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Rajeev V, Chai YL, Poh L, Selvaraji S, Fann DY, Jo DG, De Silva TM, Drummond GR, Sobey CG, Arumugam TV, Chen CP, Lai MKP. Chronic cerebral hypoperfusion: a critical feature in unravelling the etiology of vascular cognitive impairment. Acta Neuropathol Commun 2023; 11:93. [PMID: 37309012 DOI: 10.1186/s40478-023-01590-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/14/2023] Open
Abstract
Vascular cognitive impairment (VCI) describes a wide spectrum of cognitive deficits related to cerebrovascular diseases. Although the loss of blood flow to cortical regions critically involved in cognitive processes must feature as the main driver of VCI, the underlying mechanisms and interactions with related disease processes remain to be fully elucidated. Recent clinical studies of cerebral blood flow measurements have supported the role of chronic cerebral hypoperfusion (CCH) as a major driver of the vascular pathology and clinical manifestations of VCI. Here we review the pathophysiological mechanisms as well as neuropathological changes of CCH. Potential interventional strategies for VCI are also reviewed. A deeper understanding of how CCH can lead to accumulation of VCI-associated pathology could potentially pave the way for early detection and development of disease-modifying therapies, thus allowing preventive interventions instead of symptomatic treatments.
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Affiliation(s)
- Vismitha Rajeev
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Yuek Ling Chai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Luting Poh
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
| | - Sharmelee Selvaraji
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- Integrative Sciences and Engineering Programme, NUS Graduate School, National University of Singapore, Singapore, Singapore
| | - David Y Fann
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Dong-Gyu Jo
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - T Michael De Silva
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Grant R Drummond
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher G Sobey
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Thiruma V Arumugam
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
- Department of Physiology, Anatomy and Microbiology, La Trobe University, Bundoora, Victoria, Australia
| | - Christopher P Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Mitchell K P Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Memory Aging and Cognition Centre, National University Health System, Singapore, Singapore.
- NUS Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
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Do Carmo S, Kannel B, Cuello AC. Nerve Growth Factor Compromise in Down Syndrome. Front Aging Neurosci 2021; 13:719507. [PMID: 34434101 PMCID: PMC8381049 DOI: 10.3389/fnagi.2021.719507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/12/2021] [Indexed: 11/13/2022] Open
Abstract
The basal forebrain cholinergic system relies on trophic support by nerve growth factor (NGF) to maintain its phenotype and function. In Alzheimer's disease (AD), basal forebrain cholinergic neurons (BFCNs) undergo progressive atrophy, suggesting a deficit in NGF trophic support. Within the central nervous system, NGF maturation and degradation are tightly regulated by an activity-dependent metabolic cascade. Here, we present a brief overview of the characteristics of Alzheimer's pathology in Down syndrome (DS) with an emphasis on this NGF metabolic pathway's disruption during the evolving Alzheimer's pathology. Such NGF dysmetabolism is well-established in Alzheimer's brains with advanced pathology and has been observed in mild cognitive impairment (MCI) and non-demented individuals with elevated brain amyloid levels. As individuals with DS inexorably develop AD, we then review findings that support the existence of a similar NGF dysmetabolism in DS coinciding with atrophy of the basal forebrain cholinergic system. Lastly, we discuss the potential of NGF-related biomarkers as indicators of an evolving Alzheimer's pathology in DS.
