptide antibodies have met their primary goal, i.e. slowing of Alzheimer's disease (AD) progression. However, antibody therapy may not be the optimal therapeutic modality for AD prevention, as we will discuss in the context of the earlier small molecules described as "γ-secretase modulators" (GSM). We review here the structure, function, and pathobiology of γ-secretases, with a focus on how mutations in presenilin genes result in early-onset AD. Significant progress has been made in generating compounds that act in a manner opposite to pathogenic presenilin mutations: they stabilize the proteinase-substrate complex, thereby increasing the processivity of substrate cleavage and altering the size spectrum of Aβ peptides produced. We propose the term "γ-secretase allosteric stabilizers" (GSAS) to distinguish these compounds from the rather heterogenous class of GSM. The GSAS represent, in theory, a precision medicine approach to the prevention of amyloid deposition, as they specifically target a discrete aspect in a complex cell biological signalling mechanism that initiates the pathological processes leading to Alzheimer's disease.
Collapse
Affiliation(s)
- Bart De Strooper
- Dementia Research Institute, Institute of Neurology, University College London, at the Francis Crick Institute, London, NW1 AT, UK.
- Laboratory for the Research of Neurodegenerative Diseases, VIB Center for Brain & Disease Research, and Leuven Brain Institute, KU Leuven, Leuven, 3000, Belgium.
| | - Eric Karran
- Cambridge Research Center, AbbVie, Inc., Cambridge, MA, USA
| |
Collapse
|
6
|
Hayes-Larson E, Ackley SF, Turney IC, La Joie R, Mayeda ER, Glymour MM. Considerations for Use of Blood-Based Biomarkers in Epidemiologic Dementia Research. Am J Epidemiol 2024; 193:527-535. [PMID: 37846130 PMCID: PMC10911539 DOI: 10.1093/aje/kwad197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 07/13/2023] [Accepted: 10/05/2023] [Indexed: 10/18/2023] Open
Abstract
Dementia represents a growing public health burden with large social, racial, and ethnic disparities. The etiology of dementia is poorly understood, and the lack of robust biomarkers in diverse, population-representative samples is a barrier to moving dementia research forward. Existing biomarkers and other measures of pathology-derived from neuropathology, neuroimaging, and cerebrospinal fluid samples-are commonly collected from predominantly White and highly educated samples drawn from academic medical centers in urban settings. Blood-based biomarkers are noninvasive and less expensive, offering promise to expand our understanding of the pathophysiology of dementia, including in participants from historically excluded groups. Although largely not yet approved by the Food and Drug Administration or used in clinical settings, blood-based biomarkers are increasingly included in epidemiologic studies on dementia. Blood-based biomarkers in epidemiologic research may allow the field to more accurately understand the multifactorial etiology and sequence of events that characterize dementia-related pathophysiological changes. As blood-based dementia biomarkers continue to be developed and incorporated into research and practice, we outline considerations for using them in dementia epidemiology, and illustrate key concepts with Alzheimer's Disease Neuroimaging Initiative (2003-present) data. We focus on measurement, including both validity and reliability, and on the use of dementia blood-based biomarkers to promote equity in dementia research and cognitive aging. This article is part of a Special Collection on Mental Health.
Collapse
Affiliation(s)
| | | | | | | | | | - M Maria Glymour
- Correspondence to Dr. M. Maria Glymour, Department of Epidemiology, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118 (e-mail: )
| | | |
Collapse
|
7
|
Lopez OL, Villemagne VL, Chang YF, Cohen AD, Klunk WE, Mathis CA, Pascoal T, Ikonomovic MD, Rowe C, Dore V, Snitz BE, Lopresti BJ, Kamboh MI, Aizenstein HJ, Kuller LH. Association Between β-Amyloid Accumulation and Incident Dementia in Individuals 80 Years or Older Without Dementia. Neurology 2024; 102:e207920. [PMID: 38165336 PMCID: PMC10870745 DOI: 10.1212/wnl.0000000000207920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/03/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES While the highest prevalence of dementia occurs in individuals older than 80 years, most imaging studies focused on younger populations. The rates of β-amyloid (Aβ) accumulation and the effect of Alzheimer disease (AD) pathology on progression to dementia in this age group remain unexplored. In this study, we examined the relationship between changes in Aβ deposition over time and incident dementia in nondemented individuals followed during a period of 11 years. METHODS We examined 94 participants (age 85.9 + 2.8 years) who had up to 5 measurements of Pittsburgh compound-B (PiB)-PET and clinical evaluations from 2009 to 2020. All 94 participants had 2 PiB-PET scans, 76 participants had 3 PiB-PET scans, 18 participants had 4 PiB-PET scans, and 10 participants had 5 PiB-PET scans. The rates of Aβ deposition were compared with 120 nondemented individuals younger than 80 years (69.3 ± 5.4 years) from the Australian Imaging, Biomarker, and Lifestyle (AIBL) study who had 3 or more annual PiB-PET assessments. RESULTS By 2020, 49% of the participants developed dementia and 63% were deceased. There was a gradual increase in Aβ deposition in all participants whether they were considered Aβ positive or negative at baseline. In a Cox model controlled for age, sex, education level, APOE-4 allele, baseline Mini-Mental State Examination, and mortality, short-term change in Aβ deposition was not significantly associated with incident dementia (HR 2.19 (0.41-11.73). However, baseline Aβ burden, cortical thickness, and white matter lesions volume were the predictors of incident dementia. Aβ accumulation was faster (p = 0.01) in the older cohort (5.6%/year) when compared with AIBL (4.1%/year). In addition, baseline Aβ deposition was a predictor of short-term change (mean time 1.88 years). DISCUSSION There was an accelerated Aβ accumulation in cognitively normal individuals older than 80 years. Baseline Aβ deposition was a determinant of incident dementia and short-term change in Aβ deposition suggesting that an active Aβ pathologic process was present when these participants were cognitively normal. Consequently, age may not be a limiting factor for the use of the emergent anti-Aβ therapies.
Collapse
Affiliation(s)
- Oscar L Lopez
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Victor L Villemagne
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Yue-Fang Chang
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Ann D Cohen
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - William E Klunk
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Chester A Mathis
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Tharick Pascoal
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Milos D Ikonomovic
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Christopher Rowe
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Vincent Dore
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Beth E Snitz
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Brian J Lopresti
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - M Ilyas Kamboh
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Howard J Aizenstein
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| | - Lewis H Kuller
- From the Departments of Neurology (O.L.L., W.E.K., M.D.I., B.E.S.), Psychiatry (O.L.L., V.L.V., A.D.C., W.E.K., T.P., H.J.A.), Neurosurgery (Y.-F.C.), Radiology (A.D.C., C.A.M., B.J.L.), Epidemiology (L.H.K.), and Human Genetics, Graduate School of Public Health (M.I.K.), University of Pittsburgh, PA; Department of Molecular Imaging and Therapy (C.R.), Austin Health, Melbourne; The Florey Institute of Neuroscience and Mental Health (C.R., V.D.), University of Melbourne; and CSIRO Health and Biosecurity (V.D.), Melbourne, Australia
| |
Collapse
|
8
|
Cho H, Mundada NS, Apostolova LG, Carrillo MC, Shankar R, Amuiri AN, Zeltzer E, Windon CC, Soleimani-Meigooni DN, Tanner JA, Heath CL, Lesman-Segev OH, Aisen P, Eloyan A, Lee HS, Hammers DB, Kirby K, Dage JL, Fagan A, Foroud T, Grinberg LT, Jack CR, Kramer J, Kukull WA, Murray ME, Nudelman K, Toga A, Vemuri P, Atri A, Day GS, Duara R, Graff-Radford NR, Honig LS, Jones DT, Masdeu J, Mendez M, Musiek E, Onyike CU, Riddle M, Rogalski EJ, Salloway S, Sha S, Turner RS, Wingo TS, Wolk DA, Koeppe R, Iaccarino L, Dickerson BC, La Joie R, Rabinovici GD. Amyloid and tau-PET in early-onset AD: Baseline data from the Longitudinal Early-onset Alzheimer's Disease Study (LEADS). Alzheimers Dement 2023; 19 Suppl 9:S98-S114. [PMID: 37690109 PMCID: PMC10807231 DOI: 10.1002/alz.13453] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 09/12/2023]
Abstract
INTRODUCTION We aimed to describe baseline amyloid-beta (Aβ) and tau-positron emission tomograrphy (PET) from Longitudinal Early-onset Alzheimer's Disease Study (LEADS), a prospective multi-site observational study of sporadic early-onset Alzheimer's disease (EOAD). METHODS We analyzed baseline [18F]Florbetaben (Aβ) and [18F]Flortaucipir (tau)-PET from cognitively impaired participants with a clinical diagnosis of mild cognitive impairment (MCI) or AD dementia aged < 65 years. Florbetaben scans were used to distinguish cognitively impaired participants with EOAD (Aβ+) from EOnonAD (Aβ-) based on the combination of visual read by expert reader and image quantification. RESULTS 243/321 (75.7%) of participants were assigned to the EOAD group based on amyloid-PET; 231 (95.1%) of them were tau-PET positive (A+T+). Tau-PET signal was elevated across cortical regions with a parietal-predominant pattern, and higher burden was observed in younger and female EOAD participants. DISCUSSION LEADS data emphasizes the importance of biomarkers to enhance diagnostic accuracy in EOAD. The advanced tau-PET binding at baseline might have implications for therapeutic strategies in patients with EOAD. HIGHLIGHTS 72% of patients with clinical EOAD were positive on both amyloid- and tau-PET. Amyloid-positive patients with EOAD had high tau-PET signal across cortical regions. In EOAD, tau-PET mediated the relationship between amyloid-PET and MMSE. Among EOAD patients, younger onset and female sex were associated with higher tau-PET.
