1
|
Monge-García S, García-Ayllón MS, Sánchez-Payá J, Gasparini-Berenguer R, Cortés-Gómez MÁ, Sáez-Valero J, Monge-Argilés JA. Validity of CSF alpha-synuclein to predict psychosis in prodromal Alzheimer's disease. Front Neurol 2023; 14:1124145. [PMID: 37292130 PMCID: PMC10244520 DOI: 10.3389/fneur.2023.1124145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
Background Alzheimer's disease (AD) accompanied by psychotic symptoms (PS) has a poor prognosis and may be associated with imbalances in key neural proteins such as alpha-synuclein (AS). Aim The aim of the study was to evaluate the diagnostic validity of AS levels in the cerebrospinal fluid (CSF) as a predictor of the emergence of PS in patients with prodromal AD. Materials and methods Patients with mild cognitive impairment were recruited between 2010 and 2018. Core AD biomarkers and AS levels were measured in CSF obtained during the prodromal phase of the illness. All patients who met the NIA-AA 2018 criteria for AD biomarkers received treatment with anticholinesterasic drugs. Follow-up evaluations were conducted to assess patients for the presence of psychosis using current criteria; the use of neuroleptic drugs was required for inclusion in the psychosis group. Several comparisons were made, taking into account the timing of the emergence of PS. Results A total of 130 patients with prodromal AD were included in this study. Of these, 50 (38.4%) met the criteria for PS within an 8-year follow-up period. AS was found to be a valuable CSF biomarker to differentiate between the psychotic and non-psychotic groups in every comparison made, depending on the onset of PS. Using an AS level of 1,257 pg/mL as the cutoff, this predictor achieved at least 80% sensitivity. Conclusion To our knowledge, this study represents the first time that a CSF biomarker has shown diagnostic validity for prediction of the emergence of PS in patients with prodromal AD.
Collapse
Affiliation(s)
- Sonia Monge-García
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
| | - María-Salud García-Ayllón
- Hospital General Universitario de Elche, FISABIO,Unidad de Investigación, Valencia, Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
- Unidad de Investigación, Hospital General Universitario de Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Elche, Spain
| | - José Sánchez-Payá
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Servicio de Medicina Preventiva, Hospital General Universitario Dr. Balmis, Alicante, Spain
| | | | - María-Ángeles Cortés-Gómez
- Hospital General Universitario de Elche, FISABIO,Unidad de Investigación, Valencia, Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
- Unidad de Investigación, Hospital General Universitario de Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Elche, Spain
| | - Javier Sáez-Valero
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d'Alacant, Spain
- Unidad de Investigación, Hospital General Universitario de Elche, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Elche, Spain
| | - José-Antonio Monge-Argilés
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain
- Servicio de Neurología, Hospital General Universitario Dr. Balmis, Alicante, Spain
| |
Collapse
|
2
|
Woyk K, Sahlmann CO, Hansen N, Timäus C, Müller SJ, Khadhraoui E, Wiltfang J, Lange C, Bouter C. Brain 18 F-FDG-PET and an optimized cingulate island ratio to differentiate Lewy body dementia and Alzheimer's disease. J Neuroimaging 2023; 33:256-268. [PMID: 36465027 DOI: 10.1111/jon.13068] [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: 08/17/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND PURPOSE The diagnosis of Dementia with Lewy Bodies (DLB) is challenging due to various clinical presentations and clinical and neuropathological features that overlap with Alzheimer's disease (AD). The use of 18 F-Fluorodeoxyglucose-PET (18 F-FDG-PET) can be limited due to similar patterns in DLB and AD. However, metabolism in the posterior cingulate cortex is known to be relatively preserved in DLB and visual assessment of the "cingulate island sign" became a helpful tool in the analysis of 18F-FDG-PET. The aim of this study was the evaluation of visual and semiquantitative 18F-FDG-PET analyses in the diagnosis of DLB and the differentiation to AD as well as its relation to other dementia biomarkers. METHODS This retrospective study comprises 81 patients with a clinical diagnosis of DLB or AD that underwent 18 F-FDG-PET/CT. PET scans were analyzed visually and semiquantitatively and results were compared to clinical data, cerebrospinal fluid results, dopamine transporter scintigraphy, and 18F-Florbetaben-PET. Furthermore, different cingulate island ratios were calculated to analyze their diagnostic accuracy. RESULTS Visual assessment of 18F-FDG-PET showed an accuracy of 62%-77% in differentiating between DLB and AD. Standard uptake values were significantly lower in the primary visual cortex and the lateral occipital cortex of DLB patients compared to AD patients. The cingulate island ratio was significantly higher in the DLB group compared to the AD group and the ratio posterior cingulate cortex to visual cortex plus lateral occipital cortex showed the highest diagnostic accuracy to discriminate between DLB and AD at 81%. CONCLUSIONS Semiquantitative 18F-FDG-PET imaging and especially the use of an optimized cingulate island ratio are valuable tools to differentiate between DLB and AD.