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Affiliation(s)
- Sonia Do Carmo
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
| | - Benjamin Kannel
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - A Claudio Cuello
- Department of Pharmacology and Therapeutics, McGill University, Montreal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Department of Anatomy and Cell Biology, McGill University, Montreal, QC, Canada
- Department of Pharmacology, Oxford University, Oxford, United Kingdom
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Screening of Cognitive Changes in Adults with Intellectual Disabilities: A Systematic Review. Brain Sci 2020; 10:brainsci10110848. [PMID: 33198271 PMCID: PMC7698112 DOI: 10.3390/brainsci10110848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/03/2020] [Accepted: 11/05/2020] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Screening and assessment of cognitive changes in adults with Intellectual Disabilities (ID), mainly Down Syndrome (DS), is crucial to offer appropriate services to their needs. We present a systematic review of the existing instruments assessing dementia, aiming to support researchers and clinicians’ best practice. Methods: Searches were carried out in the databases Web of Science; PubMed; PsycINFO in March 2019 and updated in October 2020. Studies were selected and examined if they: (1) focused on assessing age-related cognitive changes in persons with ID; (2) included adults and/or older adults; (3) included scales and batteries for cognitive assessment. Results: Forty-eight cross-sectional studies and twenty-seven longitudinal studies were selected representing a total sample of 6451 participants (4650 DS and 1801 with other ID). In those studies, we found 39 scales, questionnaires, and inventories, and 13 batteries for assessing cognitive and behavioural changes in adults with DS and other ID. Conclusion: The most used instrument completed by an informant or carer was the Dementia Questionnaire for Learning Disabilities (DLD), and its previous versions. We discuss the strengths and limitations of the instruments and outline recommendations for future use.
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Antonarakis SE, Skotko BG, Rafii MS, Strydom A, Pape SE, Bianchi DW, Sherman SL, Reeves RH. Down syndrome. Nat Rev Dis Primers 2020; 6:9. [PMID: 32029743 PMCID: PMC8428796 DOI: 10.1038/s41572-019-0143-7] [Citation(s) in RCA: 313] [Impact Index Per Article: 78.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2019] [Indexed: 12/11/2022]
Abstract
Trisomy 21, the presence of a supernumerary chromosome 21, results in a collection of clinical features commonly known as Down syndrome (DS). DS is among the most genetically complex of the conditions that are compatible with human survival post-term, and the most frequent survivable autosomal aneuploidy. Mouse models of DS, involving trisomy of all or part of human chromosome 21 or orthologous mouse genomic regions, are providing valuable insights into the contribution of triplicated genes or groups of genes to the many clinical manifestations in DS. This endeavour is challenging, as there are >200 protein-coding genes on chromosome 21 and they can have direct and indirect effects on homeostasis in cells, tissues, organs and systems. Although this complexity poses formidable challenges to understanding the underlying molecular basis for each of the many clinical features of DS, it also provides opportunities for improving understanding of genetic mechanisms underlying the development and function of many cell types, tissues, organs and systems. Since the first description of trisomy 21, we have learned much about intellectual disability and genetic risk factors for congenital heart disease. The lower occurrence of solid tumours in individuals with DS supports the identification of chromosome 21 genes that protect against cancer when overexpressed. The universal occurrence of the histopathology of Alzheimer disease and the high prevalence of dementia in DS are providing insights into the pathology and treatment of Alzheimer disease. Clinical trials to ameliorate intellectual disability in DS signal a new era in which therapeutic interventions based on knowledge of the molecular pathophysiology of DS can now be explored; these efforts provide reasonable hope for the future.
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Affiliation(s)
- Stylianos E Antonarakis
- Department of Genetic Medicine and Development, University of Geneva Medical School, Geneva, Switzerland.
| | - Brian G Skotko
- Down Syndrome Program, Division of Medical Genetics, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Michael S Rafii
- Keck School of Medicine of University of Southern California, California, CA, USA
| | - Andre Strydom
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sarah E Pape
- Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Diana W Bianchi
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Stephanie L Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Roger H Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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5
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Abstract
Virtually all adults with Down syndrome (DS) show the neuropathological changes of Alzheimer disease (AD) by the age of 40 years. This association is partially due to overexpression of amyloid precursor protein, encoded by APP, as a result of the location of this gene on chromosome 21. Amyloid-β accumulates in the brain across the lifespan of people with DS, which provides a unique opportunity to understand the temporal progression of AD and the epigenetic factors that contribute to the age of dementia onset. This age dependency in the development of AD in DS can inform research into the presentation of AD in the general population, in whom a longitudinal perspective of the disease is not often available. Comparison of the risk profiles, biomarker profiles and genetic profiles of adults with DS with those of individuals with AD in the general population can help to determine common and distinct pathways as well as mechanisms underlying increased risk of dementia. This Review evaluates the similarities and differences between the pathological cascades and genetics underpinning DS and AD with the aim of providing a platform for common exploration of these disorders.