Collapse
Affiliation(s)
- Hanna Cho
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- Global Brain Health Institute, University of California, San Francisco, California, USA
| | - Nidhi S Mundada
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Liana G Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine Indianapolis, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Maria C Carrillo
- Medical & Scientific Relations Division, Alzheimer's Association, Chicago, Illinois, USA
| | - Ranjani Shankar
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Alinda N Amuiri
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Ehud Zeltzer
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Charles C Windon
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - David N Soleimani-Meigooni
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Jeremy A Tanner
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Courtney Lawhn Heath
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Orit H Lesman-Segev
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
- Department of Diagnostic Imaging, Sheba Medical Center, Tel HaShomer, Israel
| | - Paul Aisen
- Alzheimer's Therapeutic Research Institute, University of Southern California, San Diego, California, USA
| | - Ani Eloyan
- Department of Biostatistics, Center for Statistical Sciences, Brown University, Rhode Island, USA
| | - Hye Sun Lee
- Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Dustin B Hammers
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kala Kirby
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jeffrey L Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Anne Fagan
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Lea T Grinberg
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
- Department of Pathology, University of California - San Francisco, San Francisco, California, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joel Kramer
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Walter A Kukull
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Kelly Nudelman
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, California, USA
| | | | - Alireza Atri
- Banner Sun Health Research Institute, Sun City, Arizona, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ranjan Duara
- Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami, Florida, USA
| | | | - Lawrence S Honig
- Taub Institute and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - David T Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Joseph Masdeu
- Nantz National Alzheimer Center, Houston Methodist and Weill Cornell Medicine, Houston, Texas, USA
| | - Mario Mendez
- Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Erik Musiek
- Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Meghan Riddle
- Department of Neurology, Alpert Medical School, Brown University, Rhode Island, USA
| | - Emily J Rogalski
- Department of Psychiatry and Behavioral Sciences, Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Stephen Salloway
- Department of Neurology, Alpert Medical School, Brown University, Rhode Island, USA
| | - Sharon Sha
- Department of Neurology & Neurological Sciences, Stanford University, Palo Alto, California, USA
| | | | - Thomas S Wingo
- Department of Neurology and Human Genetics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - David A Wolk
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Robert Koeppe
- Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Leonardo Iaccarino
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Renaud La Joie
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
| | - Gil D Rabinovici
- Memory and Aging Center, UCSF Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco, California, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| |
Collapse
|
9
|
Gollan TH, Stasenko A, Li C, Smirnov DS, Galasko D, Salmon DP. Autocorrection if→of function words in reading aloud: A novel marker of Alzheimer's risk. Neuropsychology 2023; 37:813-826. [PMID: 35925735 PMCID: PMC9898462 DOI: 10.1037/neu0000829] [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] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE The present study investigated cognitive mechanisms underlying the ability to stop "autocorrect" errors elicited by unexpected words in a read-aloud task, and the utility of autocorrection for predicting Alzheimer's disease (AD) biomarkers. METHOD Cognitively normal participants (total n = 85; n = 64 with cerebrospinal fluid [CSF] biomarkers) read aloud six short paragraphs in which 10 critical target words were replaced with autocorrect targets, for example, The player who scored that final [paint] for the local team reported [him] experience. Autocorrect targets either replaced the most expected/dominant completion (i.e., point) or a less expected/nondominant completion (i.e., basket), and within each paragraph half of the autocorrect targets were content words (e.g., point/paint) and half were function words (e.g., his/him). Participants were instructed to avoid autocorrecting. RESULTS Participants produced more autocorrect errors in paragraphs with dominant than with nondominant targets, and with function than with content targets. Cognitively normal participants with high CSF Tau/Aβ42 (i.e., an AD-like biomarker profile) produced more autocorrect total errors than those below the Tau/Aβ42 threshold, an effect also significant with dominant-function targets alone (e.g., saying his instead of him). A logistic regression model with dominant-function errors and age showed errors as the stronger predictor of biomarker status (sensitivity 83%; specificity 85%). CONCLUSIONS Difficulty stopping autocorrect errors is associated with biomarkers indicating preclinical AD, and reveals promise as a diagnostic tool. Greater vulnerability of function over content words to autocorrection in individuals with AD-like biomarkers implicates monitoring and attention (rather than semantic processing) in the earliest of cognitive changes associated with AD risk. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Tamar H. Gollan
- Department of Neurosciences, University of California, San Diego
| | - Alena Stasenko
- Department of Neurosciences, University of California, San Diego
| | - Chuchu Li
- Department of Neurosciences, University of California, San Diego
| | - Denis S. Smirnov
- Department of Neurosciences, University of California, San Diego
| | - Douglas Galasko
- Department of Neurosciences, University of California, San Diego
| | - David P. Salmon
- Department of Neurosciences, University of California, San Diego
| |
Collapse
|
10
|
Jovalekic A, Roé-Vellvé N, Koglin N, Quintana ML, Nelson A, Diemling M, Lilja J, Gómez-González JP, Doré V, Bourgeat P, Whittington A, Gunn R, Stephens AW, Bullich S. Validation of quantitative assessment of florbetaben PET scans as an adjunct to the visual assessment across 15 software methods. Eur J Nucl Med Mol Imaging 2023; 50:3276-3289. [PMID: 37300571 PMCID: PMC10542295 DOI: 10.1007/s00259-023-06279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/19/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Amyloid positron emission tomography (PET) with [18F]florbetaben (FBB) is an established tool for detecting Aβ deposition in the brain in vivo based on visual assessment of PET scans. Quantitative measures are commonly used in the research context and allow continuous measurement of amyloid burden. The aim of this study was to demonstrate the robustness of FBB PET quantification. METHODS This is a retrospective analysis of FBB PET images from 589 subjects. PET scans were quantified with 15 analytical methods using nine software packages (MIMneuro, Hermes BRASS, Neurocloud, Neurology Toolkit, statistical parametric mapping (SPM8), PMOD Neuro, CapAIBL, non-negative matrix factorization (NMF), AmyloidIQ) that used several metrics to estimate Aβ load (SUVR, centiloid, amyloid load, and amyloid index). Six analytical methods reported centiloid (MIMneuro, standard centiloid, Neurology Toolkit, SPM8 (PET only), CapAIBL, NMF). All results were quality controlled. RESULTS The mean sensitivity, specificity, and accuracy were 96.1 ± 1.6%, 96.9 ± 1.0%, and 96.4 ± 1.1%, respectively, for all quantitative methods tested when compared to histopathology, where available. The mean percentage of agreement between binary quantitative assessment across all 15 methods and visual majority assessment was 92.4 ± 1.5%. Assessments of reliability, correlation analyses, and comparisons across software packages showed excellent performance and consistent results between analytical methods. CONCLUSION This study demonstrated that quantitative methods using both CE marked software and other widely available processing tools provided comparable results to visual assessments of FBB PET scans. Software quantification methods, such as centiloid analysis, can complement visual assessment of FBB PET images and could be used in the future for identification of early amyloid deposition, monitoring disease progression and treatment effectiveness.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, Australia