Collapse
Affiliation(s)
- Katharina Woyk
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Carsten Oliver Sahlmann
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Charles Timäus
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Sebastian Johannes Müller
- Department of Neuroradiology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Eya Khadhraoui
- Department of Neuroradiology, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany.,Neurosciences and Signaling Group, Department of Medical Sciences, Institute of Biomedicine, University of Aveiro, Aveiro, Portugal.,German Center for Neurodegenerative Diseases, Göttingen, Germany
| | - Claudia Lange
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| | - Caroline Bouter
- Department of Nuclear Medicine, University Medical Center Göttingen (UMG), Georg-August-University, Göttingen, Germany
| |
Collapse
|
3
|
From protein biomarkers to proteomics in dementia with Lewy Bodies. Ageing Res Rev 2023; 83:101771. [PMID: 36328346 DOI: 10.1016/j.arr.2022.101771] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/15/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022]
Abstract
Dementia with Lewy Bodies (DLB) is the second most common neurodegenerative dementia. Despite considerable research progress, there remain gaps in our understanding of the pathophysiology and there is no disease-modifying treatment. Proteomics is a powerful tool to elucidate complex biological pathways across heterogenous conditions. This review summarizes the widely used proteomic methods and presents evidence for protein dysregulation in the brain and peripheral tissues in DLB. Proteomics of post-mortem brain tissue shows that DLB shares common features with other dementias, such as synaptic dysfunction, but retains a unique protein signature. Promising diagnostic biomarkers are being identified in cerebrospinal fluid (CSF), blood, and peripheral tissues, such as serum Heart-type fatty acid binding protein. Research is needed to track these changes from the prodromal stage to established dementia, with standardized workflows to ensure replicability. Identifying novel protein targets in causative biological pathways could lead to the development of new targeted therapeutics or the stratification of participants for clinical trials.
Collapse
|
4
|
Cerebrospinal Fluid Alpha-Synuclein Improves the Differentiation between Dementia with Lewy Bodies and Alzheimer's Disease in Clinical Practice. Int J Mol Sci 2022; 23:ijms232113488. [PMID: 36362275 PMCID: PMC9654229 DOI: 10.3390/ijms232113488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background: Alpha-synuclein, abnormally aggregated in Dementia with Lewy Bodies (DLB), could represent a potential biomarker to improve the differentiation between DLB and Alzheimer’s disease (AD). Our main objective was to compare Cerebrospinal Fluid (CSF) alpha-synuclein levels between patients with DLB, AD and Neurological Control (NC) individuals. Methods: In a monocentric retrospective study, we assessed CSF alpha-synuclein concentration with a validated ELISA kit (ADx EUROIMMUN) in patients with DLB, AD and NC from a tertiary memory clinic. Between-group comparisons were performed, and Receiver Operating Characteristic analysis was used to identify the best CSF alpha-synuclein threshold. We examined the associations between CSF alpha-synuclein, other core AD CSF biomarkers and brain MRI characteristics. Results: We included 127 participants (mean age: 69.3 ± 8.1, Men: 41.7%). CSF alpha-synuclein levels were significantly lower in DLB than in AD (1.28 ± 0.52 ng/mL vs. 2.26 ± 0.91 ng/mL, respectively, p < 0.001) without differences due to the stage of cognitive impairment. The best alpha-synuclein threshold was characterized by an Area Under the Curve = 0.85, Sensitivity = 82.0% and Specificity = 76.0%. CSF alpha-synuclein was associated with CSF AT(N) biomarkers positivity (p < 0.01) but not with hippocampal atrophy or white matter lesions. Conclusion: CSF Alpha-synuclein evaluation could help to early differentiate patients with DLB and AD in association with existing biomarkers.