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Affiliation(s)
- Ira T Lott
- Department of Pediatrics and Neurology, School of Medicine, University of California, Irvine, CA, USA.
| | - Elizabeth Head
- Sanders Brown Center on Aging, University of Kentucky, Lexington, KY, USA
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6
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Sinai A, Mokrysz C, Bernal J, Bohnen I, Bonell S, Courtenay K, Dodd K, Gazizova D, Hassiotis A, Hillier R, McBrien J, McCarthy J, Mukherji K, Naeem A, Perez-Achiaga N, Rantell K, Sharma V, Thomas D, Walker Z, Whitham S, Strydom A. Predictors of Age of Diagnosis and Survival of Alzheimer's Disease in Down Syndrome. J Alzheimers Dis 2019; 61:717-728. [PMID: 29226868 PMCID: PMC6004911 DOI: 10.3233/jad-170624] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: People with Down syndrome (DS) are an ultra-high risk population for Alzheimer’s disease (AD). Understanding the factors associated with age of onset and survival in this population could highlight factors associated with modulation of the amyloid cascade. Objective: This study aimed to establish the typical age at diagnosis and survival associated with AD in DS and the risk factors associated with these. Methods: Data was obtained from the Aging with Down Syndrome and Intellectual Disabilities (ADSID) research database, consisting of data extracted from clinical records of patients seen by Community Intellectual Disability Services (CIDS) in England. Survival times when considering different risk factors were calculated. Results: The mean age of diagnosis was 55.80 years, SD 6.29. Median survival time after diagnosis was 3.78 years, and median age at death was approximately 60 years. Survival time was associated with age of diagnosis, severity of intellectual disability, living status, anti-dementia medication status, and history of epilepsy. Age at diagnosis and treatment status remained predictive of survival time following adjustment. Conclusion: This study provides the best estimate of survival in dementia within the DS population to date, and is in keeping with previous estimates from smaller studies in the DS population. This study provides important estimates and insights into possible predictors of survival and age of diagnosis of AD in adults with DS, which will inform selection of participants for treatment trials in the future.
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Affiliation(s)
- Amanda Sinai
- Division of Psychiatry, University College London, London, UK.,Sheba Medical Center, Tel Hashomer, Israel
| | - Claire Mokrysz
- Division of Psychiatry, University College London, London, UK
| | - Jane Bernal
- Cornwall Partnership Foundation NHS Trust, UK
| | - Ingrid Bohnen
- Westminster Learning Disability Partnership, Central and North West London NHS Foundation Trust, London, UK
| | - Simon Bonell
- Livewell SouthWest (CIC), Plymouth, UK (data from South London and Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK).,Plymouth University Peninsula School of Medicine and Dentistry, Plymouth, UK
| | - Ken Courtenay
- Division of Psychiatry, University College London, London, UK.,Barnet Enfield and Haringey Mental Health NHS Trust, UK
| | - Karen Dodd
- Surrey and Borders Partnership NHS Foundation Trust, Epsom, UK
| | - Dina Gazizova
- Enfield Integrated Learning Disabilities Service, Enfield, UK
| | - Angela Hassiotis
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK
| | | | - Judith McBrien
- Plymouth Teaching Primary Care Trust (now known as Livewell Southwest CIC), UK
| | - Jane McCarthy
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Asim Naeem
- Sutton MHLD Team, SW London and St George's Mental Health NHS Trust, Surrey, UK.,St George's University of London, UK
| | | | - Khadija Rantell
- Institute of Neurology, Queen Square, Education Unit, London, UK
| | - Vijaya Sharma
- Hertfordshire Partnership University NHS Foundation Trust, UK
| | - David Thomas