| | | | | | | | | | | |
Collapse
|
11
|
Jo S, Lee H, Kim HJ, Suh CH, Kim SJ, Lee Y, Roh JH, Lee JH. Do radiomics or diffusion-tensor images provide additional information to predict brain amyloid-beta positivity? Sci Rep 2023; 13:9755. [PMID: 37328578 PMCID: PMC10275931 DOI: 10.1038/s41598-023-36639-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 06/07/2023] [Indexed: 06/18/2023] Open
Abstract
The aim of the present study was to predict amyloid-beta positivity using a conventional T1-weighted image, radiomics, and a diffusion-tensor image obtained by magnetic resonance imaging (MRI). We included 186 patients with mild cognitive impairment (MCI) who underwent Florbetaben positron emission tomography (PET), MRI (three-dimensional T1-weighted and diffusion-tensor images), and neuropsychological tests at the Asan Medical Center. We developed a stepwise machine learning algorithm using demographics, T1 MRI features (volume, cortical thickness and radiomics), and diffusion-tensor image to distinguish amyloid-beta positivity on Florbetaben PET. We compared the performance of each algorithm based on the MRI features used. The study population included 72 patients with MCI in the amyloid-beta-negative group and 114 patients with MCI in the amyloid-beta-positive group. The machine learning algorithm using T1 volume performed better than that using only clinical information (mean area under the curve [AUC]: 0.73 vs. 0.69, p < 0.001). The machine learning algorithm using T1 volume showed better performance than that using cortical thickness (mean AUC: 0.73 vs. 0.68, p < 0.001) or texture (mean AUC: 0.73 vs. 0.71, p = 0.002). The performance of the machine learning algorithm using fractional anisotropy in addition to T1 volume was not better than that using T1 volume alone (mean AUC: 0.73 vs. 0.73, p = 0.60). Among MRI features, T1 volume was the best predictor of amyloid PET positivity. Radiomics or diffusion-tensor images did not provide additional benefits.
Collapse
Affiliation(s)
- Sungyang Jo
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Hyunna Lee
- Bigdata Research Center, Asan Institute for Life Science, Asan Medical Center, Seoul, Republic of Korea
| | - Hyung-Ji Kim
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Republic of Korea
| | - Chong Hyun Suh
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang Joon Kim
- Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yoojin Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea
| | - Jee Hoon Roh
- Department of Physiology, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
| |
Collapse
|
12
|
Pemberton HG, Buckley C, Battle M, Bollack A, Patel V, Tomova P, Cooke D, Balhorn W, Hegedorn K, Lilja J, Brand C, Farrar G. Software compatibility analysis for quantitative measures of [ 18F]flutemetamol amyloid PET burden in mild cognitive impairment. EJNMMI Res 2023; 13:48. [PMID: 37225974 DOI: 10.1186/s13550-023-00994-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 05/05/2023] [Indexed: 05/26/2023] Open
Abstract
RATIONALE Amyloid-β (Aβ) pathology is one of the earliest detectable brain changes in Alzheimer's disease pathogenesis. In clinical practice, trained readers will visually categorise positron emission tomography (PET) scans as either Aβ positive or negative. However, adjunct quantitative analysis is becoming more widely available, where regulatory approved software can currently generate metrics such as standardised uptake value ratios (SUVr) and individual Z-scores. Therefore, it is of direct value to the imaging community to assess the compatibility of commercially available software packages. In this collaborative project, the compatibility of amyloid PET quantification was investigated across four regulatory approved software packages. In doing so, the intention is to increase visibility and understanding of clinically relevant quantitative methods. METHODS Composite SUVr using the pons as the reference region was generated from [18F]flutemetamol (GE Healthcare) PET in a retrospective cohort of 80 amnestic mild cognitive impairment (aMCI) patients (40 each male/female; mean age = 73 years, SD = 8.52). Based on previous autopsy validation work, an Aβ positivity threshold of ≥ 0.6 SUVrpons was applied. Quantitative results from MIM Software's MIMneuro, Syntermed's NeuroQ, Hermes Medical Solutions' BRASS and GE Healthcare's CortexID were analysed using intraclass correlation coefficient (ICC), percentage agreement around the Aβ positivity threshold and kappa scores. RESULTS Using an Aβ positivity threshold of ≥ 0.6 SUVrpons, 95% agreement was achieved across the four software packages. Two patients were narrowly classed as Aβ negative by one software package but positive by the others, and two patients vice versa. All kappa scores around the same Aβ positivity threshold, both combined (Fleiss') and individual software pairings (Cohen's), were ≥ 0.9 signifying "almost perfect" inter-rater reliability. Excellent reliability was found between composite SUVr measurements for all four software packages, with an average measure ICC of 0.97 and 95% confidence interval of 0.957-0.979. Correlation coefficient analysis between the two software packages reporting composite z-scores was strong (r2 = 0.98). CONCLUSION Using an optimised cortical mask, regulatory approved software packages provided highly correlated and reliable quantification of [18F]flutemetamol amyloid PET with a ≥ 0.6 SUVrpons positivity threshold. In particular, this work could be of interest to physicians performing routine clinical imaging rather than researchers performing more bespoke image analysis. Similar analysis is encouraged using other reference regions as well as the Centiloid scale, when it has been implemented by more software packages.
Collapse
Affiliation(s)
- Hugh G Pemberton
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK.
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.
- UCL Queen Square Institute of Neurology, University College London, London, UK.
| | | | - Mark Battle
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Ariane Bollack
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Vrajesh Patel
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK
| | - Petya Tomova
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK
| | | | | | | | | | - Christine Brand
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK
| | - Gill Farrar
- GE Healthcare, Pollards Wood, Chalfont St Giles, Amersham, HP8 4SP, UK
| |
Collapse
|
13
|
Hansson O, Blennow K, Zetterberg H, Dage J. Blood biomarkers for Alzheimer's disease in clinical practice and trials. NATURE AGING 2023; 3:506-519. [PMID: 37202517 PMCID: PMC10979350 DOI: 10.1038/s43587-023-00403-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 03/21/2023] [Indexed: 05/20/2023]
Abstract
Blood-based biomarkers hold great promise to revolutionize the diagnostic and prognostic work-up of Alzheimer's disease (AD) in clinical practice. This is very timely, considering the recent development of anti-amyloid-β (Aβ) immunotherapies. Several assays for measuring phosphorylated tau (p-tau) in plasma exhibit high diagnostic accuracy in distinguishing AD from all other neurodegenerative diseases in patients with cognitive impairment. Prognostic models based on plasma p-tau levels can also predict future development of AD dementia in patients with mild cognitive complaints. The use of such high-performing plasma p-tau assays in the clinical practice of specialist memory clinics would reduce the need for more costly investigations involving cerebrospinal fluid samples or positron emission tomography. Indeed, blood-based biomarkers already facilitate identification of individuals with pre-symptomatic AD in the context of clinical trials. Longitudinal measurements of such biomarkers will also improve the detection of relevant disease-modifying effects of new drugs or lifestyle interventions.
Collapse
Affiliation(s)
- Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden.
- Memory Clinic, Skåne University Hospital, Lund, Sweden.