Collapse
|
5
|
CSF α-Synuclein and Tau as Biomarkers for Dementia With Lewy Bodies: A Systematic Review and Meta-analysis. Alzheimer Dis Assoc Disord 2022; 36:368-373. [PMID: 36183420 DOI: 10.1097/wad.0000000000000516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/30/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVE This study investigated whether α-synuclein and tau in cerebrospinal fluid (CSF) can be used as biomarkers to diagnose dementia with Lewy bodies (DLB). MATERIALS AND METHODS We retrieved 3303 studies with "Dementia with Lewy bodies," "α-synuclein," and "tau" as keywords. We formulated screening criteria, and 2 researchers completed the screening, quality evaluation, and data extraction tasks. Finally, 35 studies related to tau, and 14 studies related to α-synuclein were included. Review Manager 5.4 and Stata16 were used for meta-analysis. Subgroup, sensitivity, and meta-regression analyses were performed to identify sources of heterogeneity and strengthen the results. RESULTS Compared with the control group, DLB patients showed significantly higher CSF levels of tau [weighted mean difference=81.36 (59.82, 102.91); Z =7.40; P <0.00001], and lower CSF levels of α-synuclein [weighted mean difference=-95.25 (-162.02, -28.48); Z =2.80; P =0.005]. Mini-Mental State Examination (MMSE) score, male ratio, and disease duration were not sources of heterogeneity on subgroup and meta-regression analyses. Sensitivity analysis revealed no significant differences. CONCLUSIONS Higher levels of tau and lower levels of α-synuclein were found in the CSF of patients with DLB compared with the control group. Therefore, CSF tau and α-synuclein levels may be diagnostic biomarkers for DLB.
Collapse
|
6
|
Petricca L, Chiki N, Hanna-El-Daher L, Aeschbach L, Burai R, Stoops E, Fares MB, Lashuel HA. Comparative Analysis of Total Alpha-Synuclein (αSYN) Immunoassays Reveals That They Do Not Capture the Diversity of Modified αSYN Proteoforms. JOURNAL OF PARKINSON'S DISEASE 2022; 12:1449-1462. [PMID: 35527570 PMCID: PMC9398082 DOI: 10.3233/jpd-223285] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: The development of therapeutics for Parkinson’s disease (PD) requires the establishment of biomarker assays to enable stratifying patients, monitoring disease progression, and assessing target engagement. Attempts to develop diagnostic assays based on detecting levels of the α-synuclein (αSYN) protein, a central player in the pathogenesis of PD, have yielded inconsistent results. Objective: To determine whether the three commercial kits that have been extensively used for total αSYN quantification in human biological fluids (from Euroimmun, MSD, and Biolegend) are capable of capturing the diversity and complexity of relevant αSYN proteoforms. Methods: We investigated and compared the ability of the different assays to detect the diversity of αSYN proteoforms using a library of αSYN proteins that comprise the majority of disease-relevant αSYN variants and post-translational modifications (PTMs). Results: Our findings showed that none of the three tested immunoassays accurately capture the totality of relevant αSYN species, and that these assays are unable to recognize most disease-associated C-terminally truncated variants of αSYN. Moreover, several N-terminal truncations and phosphorylation/nitration PTMs differentially modify the level of αSYN detection and recovery by different immunoassays, and a CSF matrix effect was observed for most of the αSYN proteoforms analyzed by the three immunoassays. Conclusion: Our results show that the tested immunoassays do not capture the totality of the relevant αSYN species and therefore may not be appropriate tools to provide an accurate measure of total αSYN levels in samples containing modified forms of the protein. This highlights the need for next generation αSYN immunoassays that capture the diversity of αSYN proteoforms.
Collapse
Affiliation(s)
| | - Nour Chiki
- ND Biosciences SA, Epalinges, Switzerland
| | - Layane Hanna-El-Daher
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, Brain Mind Institute,Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Lorène Aeschbach
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, Brain Mind Institute,Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Ritwik Burai
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, Brain Mind Institute,Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Erik Stoops
- ADx NeuroSciences NV, Technologiepark 94 - Bio Incubator, Gent, Belgium
| | | | - Hilal A Lashuel
- ND Biosciences SA, Epalinges, Switzerland.,Laboratory of Molecular and Chemical Biology of Neurodegeneration, Brain Mind Institute,Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| |
Collapse
|
7
|
Chen YT, Orimo S, Wei CY, Hung GU, Yang SY, Chiu PY. Synuclein Motor Dysfunction Composite Scale for the Discrimination of Dementia With Lewy Bodies From Alzheimer’s Disease. Front Aging Neurosci 2022; 14:920591. [PMID: 35663565 PMCID: PMC9161692 DOI: 10.3389/fnagi.2022.920591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background An abnormal increase of α-synuclein in the brain is the hallmark of dementia with Lewy bodies (DLB). However, the diagnostic power of plasma α-synuclein in DLB is not yet confirmed. Parkinsonism is highly associated with and is one of the core clinical features of DLB. We studied plasma α-synuclein and developed a novel tool that combined plasma α-synuclein level and Motor Dysfunction Questionnaire (MDQ), namely Synuclein Motor Dysfunction Composite Scale (SMDCS), for the clinical discrimination of DLB from Alzheimer’s disease (AD). Methods This cross-sectional study analyzed participants’ demographical data, plasma α-synuclein level, MDQ, structured clinical history questionnaire, neuropsychological and motor function tests, and neuroimaging studies. The power of plasma α-synuclein level, MDQ, and SMDCS for discriminating DLB from non-demented controls (NC) or AD were compared. Results Overall, 121 participants diagnosed as 58 DLB, 31 AD, and 31 NC were enrolled. Patients with DLB had significantly higher mean plasma α-synuclein level (0.24 ± 0.32 pg/ml) compared to the NC group (0.08 ± 0.05 pg/ml) and the AD group (0.08 ± 0.05 pg/ml). The DLB group demonstrated higher MDQ (2.95 ± 1.60) compared to the NC (0.42 ± 0.98) or AD (0.44 ± 0.99) groups. The sensitivity/specificity of plasma α-synuclein level, MDQ, and SMDCS for differentiating DLB from non-DLB were 0.80/0.64, 0.83/0.89, and 0.88/0.93, respectively. Conclusion Both plasma α-synuclein and MDQ were significantly higher in patients with DLB compared to the NC or AD groups. The novel SMDCS, significantly improved accuracy for the clinical differentiation of DLB from AD or NC.