- Department of Community Mental Health, RAF Marham, Norfolk, UK (data from East London NHS Foundation Trust, UK)
| | - Zuzana Walker
- Division of Psychiatry, University College London, London, UK.,Essex Partnership University NHS Foundation Trust, UK
| | | | - Andre Strydom
- Division of Psychiatry, University College London, London, UK.,Camden and Islington NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,The LonDownS Consortium
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7
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Ce O, Rs P, Ab W, S D, Cj W, Qm M, D L. Potential Link Between Proprotein Convertase Subtilisin/Kexin Type 9 and Alzheimer's Disease. ACTA ACUST UNITED AC 2018; 1. [PMID: 32352077 DOI: 10.31531/2581-4745.1000106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Alzheimer's disease [AD] is not only the most common neurodegenerative disease but is also currently incurable. Proprotein convertase subtilisin/kexin-9 [PCSK9] is an indirect regulator of plasma low density lipoprotein [LDL] levels controlling LDL receptor expression at the plasma membrane. PCSK9 also appears to regulate the development of glucose intolerance, insulin resistance, abdominal obesity, inflammation, and hypertension, conditions that have been identified as risk factors for AD. PCSK9 levels also depend on age, sex, and ethnic background, factors associated with AD. Herein, we will review indirect evidence that suggests a link between PCSK9 levels and AD.
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Affiliation(s)
- Oldham Ce
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Powell Rs
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Williams Ab
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Dixon S
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Wooten Cj
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Melendez Qm
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
| | - Lopez D
- Department of Pharmaceutical Sciences, Biomanufacturing Research Institute and Technology Enterprise [BRITE], College of Arts and Sciences, North Carolina Central University, Durham, USA
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Doran E, Keator D, Head E, Phelan MJ, Kim R, Totoiu M, Barrio JR, Small GW, Potkin SG, Lott IT. Down Syndrome, Partial Trisomy 21, and Absence of Alzheimer's Disease: The Role of APP. J Alzheimers Dis 2017; 56:459-470. [PMID: 27983553 PMCID: PMC5662115 DOI: 10.3233/jad-160836] [Citation(s) in RCA: 114] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Overexpression of the amyloid precursor protein (APP) gene on chromosome 21 in Down syndrome (DS) has been linked to increased brain amyloid levels and early-onset Alzheimer's disease (AD). An elderly man with phenotypic DS and partial trisomy of chromosome 21 (PT21) lacked triplication of APP affording an opportunity to study the role of this gene in the pathogenesis of dementia. Multidisciplinary studies between ages 66-72 years comprised neuropsychological testing, independent neurological exams, amyloid PET imaging with 11C-Pittsburgh compound-B (PiB), plasma amyloid-β (Aβ) measurements, and a brain autopsy examination. The clinical phenotype was typical for DS and his intellectual disability was mild in severity. His serial neuropsychological test scores showed less than a 3% decline as compared to high functioning individuals with DS who developed dementia wherein the scores declined 17-28% per year. No dementia was detected on neurological examinations. On PiB-PET scans, the patient with PT21 had lower PiB standard uptake values than controls with typical DS or sporadic AD. Plasma Aβ42 was lower than values for demented or non-demented adults with DS. Neuropathological findings showed only a single neuritic plaque and neurofibrillary degeneration consistent with normal aging but not AD. Taken together the findings in this rare patient with PT21 confirm the obligatory role of APP in the clinical, biochemical, and neuropathological findings of AD in DS.