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for 27 Neurodegenerative Diseases, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Jeffrey Dage
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
14
|
The association of subjective sleep characteristics and plasma biomarkers of Alzheimer's disease pathology in older cognitively unimpaired adults with higher amyloid-β burden. J Neurol 2023; 270:3008-3021. [PMID: 36806992 DOI: 10.1007/s00415-023-11626-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/23/2023]
Abstract
We aimed to investigate the association of subjective sleep characteristics and plasma Alzheimer's disease (AD) biomarkers in older cognitively unimpaired adults with higher amyloid-β (Aβ) burden. Unimpaired cognition was determined by education-adjusted performance for the Mini-Mental State Examination and exclusion of dementia and mild cognitive impairment via standardized neuropsychological tests. We used Pittsburgh Sleep Quality Index (PSQI) to assess subjective sleep quality. The participants also underwent examination of plasma AD biomarkers and 18F-florbetapir PET scan. Correlation and multiple linear regression analyses were used to investigate the association between subjective sleep characteristics and AD biomarkers. A total of 335 participants were included and 114 were Aβ-PET positive. Multivariable regression analysis showed sleep duration > 8 h and sleep disturbance were associated with Aβ deposition in total participants. Two multiple linear regression models were applied and the results revealed in participants with Aβ-PET (+), falling asleep at ≥ 22:00 to ≤ 23:00 was associated with higher levels of Aβ42 and Aβ42/40. Other associations with higher Aβ42/40 and standard uptake value ratio contained sleep efficiency value, sleep efficiency ≥ 75%, no/mild daytime dysfunction and PSQI score ≤ 5. Higher p-Tau-181 level was associated with sleep latency > 30 min in Aβ-PET (+) group and moderate/severe sleep disturbance in Aβ-PET (-) group. Our data suggests sleep duration ≤ 8 h and no/mild sleep disturbance may be related to less Aβ burden. In participants with Aβ deposition, falling asleep at 22:00 to 23:00, higher sleep efficiency (at least ≥ 75%), no/mild daytime dysfunction, sleep latency ≤ 30 min, and good sleep quality may help improve AD pathology.
Collapse
|
15
|
Nakaya M, Sato N, Matsuda H, Maikusa N, Shigemoto Y, Sone D, Yamao T, Ogawa M, Kimura Y, Chiba E, Ohnishi M, Kato K, Okita K, Tsukamoto T, Yokoi Y, Sakata M, Abe O. Free water derived by multi-shell diffusion MRI reflects tau/neuroinflammatory pathology in Alzheimer's disease. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12356. [PMID: 36304723 PMCID: PMC9594557 DOI: 10.1002/trc2.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/03/2022] [Accepted: 08/20/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Free-water (FW) imaging, a new analysis method for diffusion magnetic resonance imaging (MRI), can indicate neuroinflammation and degeneration. We evaluated FW in Alzheimer's disease (AD) using tau/inflammatory and amyloid positron emission tomography (PET). METHODS Seventy-one participants underwent multi-shell diffusion MRI, 18F-THK5351 PET, 11C-Pittsburgh compound B PET, and neuropsychological assessments. They were categorized into two groups: healthy controls (HCs) (n = 40) and AD-spectrum group (AD-S) (n = 31) using the Centiloid scale with amyloid PET and cognitive function. We analyzed group comparisons in FW and PET, correlations between FW and PET, and correlation analysis with neuropsychological scores. RESULTS In AD-S group, there was a significant positive correlation between FW and 18F-THK5351 in the temporal lobes. In addition, there were negative correlations between FW and cognitive function in the temporal lobe and cingulate gyrus, and negative correlations between 18F-THK5351 and cognitive function in the same regions. DISCUSSION FW imaging could be a biomarker for tau in AD alongside clinical correlations.
Collapse
Affiliation(s)
- Moto Nakaya
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan,Department of RadiologyGraduate School of MedicineUniversity of TokyoHongoBunkyo‐kuTokyoJapan
| | - Noriko Sato
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Hiroshi Matsuda
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan,Drug Discovery and Cyclotron Research CenterSouthern TOHOKU Research Institute for NeuroscienceKoriyamaJapan
| | - Norihide Maikusa
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Yoko Shigemoto
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Daichi Sone
- Department of PsychiatryThe Jikei University School of MedicineTokyoJapan,Integrative Brain Imaging CenterNational Center of Neurology and PsychiatryTokyoJapan
| | - Tensho Yamao
- Department of Radiological SciencesSchool of Health SciencesFukushima Medical UniversityFukushimaJapan
| | - Masayo Ogawa
- Integrative Brain Imaging CenterNational Center of Neurology and PsychiatryTokyoJapan
| | - Yukio Kimura
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Emiko Chiba
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Masahiro Ohnishi
- Departmentof RadiologyNational Center Hospital of Neurology and PsychiatryOgawa‐HigashiKodairaTokyoJapan
| | - Koichi Kato
- Integrative Brain Imaging CenterNational Center of Neurology and PsychiatryTokyoJapan
| | - Kyoji Okita
- Integrative Brain Imaging CenterNational Center of Neurology and PsychiatryTokyoJapan
| | - Tadashi Tsukamoto
- Department of NeurologyNational Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Yuma Yokoi
- Department of PsychiatryNational Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Masuhiro Sakata
- Department of PsychiatryNational Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Osamu Abe
- Department of RadiologyGraduate School of MedicineUniversity of TokyoHongoBunkyo‐kuTokyoJapan
| |
Collapse
|
16
|
Morató X, Pytel V, Jofresa S, Ruiz A, Boada M. Symptomatic and Disease-Modifying Therapy Pipeline for Alzheimer’s Disease: Towards a Personalized Polypharmacology Patient-Centered Approach. Int J Mol Sci 2022; 23:ijms23169305. [PMID: 36012569 PMCID: PMC9409252 DOI: 10.3390/ijms23169305] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 02/07/2023] Open
Abstract
Since 1906, when Dr. Alois Alzheimer first described in a patient “a peculiar severe disease process of the cerebral cortex”, people suffering from this pathology have been waiting for a breakthrough therapy. Alzheimer’s disease (AD) is an irreversible, progressive neurodegenerative brain disorder and the most common form of dementia in the elderly with a long presymptomatic phase. Worldwide, approximately 50 million people are living with dementia, with AD comprising 60–70% of cases. Pathologically, AD is characterized by the deposition of amyloid β-peptide (Aβ) in the neuropil (neuritic plaques) and blood vessels (amyloid angiopathy), and by the accumulation of hyperphosphorylated tau in neurons (neurofibrillary tangles) in the brain, with associated loss of synapses and neurons, together with glial activation, and neuroinflammation, resulting in cognitive deficits and eventually dementia. The current competitive landscape in AD consists of symptomatic treatments, of which there are currently six approved medications: three AChEIs (donepezil, rivastigmine, and galantamine), one NMDA-R antagonist (memantine), one combination therapy (memantine/donepezil), and GV-971 (sodium oligomannate, a mixture of oligosaccharides derived from algae) only approved in China. Improvements to the approved therapies, such as easier routes of administration and reduced dosing frequencies, along with the developments of new strategies and combined treatments are expected to occur within the next decade and will positively impact the way the disease is managed. Recently, Aducanumab, the first disease-modifying therapy (DMT) has been approved for AD, and several DMTs are in advanced stages of clinical development or regulatory review. Small molecules, mAbs, or multimodal strategies showing promise in animal studies have not confirmed that promise in the clinic (where small to moderate changes in clinical efficacy have been observed), and therefore, there is a significant unmet need for a better understanding of the AD pathogenesis and the exploration of alternative etiologies and therapeutic effective disease-modifying therapies strategies for AD. Therefore, a critical review of the disease-modifying therapy pipeline for Alzheimer’s disease is needed.
Collapse
Affiliation(s)
- Xavier Morató
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Correspondence:
| | - Vanesa Pytel
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Sara Jofresa
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
| | - Agustín Ruiz
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercè Boada
- Research Center and Memory Clinic, Fundació ACE, Institut Català de Neurociències Aplicades, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Instituto de Salud Carlos III, 28029 Madrid, Spain
| |
Collapse
|
17
|
Pemberton HG, Collij LE, Heeman F, Bollack A, Shekari M, Salvadó G, Alves IL, Garcia DV, Battle M, Buckley C, Stephens AW, Bullich S, Garibotto V, Barkhof F, Gispert JD, Farrar G. Quantification of amyloid PET for future clinical use: a state-of-the-art review. Eur J Nucl Med Mol Imaging 2022; 49:3508-3528. [PMID: 35389071 PMCID: PMC9308604 DOI: 10.1007/s00259-022-05784-y] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 03/25/2022] [Indexed: 12/15/2022]
Abstract
Amyloid-β (Aβ) pathology is one of the earliest detectable brain changes in Alzheimer's disease (AD) pathogenesis. The overall load and spatial distribution of brain Aβ can be determined in vivo using positron emission tomography (PET), for which three fluorine-18 labelled radiotracers have been approved for clinical use. In clinical practice, trained readers will categorise scans as either Aβ positive or negative, based on visual inspection. Diagnostic decisions are often based on these reads and patient selection for clinical trials is increasingly guided by amyloid status. However, tracer deposition in the grey matter as a function of amyloid load is an inherently continuous process, which is not sufficiently appreciated through binary cut-offs alone. State-of-the-art methods for amyloid PET quantification can generate tracer-independent measures of Aβ burden. Recent research has shown the ability of these quantitative measures to highlight pathological changes at the earliest stages of the AD continuum and generate more sensitive thresholds, as well as improving diagnostic confidence around established binary cut-offs. With the recent FDA approval of aducanumab and more candidate drugs on the horizon, early identification of amyloid burden using quantitative measures is critical for enrolling appropriate subjects to help establish the optimal window for therapeutic intervention and secondary prevention. In addition, quantitative amyloid measurements are used for treatment response monitoring in clinical trials. In clinical settings, large multi-centre studies have shown that amyloid PET results change both diagnosis and patient management and that quantification can accurately predict rates of cognitive decline. Whether these changes in management reflect an improvement in clinical outcomes is yet to be determined and further validation work is required to establish the utility of quantification for supporting treatment endpoint decisions. In this state-of-the-art review, several tools and measures available for amyloid PET quantification are summarised and discussed. Use of these methods is growing both clinically and in the research domain. Concurrently, there is a duty of care to the wider dementia community to increase visibility and understanding of these methods.
Collapse
Affiliation(s)
- Hugh G Pemberton
- GE Healthcare, Amersham, UK.
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK.
- UCL Queen Square Institute of Neurology, University College London, London, UK.
| | - Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam Neurocience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fiona Heeman
- Department of Radiology and Nuclear Medicine, Amsterdam Neurocience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ariane Bollack
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Isadora Lopes Alves
- Department of Radiology and Nuclear Medicine, Amsterdam Neurocience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Brain Research Center, Amsterdam, The Netherlands
| | - David Vallez Garcia
- Department of Radiology and Nuclear Medicine, Amsterdam Neurocience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Mark Battle
- GE Healthcare, Amersham, UK
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | | | | | | | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, University Hospitals of Geneva, Geneva, Switzerland
- NIMTLab, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Frederik Barkhof
- Centre for Medical Image Computing (CMIC), Department of Medical Physics and Bioengineering, University College London, London, UK
- UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Radiology and Nuclear Medicine, Amsterdam Neurocience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | | |
Collapse
|
18
|
Collij LE, Salvadó G, Wottschel V, Mastenbroek SE, Schoenmakers P, Heeman F, Aksman L, Wink AM, Berckel BNM, van de Flier WM, Scheltens P, Visser PJ, Barkhof F, Haller S, Gispert JD, Lopes Alves I. Spatial-Temporal Patterns of β-Amyloid Accumulation: A Subtype and Stage Inference Model Analysis. Neurology 2022; 98:e1692-e1703. [PMID: 35292558 PMCID: PMC9071373 DOI: 10.1212/wnl.0000000000200148] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/18/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES β-amyloid (Aβ) staging models assume a single spatial-temporal progression of amyloid accumulation. We assessed evidence for Aβ accumulation subtypes by applying the data-driven Subtype and Stage Inference (SuStaIn) model to amyloid-PET data. METHODS Amyloid-PET data of 3,010 participants were pooled from 6 cohorts (ALFA+, EMIF-AD, ABIDE, OASIS, and ADNI). Standardized uptake value ratios were calculated for 17 regions. We applied the SuStaIn algorithm to identify consistent subtypes in the pooled dataset based on the cross-validation information criterion and the most probable subtype/stage classification per scan. The effects of demographics and risk factors on subtype assignment were assessed using multinomial logistic regression. RESULTS Participants were mostly cognitively unimpaired (n = 1890 [62.8%]), had a mean age of 68.72 (SD 9.1) years, 42.1% were APOE ε4 carriers, and 51.8% were female. A 1-subtype model recovered the traditional amyloid accumulation trajectory, but SuStaIn identified 3 optimal subtypes, referred to as frontal, parietal, and occipital based on the first regions to show abnormality. Of the 788 (26.2%) with strong subtype assignment (>50% probability), the majority was assigned to frontal (n = 415 [52.5%]), followed by parietal (n = 199 [25.3%]) and occipital subtypes (n = 175 [22.2%]). Significant differences across subtypes included distinct proportions of APOE ε4 carriers (frontal 61.8%, parietal 57.1%, occipital 49.4%), participants with dementia (frontal 19.7%, parietal 19.1%, occipital 31.0%), and lower age for the parietal subtype (frontal/occipital 72.1 years, parietal 69.3 years). Higher amyloid (Centiloid) and CSF p-tau burden was observed for the frontal subtype; parietal and occipital subtypes did not differ. At follow-up, most participants (81.1%) maintained baseline subtype assignment and 25.6% progressed to a later stage. DISCUSSION Whereas a 1-trajectory model recovers the established pattern of amyloid accumulation, SuStaIn determined that 3 subtypes were optimal, showing distinct associations with Alzheimer disease risk factors. Further analyses to determine clinical utility are warranted.
Collapse
Affiliation(s)
- Lyduine E Collij
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Gemma Salvadó
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Viktor Wottschel
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Sophie E Mastenbroek
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Pierre Schoenmakers
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Fiona Heeman
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Leon Aksman
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Alle Meije Wink
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Bart N M Berckel
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Wiesje M van de Flier
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Philip Scheltens
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Pieter Jelle Visser
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Frederik Barkhof
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Sven Haller
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Juan Domingo Gispert
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| | - Isadora Lopes Alves
- From the Department of Radiology and Nuclear Medicine (L.E.C., V.W., S.E.M., P.S., F.H., A.M.W., B.N.M.B., F.B., I.L.A.), Alzheimer Center and Department of Neurology (W.M.v.d.F., P.S., P.J.V.), and Department of Epidemiology & Data Science (W.M.v.d.F.), Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands; Barcelonaβeta Brain Research Center (BBRC) (G.S., J.D.G.), Pasqual Maragall Foundation; IMIM (Hospital del Mar Medical Research Institute) (G.S., J.D.G.), Barcelona, Spain; Stevens Neuroimaging and Informatics Institute (L.A.), Keck School of Medicine, University of Southern California, Los Angeles; Centre for Medical Image Computing and Queen Square Institute of Neurology (F.B.), UCL, UK; Faculty of Medicine of the University of Geneva (S.H.); CIMC-Centre d'Imagerie Médicale de Cornavin (S.H.), Genève, Switzerland; Department of Surgical Sciences, Radiology (S.H.), Uppsala University, Sweden; Department of Radiology (S.H.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China; and Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN) (J.D.G.), Madrid, Spain
| |
Collapse
|
19
|
Rosenich E, Bransby L, Yassi N, Fripp J, Laws SM, Martins RN, Fowler C, Rainey-Smith SR, Rowe CC, Masters CL, Maruff P, Lim YY. Differential Effects of APOE and Modifiable Risk Factors on Hippocampal Volume Loss and Memory Decline in Aβ- and Aβ+ Older Adults. Neurology 2022; 98:e1704-e1715. [PMID: 35169009 PMCID: PMC9071368 DOI: 10.1212/wnl.0000000000200118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This prospective study sought to determine the association of modifiable/nonmodifiable components included in the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score with hippocampal volume (HV) loss and episodic memory (EM) decline in cognitively normal (CN) older adults classified as brain β-amyloid (Aβ) negative (Aβ-) or positive (Aβ+). METHODS Australian Imaging, Biomarkers and Lifestyle study participants (age 58-91 years) who completed ≥2 neuropsychological assessments and a brain Aβ PET scan (n = 592) were included in this study. We computed the CAIDE risk score (age, sex, APOE ε4 status, education, hypertension, body mass index [BMI], hypercholesterolemia, physical inactivity) and a modifiable CAIDE risk score (CAIDE-MR; education, hypertension, BMI, hypercholesterolemia, physical inactivity) for each participant. Aβ+ was classified using Centiloid >25. Linear mixed models assessed interactions between each CAIDE score, Aβ group, and time on HV loss and EM decline. Age, sex, and APOE ε4 were included as separate predictors in CAIDE-MR models to assess differential associations. Exploratory analyses examined relationships between individual modifiable risk factors and outcomes in Aβ- cognitively normal (CN) adults. RESULTS We observed a significant Aβ group × CAIDE × time interaction on HV loss (β [SE] = -0.04 [0.01]; p < 0.000) but not EM decline (β [SE] = -2.33 [9.96]; p = 0.98). Decomposition revealed a significant CAIDE × time interaction in Aβ+ participants only. When modifiable/nonmodifiable CAIDE components were considered separately, we observed a significant Aβ group × CAIDE-MR × time interaction on EM decline only (β [SE] = 3.03 [1.18]; p = 0.01). A significant CAIDE-MR score × time interaction was observed in Aβ- participants only. Significant interactions between APOE ε4 and age × time on HV loss and EM decline were observed in both groups. Exploratory analyses in Aβ- CN participants revealed a significant interaction between BMI × time on EM decline (β [SE] = -3.30 [1.43]; p = 0.02). DISCUSSION These results are consistent with studies showing that increasing age and APOE ε4 are associated with increased rates of HV loss and EM decline. In Aβ- CN adults, lower prevalence of modifiable cardiovascular risk factors was associated with less HV loss and EM decline over ∼10 years, suggesting interventions to reduce modifiable cardiovascular risk factors could be beneficial in this group.