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Affiliation(s)
- Eric Doran
- Department of Pediatrics, University of California, Irvine, Orange, CA, USA
| | - David Keator
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Elizabeth Head
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Michael J. Phelan
- Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Ron Kim
- Department of Pathology, University of California, Irvine, Orange, CA, USA
| | - Minodora Totoiu
- Department of Pediatrics, University of California, Irvine, Orange, CA, USA
| | - Jorge R. Barrio
- Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at University of California, Los Angeles, CA, USA
| | - Gary W. Small
- Department of Psychiatry and Biobehavioral Sciences and the Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA
| | - Steven G. Potkin
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Ira T. Lott
- Department of Pediatrics, University of California, Irvine, Orange, CA, USA,Corresponding author: Ira T. Lott, MD, Address: University of California, Irvine Medical Center, 101 The City Drive South, ZC 4482, Orange, CA 92868, Phone: 714-456-5333, Fax: 714-456-8466,
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9
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Loeffler DA, Klaver AC, Coffey MP, Aasly JO, LeWitt PA. Age-Related Decrease in Heat Shock 70-kDa Protein 8 in Cerebrospinal Fluid Is Associated with Increased Oxidative Stress. Front Aging Neurosci 2016; 8:178. [PMID: 27507943 PMCID: PMC4960228 DOI: 10.3389/fnagi.2016.00178] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 07/12/2016] [Indexed: 12/26/2022] Open
Abstract
Age-associated declines in protein homeostasis mechanisms (“proteostasis”) are thought to contribute to age-related neurodegenerative disorders. The increased oxidative stress which occurs with aging can activate a key proteostatic process, chaperone-mediated autophagy. This study investigated age-related alteration in cerebrospinal fluid (CSF) concentrations of heat shock 70-kDa protein 8 (HSPA8), a molecular chaperone involved in proteostatic mechanisms including chaperone-mediated autophagy, and its associations with indicators of oxidative stress (8-hydroxy-2′-deoxyguanosine [8-OHdG] and 8-isoprostane) and total anti-oxidant capacity. We examined correlations between age, HSPA8, 8-OHdG, 8-isoprostane, and total antioxidant capacity (TAC) in CSF samples from 34 healthy subjects ranging from 20 to 75 years of age. Age was negatively associated with HSPA8 (ρ = –0.47; p = 0.005). An age-related increase in oxidative stress was indicated by a positive association between age and 8-OHdG (ρ = 0.61; p = 0.0001). HSPA8 was moderately negatively associated with 8-OHdG (ρ = –0.58; p = 0.0004). Age and HSPA8 were weakly associated with 8-isoprostane and TAC (range of ρ values: –0.15 to 0.16). Our findings in this exploratory study suggest that during healthy aging, CSF HSPA8 may decrease, perhaps due in part to an increase in oxidative stress. Our results also suggest that 8-OHdG may be more sensitive than 8-isoprostane for measuring oxidative stress in CSF. Further studies are indicated to determine if our findings can be replicated with a larger cohort, and if the age-related decrease in HSPA8 in CSF is reflected by a similar change in the brain.
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Affiliation(s)
- David A Loeffler
- Departments of Neurology, Beaumont Hospital-Royal Oak, Beaumont Health, Royal Oak MI, USA
| | - Andrea C Klaver
- Departments of Neurology, Beaumont Hospital-Royal Oak, Beaumont Health, Royal Oak MI, USA
| | - Mary P Coffey
- Departments of Biostatistics, Beaumont Hospital-Royal Oak, Beaumont Health, Royal Oak MI, USA
| | - Jan O Aasly
- Department of Neurology, St. Olav's Hospital Trondheim, Norway
| | - Peter A LeWitt
- Department of Neurology, Henry Ford West Bloomfield Hospital, West Bloomfield TownshipMI, USA; Department of Neurology, Wayne State University School of Medicine, DetroitMI, USA
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10
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Elliott-King J, Shaw S, Bandelow S, Devshi R, Kassam S, Hogervorst E. A critical literature review of the effectiveness of various instruments in the diagnosis of dementia in adults with intellectual disabilities. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 4:126-148. [PMID: 27752536 PMCID: PMC5061450 DOI: 10.1016/j.dadm.2016.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Introduction Currently, there is no consensus on dementia diagnostics in adults with intellectual disabilities (ID). There are three types of assessments available: direct cognitive tests, test batteries, and informant reports. Methods A systematic literature search was conducted in four databases yielding 9840 records. Relevant studies were identified and selected using predefined inclusion and exclusion criteria and then coded and classified according to assessment type. This was completed by two independent researchers, with a third consulted when discrepancies arose. The review collates diagnostic instruments and presents strengths and weaknesses. Results Overall 47 studies met the search criteria, and 43 instruments were extracted from the selected studies. Of which, 10 instruments were classified as test batteries, 23 were classified as direct cognitive tests, and the remaining 10 were informant reports. Discussion This review can recommend that cognitive test batteries can offer the most practical and efficient method for dementia diagnosis in individuals with ID.