Collapse
Affiliation(s)
- Emily Rosenich
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Lisa Bransby
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Nawaf Yassi
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Jurgen Fripp
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Simon M Laws
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Ralph N Martins
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Christopher Fowler
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Stephanie R Rainey-Smith
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Christopher C Rowe
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Colin L Masters
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Paul Maruff
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Yen Ying Lim
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| |
Collapse
|
20
|
Hu Y, Kirmess KM, Meyer MR, Rabinovici GD, Gatsonis C, Siegel BA, Whitmer RA, Apgar C, Hanna L, Kanekiyo M, Kaplow J, Koyama A, Verbel D, Holubasch MS, Knapik SS, Connor J, Contois JH, Jackson EN, Harpstrite SE, Bateman RJ, Holtzman DM, Verghese PB, Fogelman I, Braunstein JB, Yarasheski KE, West T. Assessment of a Plasma Amyloid Probability Score to Estimate Amyloid Positron Emission Tomography Findings Among Adults With Cognitive Impairment. JAMA Netw Open 2022; 5:e228392. [PMID: 35446396 PMCID: PMC9024390 DOI: 10.1001/jamanetworkopen.2022.8392] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE The diagnostic evaluation for Alzheimer disease may be improved by a blood-based diagnostic test identifying presence of brain amyloid plaque pathology. OBJECTIVE To determine the clinical performance associated with a diagnostic algorithm incorporating plasma amyloid-β (Aβ) 42:40 ratio, patient age, and apoE proteotype to identify brain amyloid status. DESIGN, SETTING, AND PARTICIPANTS This cohort study includes analysis from 2 independent cross-sectional cohort studies: the discovery cohort of the Plasma Test for Amyloidosis Risk Screening (PARIS) study, a prospective add-on to the Imaging Dementia-Evidence for Amyloid Scanning study, including 249 patients from 2018 to 2019, and MissionAD, a dataset of 437 biobanked patient samples obtained at screenings during 2016 to 2019. Data were analyzed from May to November 2020. EXPOSURES Amyloid detected in blood and by positron emission tomography (PET) imaging. MAIN OUTCOMES AND MEASURES The main outcome was the diagnostic performance of plasma Aβ42:40 ratio, together with apoE proteotype and age, for identifying amyloid PET status, assessed by accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). RESULTS All 686 participants (mean [SD] age 73.2 [6.3] years; 368 [53.6%] men; 378 participants [55.1%] with amyloid PET findings) had symptoms of mild cognitive impairment or mild dementia. The AUC of plasma Aβ42:40 ratio for PARIS was 0.79 (95% CI, 0.73-0.85) and 0.86 (95% CI, 0.82-0.89) for MissionAD. Ratio cutoffs for Aβ42:40 based on the Youden index were similar between cohorts (PARIS: 0.089; MissionAD: 0.092). A logistic regression model (LRM) incorporating Aβ42:40 ratio, apoE proteotype, and age improved diagnostic performance within each cohort (PARIS: AUC, 0.86 [95% CI, 0.81-0.91]; MissionAD: AUC, 0.89 [95% CI, 0.86-0.92]), and overall accuracy was 78% (95% CI, 72%-83%) for PARIS and 83% (95% CI, 79%-86%) for MissionAD. The model developed on the prospectively collected samples from PARIS performed well on the MissionAD samples (AUC, 0.88 [95% CI, 0.84-0.91]; accuracy, 78% [95% CI, 74%-82%]). Training the LRM on combined cohorts yielded an AUC of 0.88 (95% CI, 0.85-0.91) and accuracy of 81% (95% CI, 78%-84%). The output of this LRM is the Amyloid Probability Score (APS). For clinical use, 2 APS cutoff values were established yielding 3 categories, with low, intermediate, and high likelihood of brain amyloid plaque pathology. CONCLUSIONS AND RELEVANCE These findings suggest that this blood biomarker test could allow for distinguishing individuals with brain amyloid-positive PET findings from individuals with amyloid-negative PET findings and serve as an aid for Alzheimer disease diagnosis.
Collapse
Affiliation(s)
- Yan Hu
- C2N Diagnostics, St Louis, Missouri
| | | | | | - Gil D. Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, University of California, San Francisco
| | - Constantine Gatsonis
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | - Barry A. Siegel
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Rachel A. Whitmer
- Department of Public Health Sciences, University of California, Davis
| | | | - Lucy Hanna
- Center for Statistical Sciences, Brown University School of Public Health, Providence, Rhode Island
| | | | | | | | | | | | | | | | | | | | | | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | | | | | | | | | - Tim West
- C2N Diagnostics, St Louis, Missouri
| |
Collapse
|
21
|
Lam V, Clarnette R, Francis R, Bynevelt M, Watts G, Flicker L, Orr CF, Loh P, Lautenschlager N, Reid CM, Foster JK, Dhaliwal SS, Robinson S, Corti E, Vaccarezza M, Horgan B, Takechi R, Mamo J. Efficacy of probucol on cognitive function in Alzheimer's disease: study protocol for a double-blind, placebo-controlled, randomised phase II trial (PIA study). BMJ Open 2022; 12:e058826. [PMID: 35190446 PMCID: PMC8860076 DOI: 10.1136/bmjopen-2021-058826] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Preclinical, clinical and epidemiological studies support the hypothesis that aberrant systemic metabolism of amyloid beta (Aβ) in the peripheral circulation is causally related to the development of Alzheimer's disease (AD). Specifically, recent studies suggest that increased plasma concentrations of lipoprotein-Aβ compromise the brain microvasculature, resulting in extravasation and retention of the lipoprotein-Aβ moiety. The latter results in an inflammatory response and neurodegeneration ensues. Probucol, a historic cholesterol-lowering drug, has been shown in murine models to suppress lipoprotein-Aβ secretion, concomitant with maintaining blood-brain-barrier function, suppressing neurovascular inflammation and supporting cognitive function. This protocol details the probucol in Alzheimer's study, a drug intervention trial investigating if probucol has potential to attenuate cognitive decline, delay brain atrophy and reduce cerebral amyloid burden in patients with mild-to-moderate AD. METHODS AND ANALYSIS The study is a phase II, randomised, placebo-controlled, double-blind single-site clinical trial held in Perth, Australia. The target sample is 314 participants with mild-to-moderate AD. Participants will be recruited and randomised (1:1) to a 104-week intervention consisting of placebo induction for 2 weeks followed by 102 weeks of probucol (Lorelco) or placebo. The primary outcome is changed in cognitive performance determined via the Alzheimer's Disease Assessment Scales-Cognitive Subscale test between baseline and 104 weeks. Secondary outcomes measures will be the change in brain structure and function, cerebral amyloid load, quality of life, and the safety and tolerability of Lorelco, after a 104week intervention. ETHICS AND DISSEMINATION The study has been approved by the Bellberry Limited Human Research Ethics Committee (approval number: HREC2019-11-1063; Version 4, 6 October 2021). Informed consent will be obtained from participants prior to any study procedures being performed. The investigator group will disseminate study findings through peer-reviewed publications, key conferences and local stakeholder events. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12621000726853).