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Affiliation(s)
- Jordan Elliott-King
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Sarah Shaw
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Stephan Bandelow
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Rajal Devshi
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Shelina Kassam
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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11
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Day RJ, McCarty KL, Ockerse KE, Head E, Rohn TT. Proteolytic Cleavage of Apolipoprotein E in the Down Syndrome Brain. Aging Dis 2016; 7:267-77. [PMID: 27330841 PMCID: PMC4898923 DOI: 10.14336/ad.2015.1020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/20/2015] [Indexed: 11/17/2022] Open
Abstract
Down syndrome (DS) is one of the most common genetic causes of intellectual disability and is characterized by a number of behavioral as well as cognitive symptoms. Many of the neuropathological features of early-onset Alzheimer’s disease (AD) including senile plaques and neurofibrillary tangles (NFTs) are also present in people with DS as a result of triplication of the amyloid precursor gene on chromosome 21. Evidence suggests that harboring one or both apolipoprotein E4 (APOE4) alleles may increase the risk for AD due to the proteolytic cleavage of apoE4 and a subsequent loss of function. To investigate a role for the apoE proteolysis in vivo, we compared three autopsy groups; 7 DS with AD neuropathology cases over 40 years, 5 young DS cases without AD pathology under 40 years (YDS) and 5 age-matched control cases over 40 years by immunohistochemistry utilizing an antibody that detects the amino-terminal fragment of apoE. Application of this antibody, termed the amino-terminal apoE fragment antibody (nApoECF) revealed labeling of pyramidal neurons in the frontal cortex of YDS cases, whereas in the DS-AD group, labeling with nApoECF was prominent within NFTs. NFT labeling with nApoECF was significantly greater in the hippocampus versus the frontal cortex in the same DS-AD cases, suggesting a regional distribution of truncated apoE. Colocalization immunofluorescence experiments indicated that 52.5% and 53.2% of AT8- and PHF-1-positive NFTs, respectively, also contained nApoECF. Collectively, these data support a role for the proteolytic cleavage of apoE in DS and suggest that apoE fragmentation is closely associated with NFTs.
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Affiliation(s)
- Ryan J Day
- 1Department of Biological Sciences, Boise State University, Boise, Idaho, 83725, USA
| | - Katie L McCarty
- 2Department of Pharmacology& Nutritional Sciences, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA
| | - Kayla E Ockerse
- 1Department of Biological Sciences, Boise State University, Boise, Idaho, 83725, USA
| | - Elizabeth Head
- 2Department of Pharmacology& Nutritional Sciences, Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, 40536, USA
| | - Troy T Rohn
- 1Department of Biological Sciences, Boise State University, Boise, Idaho, 83725, USA
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Lao PJ, Betthauser TJ, Hillmer AT, Price JC, Klunk WE, Mihaila I, Higgins AT, Bulova PD, Hartley SL, Hardison R, Tumuluru RV, Murali D, Mathis CA, Cohen AD, Barnhart TE, Devenny DA, Mailick MR, Johnson SC, Handen BL, Christian BT. The effects of normal aging on amyloid-β deposition in nondemented adults with Down syndrome as imaged by carbon 11-labeled Pittsburgh compound B. Alzheimers Dement 2016; 12:380-90. [PMID: 26079411 PMCID: PMC4677061 DOI: 10.1016/j.jalz.2015.05.013] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In Down syndrome (DS), the overproduction of amyloid precursor protein is hypothesized to predispose young adults to early expression of Alzheimer-like neuropathology. METHODS PET imaging with carbon 11-labeled Pittsburgh compound B examined the pattern of amyloid-β deposition in 68 nondemented adults with DS (30-53 years) to determine the relationship between deposition and normal aging. Standard uptake value ratio (SUVR) images were created with cerebellar gray matter as the reference region. RESULTS Multiple linear regression revealed slight but highly significant (corrected P < .05) positive correlations between SUVR and age. The striatum showed the strongest correlation, followed by precuneus, parietal cortex, anterior cingulate, frontal cortex, and temporal cortex. CONCLUSION There is an age-related amyloid-β deposition in the DS population, but as a pattern of elevated cortical retention becomes apparent, the correlation of SUVR with age ceases to be significant. Factors unrelated to aging may drive an increase in deposition during early Alzheimer's disease pathogenesis.
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Affiliation(s)
- PJ Lao
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - TJ Betthauser
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - AT Hillmer
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - JC Price
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - WE Klunk
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - I Mihaila
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - AT Higgins
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - PD Bulova
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - SL Hartley
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - R Hardison
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - RV Tumuluru
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - D Murali
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - CA Mathis
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - AD Cohen
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - TE Barnhart
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - DA Devenny
- New York State Institute for Basic Research in Developmental Disabilities, 44 Holland Avenue, Albany, NY 12229, USA
| | - MR Mailick
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - SC Johnson
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
| | - BL Handen
- University of Pittsburgh, Departments of Psychiatry, Medicine, Radiology and Epidemiology Data Center, 3811 O'Hara Street, Pittsburgh, PA 15213, USA
| | - BT Christian
- University of Wisconsin-Madison Departments of Medical Physics, Psychiatry, Medicine-Geriatrics and Waisman Center,1500 Highland Ave, Madison, WI 53705, USA
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Cecchini MP, Viviani D, Sandri M, Hähner A, Hummel T, Zancanaro C. Olfaction in People with Down Syndrome: A Comprehensive Assessment across Four Decades of Age. PLoS One 2016; 11:e0146486. [PMID: 26730728 PMCID: PMC4701393 DOI: 10.1371/journal.pone.0146486] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 12/17/2015] [Indexed: 11/26/2022] Open
Abstract
Background Down syndrome (DS) shows neuropathology similar to Alzheimer disease, which presents olfactory impairment. Previous work showed olfactory impairment in DS, but a comprehensive evaluation of olfactory function in DS is lacking. Methods We investigated a large number (n = 56; M = 31, F = 25) DS participants (age range18-57y) using the “Sniffin’ Sticks” Extended test. This comprises three subtests (threshold, discrimination, and identification) yielding a global score (TDI) defining normosmia, hyposmia, and functional anosmia. To the best of our knowledge, this is the second largest group of DS people investigated for olfactory function ever. Age- and sex matched euploid individuals (n = 53) were the control. Results In DS, TDI was lower (16.7±5.13 vs. 35.4±3.74; P<0.001), with DS people performing worse in any subtests (P<0.001 for all); 27 DS participants showed functional anosmia (i.e., TDI<16). In DS, age was weakly and negatively correlated with TDI (r = -0.28, P = 0.036) and identification (r = -0.34, P = 0.012). When participants were stratified in young adults (18-29y) and older adults (30-61y), a significant effect of age was found for identification in both DS (young adults, 8.3±2.58; older adults, 6.9±2.99; P = 0.031) and control (young-adult, 14.3±1.18, older adult, 13.0±1.54; P = 0.016). Conclusion Olfactory function is overall severely impaired in DS people and may be globally impaired at relatively young age, despite of reportedly normal smell. However, specificity of this olfactory profile to DS should be considered with some caution because cognition was not evaluated in all DS participants and comparison with a control group of non-DS individuals having cognitive disabilities was lacking. Further study is required to longitudinally assess olfactory dysfunction in DS and to correlate it with brain pathology.