Collapse
Affiliation(s)
- Virginie Lam
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roger Clarnette
- Australian Alzheimer's Research Foundation, University of Western Australia, Nedlands, Western Australia, Australia
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Roslyn Francis
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Michael Bynevelt
- Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Gerald Watts
- School of Medicine, University of Western Australia, Crawley, Western Australia, Australia
- Cardiometabolic Service, Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Leon Flicker
- WA Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia
| | - Carolyn F Orr
- Cognitive Clinic, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Poh Loh
- WA Centre for Health & Ageing, University of Western Australia, Perth, Western Australia, Australia
| | - Nicola Lautenschlager
- Academic Unit of Psychiatry of Old Age, University of Melbourne, Victoria, Victoria, Australia
- North Western Mental Health, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Division of Psychiatry and WA Centre for Health and Ageing, University of Western Australia, Perth, Western Australia, Australia
| | - Christopher M Reid
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Jonathan K Foster
- Synapse Neuropsychology, Perth, Western Australia, Australia
- Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- School of Paediatrics and Child Health, Faculty of Health and Medical Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Satvinder S Dhaliwal
- Department of Radiation Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Duke-NUS Medical School, National University of Singapore, Singapore
- Institute for Research in Molecular Medicine, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Suzanne Robinson
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Emily Corti
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Mauro Vaccarezza
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Ben Horgan
- Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Ryusuke Takechi
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - John Mamo
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
22
|
Williams ME, Elman JA, McEvoy LK, Andreassen OA, Dale AM, Eglit GML, Eyler LT, Fennema-Notestine C, Franz CE, Gillespie NA, Hagler DJ, Hatton SN, Hauger RL, Jak AJ, Logue MW, Lyons MJ, McKenzie RE, Neale MC, Panizzon MS, Puckett OK, Reynolds CA, Sanderson-Cimino M, Toomey R, Tu XM, Whitsel N, Xian H, Kremen WS. 12-year prediction of mild cognitive impairment aided by Alzheimer's brain signatures at mean age 56. Brain Commun 2021; 3:fcab167. [PMID: 34396116 PMCID: PMC8361427 DOI: 10.1093/braincomms/fcab167] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/26/2021] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
Neuroimaging signatures based on composite scores of cortical thickness and hippocampal volume predict progression from mild cognitive impairment to Alzheimer's disease. However, little is known about the ability of these signatures among cognitively normal adults to predict progression to mild cognitive impairment. Towards that end, a signature sensitive to microstructural changes that may predate macrostructural atrophy should be useful. We hypothesized that: (i) a validated MRI-derived Alzheimer's disease signature based on cortical thickness and hippocampal volume in cognitively normal middle-aged adults would predict progression to mild cognitive impairment; and (ii) a novel grey matter mean diffusivity signature would be a better predictor than the thickness/volume signature. This cohort study was part of the Vietnam Era Twin Study of Aging. Concurrent analyses compared cognitively normal and mild cognitive impairment groups at each of three study waves (ns = 246-367). Predictive analyses included 169 cognitively normal men at baseline (age = 56.1, range = 51-60). Our previously published thickness/volume signature derived from independent data, a novel mean diffusivity signature using the same regions and weights as the thickness/volume signature, age, and an Alzheimer's disease polygenic risk score were used to predict incident mild cognitive impairment an average of 12 years after baseline (follow-up age = 67.2, range = 61-71). Additional analyses adjusted for predicted brain age difference scores (chronological age minus predicted brain age) to determine if signatures were Alzheimer-related and not simply ageing-related. In concurrent analyses, individuals with mild cognitive impairment had higher (worse) mean diffusivity signature scores than cognitively normal participants, but thickness/volume signature scores did not differ between groups. In predictive analyses, age and polygenic risk score yielded an area under the curve of 0.74 (sensitivity = 80.00%; specificity = 65.10%). Prediction was significantly improved with addition of the mean diffusivity signature (area under the curve = 0.83; sensitivity = 85.00%; specificity = 77.85%; P = 0.007), but not with addition of the thickness/volume signature. A model including both signatures did not improve prediction over a model with only the mean diffusivity signature. Results held up after adjusting for predicted brain age difference scores. The novel mean diffusivity signature was limited by being yoked to the thickness/volume signature weightings. An independently derived mean diffusivity signature may thus provide even stronger prediction. The young age of the sample at baseline is particularly notable. Given that the brain signatures were examined when participants were only in their 50 s, our results suggest a promising step towards improving very early identification of Alzheimer's disease risk and the potential value of mean diffusivity and/or multimodal brain signatures.
Collapse
Affiliation(s)
- McKenna E Williams
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Jeremy A Elman
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo 0316, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo 0372, Norway
| | - Anders M Dale
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Graham M L Eglit
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, CA 92093, USA
| | - Christine Fennema-Notestine
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Carol E Franz
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan A Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Donald J Hagler
- Department of Radiology, University of California San Diego, La Jolla, CA 92093, USA
| | - Sean N Hatton
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Neuroscience, University of California San Diego, La Jolla, CA 92093, USA
| | - Richard L Hauger
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Amy J Jak
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- VA San Diego Healthcare System, San Diego, CA 92093, USA
| | - Mark W Logue
- National Center for PTSD: Behavioral Science Division, VA Boston Healthcare System, Boston, MA 02130, USA
- Department of Psychiatry and the Biomedical Genetics Section, Boston University School of Medicine, Boston, MA 02118, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
| | - Michael J Lyons
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Ruth E McKenzie
- Department of Biostatistics, Boston University School of Public Health, Boston, MA 02118, USA
- School of Education and Social Policy, Merrimack College, North Andover, MA 01845, USA
| | - Michael C Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Matthew S Panizzon
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Olivia K Puckett
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Chandra A Reynolds
- Department of Psychology, University of California Riverside, Riverside, CA 92521, USA
| | - Mark Sanderson-Cimino
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Rosemary Toomey
- Department of Psychological and Brain Sciences, Boston University, Boston, MA 02212, USA
| | - Xin M Tu
- Family Medicine and Public Health, University of California San Diego, La Jolla, CA 92093, USA
| | - Nathan Whitsel
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
| | - Hong Xian
- Department of Biostatistics, St. Louis University, St. Louis, MO 63103, USA
| | - William S Kremen
- Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, CA 92093, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA 92093, USA
- Center of Excellence for Stress and Mental Health (CESAMH), VA San Diego Healthcare System, San Diego, CA 92093, USA
| |
Collapse
|
23
|
Bucci M, Savitcheva I, Farrar G, Salvadó G, Collij L, Doré V, Gispert JD, Gunn R, Hanseeuw B, Hansson O, Shekari M, Lhommel R, Molinuevo JL, Rowe C, Sur C, Whittington A, Buckley C, Nordberg A. A multisite analysis of the concordance between visual image interpretation and quantitative analysis of [ 18F]flutemetamol amyloid PET images. Eur J Nucl Med Mol Imaging 2021; 48:2183-2199. [PMID: 33844055 PMCID: PMC8175298 DOI: 10.1007/s00259-021-05311-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/09/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND [18F]flutemetamol PET scanning provides information on brain amyloid load and has been approved for routine clinical use based upon visual interpretation as either negative (equating to none or sparse amyloid plaques) or amyloid positive (equating to moderate or frequent plaques). Quantitation is however fundamental to the practice of nuclear medicine and hence can be used to supplement amyloid reading methodology especially in unclear cases. METHODS A total of 2770 [18F]flutemetamol images were collected from 3 clinical studies and 6 research cohorts with available visual reading of [18F]flutemetamol and quantitative analysis of images. These were assessed further to examine both the discordance and concordance between visual and quantitative imaging primarily using thresholds robustly established using pathology as the standard of truth. Scans covered a wide range of cases (i.e. from cognitively unimpaired subjects to patients attending the memory clinics). Methods of quantifying amyloid ranged from using CE/510K cleared marked software (e.g. CortexID, Brass), to other research-based methods (e.g. PMOD, CapAIBL). Additionally, the clinical follow-up of two types of discordance between visual and quantitation (V+Q- and V-Q+) was examined with competing risk regression analysis to assess possible differences in prediction for progression to Alzheimer's disease (AD) and other diagnoses (OD). RESULTS Weighted mean concordance between visual and quantitation using the autopsy-derived threshold was 94% using pons as the reference region. Concordance from a sensitivity analysis which assessed the maximum agreement for each cohort using a range of cut-off values was also estimated at approximately 96% (weighted mean). Agreement was generally higher in clinical cases compared to research cases. V-Q+ discordant cases were 11% more likely to progress to AD than V+Q- for the SUVr with pons as reference region. CONCLUSIONS Quantitation of amyloid PET shows a high agreement vs binary visual reading and also allows for a continuous measure that, in conjunction with possible discordant analysis, could be used in the future to identify possible earlier pathological deposition as well as monitor disease progression and treatment effectiveness.