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Affiliation(s)
- Maria Paola Cecchini
- Department of Neurological and Movement Sciences, Anatomy and Histology Section, University of Verona, Verona, Italy
- * E-mail:
| | - Dario Viviani
- U.O. Pediatria, Ospedale Sacro Cuore Don Calabria, Negrar, Italy
| | - Marco Sandri
- Department of Neurological and Movement Sciences, Anatomy and Histology Section, University of Verona, Verona, Italy
| | - Antje Hähner
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Thomas Hummel
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School, Dresden, Germany
| | - Carlo Zancanaro
- Department of Neurological and Movement Sciences, Anatomy and Histology Section, University of Verona, Verona, Italy
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Vega JN, Hohman TJ, Pryweller JR, Dykens EM, Thornton-Wells TA. Resting-State Functional Connectivity in Individuals with Down Syndrome and Williams Syndrome Compared with Typically Developing Controls. Brain Connect 2015; 5:461-75. [PMID: 25712025 PMCID: PMC4601631 DOI: 10.1089/brain.2014.0266] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The emergence of resting-state functional connectivity (rsFC) analysis, which examines temporal correlations of low-frequency (<0.1 Hz) blood oxygen level-dependent signal fluctuations between brain regions, has dramatically improved our understanding of the functional architecture of the typically developing (TD) human brain. This study examined rsFC in Down syndrome (DS) compared with another neurodevelopmental disorder, Williams syndrome (WS), and TD. Ten subjects with DS, 18 subjects with WS, and 40 subjects with TD each participated in a 3-Tesla MRI scan. We tested for group differences (DS vs. TD, DS vs. WS, and WS vs. TD) in between- and within-network rsFC connectivity for seven functional networks. For the DS group, we also examined associations between rsFC and other cognitive and genetic risk factors. In DS compared with TD, we observed higher levels of between-network connectivity in 6 out 21 network pairs but no differences in within-network connectivity. Participants with WS showed lower levels of within-network connectivity and no significant differences in between-network connectivity relative to DS. Finally, our comparison between WS and TD controls revealed lower within-network connectivity in multiple networks and higher between-network connectivity in one network pair relative to TD controls. While preliminary due to modest sample sizes, our findings suggest a global difference in between-network connectivity in individuals with neurodevelopmental disorders compared with controls and that such a difference is exacerbated across many brain regions in DS. However, this alteration in DS does not appear to extend to within-network connections, and therefore, the altered between-network connectivity must be interpreted within the framework of an intact intra-network pattern of activity. In contrast, WS shows markedly lower levels of within-network connectivity in the default mode network and somatomotor network relative to controls. These findings warrant further investigation using a task-based procedure that may help disentangle the relationship between brain function and cognitive performance across the spectrum of neurodevelopmental disorders.
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Affiliation(s)
- Jennifer N. Vega
- Neuroscience Graduate Program, Center for Cognitive Medicine, Vanderbilt University, Nashville, Tennessee
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Timothy J. Hohman
- Department of Molecular Physiology & Biophysics, Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Jennifer R. Pryweller
- Interdisciplinary Studies in Neuroimaging of Neurodevelopmental Disorders, The Graduate School, Vanderbilt University, Nashville, Tennessee
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee
| | - Elisabeth M. Dykens
- Center for Cognitive Medicine, Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, Tennessee
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, Tennessee
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Tricia A. Thornton-Wells
- Department of Molecular Physiology & Biophysics, Vanderbilt Genetics Institute, Vanderbilt University School of Medicine, Nashville, Tennessee
- Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt University, Nashville, Tennessee
- Vanderbilt University Institute of Imaging Science, Vanderbilt University, Nashville, Tennessee
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