Collapse
Affiliation(s)
- Marco Bucci
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Irina Savitcheva
- Medical Radiation Physics and Nuclear Medicine, Section for Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Gill Farrar
- Pharmaceutical Diagnostics, GE Healthcare, Amersham, UK
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Lyduine Collij
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, 1117, Amsterdam, Netherlands
| | - Vincent Doré
- Austin Health, University of Melbourne, Melbourne, Australia.,Health and Biosecurity, CSIRO, Parkville, Australia
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Centro de Investigación Biomédica en Red Bioingenieriá, Biomateriales y Nanomedicina, (CIBER-BBN), Barcelona, Spain
| | - Roger Gunn
- Invicro, London, UK.,Division of Brain Sciences, Department of Medicine, Imperial College, London, UK
| | - Bernard Hanseeuw
- Neurology and Nuclear Medicine Departments, Saint-Luc University Hospital, Av. Hippocrate, 10, 1200, Brussels, Belgium.,Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Lund, Sweden
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Renaud Lhommel
- Neurology and Nuclear Medicine Departments, Saint-Luc University Hospital, Av. Hippocrate, 10, 1200, Brussels, Belgium
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Christopher Rowe
- Austin Health, University of Melbourne, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Australia
| | | | | | | | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. .,Department of Aging, Karolinska University Hospital, Stockholm, Sweden.
| |
Collapse
|
24
|
Doré V, Krishnadas N, Bourgeat P, Huang K, Li S, Burnham S, Masters CL, Fripp J, Villemagne VL, Rowe CC. Relationship between amyloid and tau levels and its impact on tau spreading. Eur J Nucl Med Mol Imaging 2021; 48:2225-2232. [PMID: 33495928 PMCID: PMC8175299 DOI: 10.1007/s00259-021-05191-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 01/02/2021] [Indexed: 12/04/2022]
Abstract
Purpose Previous studies have shown that Aβ-amyloid (Aβ) likely promotes tau to spread beyond the medial temporal lobe. However, the Aβ levels necessary for tau to spread in the neocortex is still unclear. Methods Four hundred sixty-six participants underwent tau imaging with [18F]MK6420 and Aβ imaging with [18F]NAV4694. Aβ scans were quantified on the Centiloid (CL) scale with a cut-off of 25 CL for abnormal levels of Aβ (A+). Tau scans were quantified in three regions of interest (ROI) (mesial temporal (Me); temporoparietal neocortex (Te); and rest of neocortex (R)) and four mesial temporal region (entorhinal cortex, amygdala, hippocampus, and parahippocampus). Regional tau thresholds were established as the 95%ile of the cognitively unimpaired A- subjects. The prevalence of abnormal tau levels (T+) along the Centiloid continuum was determined. Results The plots of prevalence of T+ show earlier and greater increase along the Centiloid continuum in the medial temporal area compared to neocortex. Prevalence of T+ was low but associated with Aβ level between 10 and 40 CL reaching 23% in Me, 15% in Te, and 11% in R. Between 40 and 70 CL, the prevalence of T+ subjects per CL increased fourfold faster and at 70 CL was 64% in Me, 51% in Te, and 37% in R. In cognitively unimpaired, there were no T+ in R below 50 CL. The highest prevalence of T+ were found in the entorhinal cortex, reaching 40% at 40 CL and 80% at 60 CL. Conclusion Outside the entorhinal cortex, abnormal levels of cortical tau on PET are rarely found with Aβ below 40 CL. Above 40 CL prevalence of T+ accelerates in all areas. Moderate Aβ levels are required before abnormal neocortical tau becomes detectable. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05191-9.
Collapse
Affiliation(s)
- Vincent Doré
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, Melbourne, Victoria, Australia.
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia.
| | - Natasha Krishnadas
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia
| | - Pierrick Bourgeat
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, Brisbane, Queensland, Australia
| | - Kun Huang
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia
| | - Shenpeng Li
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, Melbourne, Victoria, Australia
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia
| | - Samantha Burnham
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, Melbourne, Victoria, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jurgen Fripp
- Health and Biosecurity Flagship, The Australian eHealth Research Centre, Brisbane, Queensland, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, LVL1 Harrold STOKES Block, 145 Studley Road, Heidelberg, Melbourne, Victoria, 3084, Australia
- Department of Medicine, The University of Melbourne, Melbourne, Victoria, Australia
- The Australian Dementia Network (ADNeT), Melbourne, Australia
| |
Collapse
|
25
|
Abstract
Amyloid-β (Aβ) PET imaging has now been available for over 15 years. The ability to detect Aβ in vivo has greatly improved the clinical and research landscape of Alzheimer's disease (AD) and other neurodegenerative conditions. Aβ imaging provides very reliable, accurate, and reproducible measurements of regional and global Aβ burden in the brain. It has proved invaluable in anti-Aβ therapy trials, and is now recognized as a powerful diagnostic tool. The appropriate use of Aβ PET, when combined with comprehensive clinical evaluation by a dementia-trained specialist, can improve the accuracy of a clinical diagnosis of AD and substantially alter management. It can assist in differentiating AD from other neurodegenerative conditions, often by its ability to rule out the presence of Aβ. When combined with tau imaging, further increase in specificity for the diagnosis of AD can be achieved. The integration of Aβ PET, in conjunction with biomarkers of tau, neurodegeneration and neuroinflammation, into large, longitudinal, observational cohort studies continues to increase our understanding of the development of AD. Its incorporation into clinical trials has been pivotal in defining the most effective anti-Aβ biological therapies and optimal dosing so that effective disease modifying therapy now appears imminent. Aβ deposition is a gradual and protracted process, permitting a wide treatment window for anti-Aβ therapies and Aβ PET has made trials in this preclinical AD period feasible. Continuing improvement in Aβ tracer target to background ratio is allowing trials in earlier AD that tailor drug dosage to Aβ level. The quest to standardize quantification and define universally applicable thresholds for all Aβ tracers has produced the Centiloid method. Centiloid values that correlate well with neuropathologic findings and prognosis have been identified. Rapid cloud-based automated individual scan analysis is now possible and does not require MRI. Challenges remain, particularly around cross camera standardized uptake value ratio variation that need to be addressed. This review will compare available Aβ radiotracers, discuss approaches to quantification, as well as the clinical and research applications of Aβ PET.
Collapse
Affiliation(s)
- Natasha Krishnadas
- Florey Department of Neurosciences and Mental Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia; Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia
| | - Vincent Doré
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia; Health and Biosecurity Flagship, The Australian eHealth Research Centre, CSIRO, Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Victoria, Australia; The Australian Dementia Network (ADNeT), Melbourne, Australia; The University of Melbourne, Victoria, Australia.
| |
Collapse
|