Collapse
Affiliation(s)
- Ying-Tsung Chen
- Department of Psychiatry, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Psychiatry, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Satoshi Orimo
- Department of Neurology, Kamiyoga Setagaya Street Clinic, Tokyo, Japan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Education, Chinese Culture University, Taipei, Taiwan
| | - Guang-Uei Hung
- Department of Nuclear Medicine, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan
| | | | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Applied Mathematics, Tunghai University, Taichung, Taiwan
- *Correspondence: Pai-Yi Chiu,
| |
Collapse
|
8
|
Blanc F, Bousiges O. Biomarkers and diagnosis of dementia with Lewy bodies including prodromal: Practical aspects. Rev Neurol (Paris) 2022; 178:472-483. [PMID: 35491246 DOI: 10.1016/j.neurol.2022.03.008] [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: 02/15/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
Dementia with Lewy Bodies (DLB) is a common form of cognitive neurodegenerative disease. More than half of the patients affected are not or misdiagnosed because of the clinical similarity with Alzheimer's disease (AD), Parkinson's disease but also psychiatric diseases such as depression or psychosis. In this review, we evaluate the interest of different biomarkers in the diagnostic process: cerebrospinal fluid (CSF), brain MRI, FP-CIT SPECT, MIBG SPECT, perfusion SPECT, FDG-PET by focusing more specifically on differential diagnosis between DLB and AD. FP-CIT SPECT is of high interest to discriminate DLB and AD, but not at the prodromal stage. Brain MRI has shown differences in group study with lower grey matter concentration of the Insula in prodromal DLB, but its interest in clinical routine is not demonstrated. Among the AD biomarkers (t-Tau, phospho-Tau181, Aβ42 and Aβ40) used routinely, t-Tau and phospho-Tau181 have shown excellent discrimination whatever the clinical stages severity. CSF Alpha-synuclein assay in the CSF has also an interest in the discrimination between DLB and AD but not in segregation between DLB and healthy elderly subjects. CSF synuclein RT-QuIC seems to be an excellent biomarker but its application in clinical routine remains to be demonstrated, given the non-automation of the process.
Collapse
Affiliation(s)
- F Blanc
- Hôpitaux Universitaire de Strasbourg, CM2R (Centre Mémoire de Ressource et de Recherche), Hôpital de jour, pôle de Gériatrie, Strasbourg, France; CNRS, laboratoire ICube UMR 7357 et FMTS (Fédération de Médecine Translationnelle de Strasbourg), équipe IMIS, Strasbourg, France.
| | - O Bousiges
- CNRS, laboratoire ICube UMR 7357 et FMTS (Fédération de Médecine Translationnelle de Strasbourg), équipe IMIS, Strasbourg, France; Hôpitaux Universitaire de Strasbourg, Laboratoire de Biochimie et Biologie Moléculaire, Strasbourg, France
| |
Collapse
|
9
|
Alpha-synuclein Levels in the Differential Diagnosis of Lewy Bodies Dementia and Other Neurodegenerative Disorders: A Meta-analysis. Alzheimer Dis Assoc Disord 2021; 34:220-224. [PMID: 32341240 DOI: 10.1097/wad.0000000000000381] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
SUBJECTIVES Lewy body dementia (LBD) is the second most common type of neurodegenerative dementia after Alzheimer disease (AD). It is characterized by the accumulation of Lewy bodies and Lewy neurites which are composed of aggregated phosphorylated alpha-synuclein, which is a presynaptic neuronal protein genetically and neuropathologically linked to Parkinson disease and to LBD. Alpha-synuclein is thought to contribute to LBD pathogenesis and to linked to disruption of cellular homeostasis and neuronal death, through effects on various intracellular targets, including synaptic function. METHODS In the present study, we did a meta-analysis on the reliability of alpha-synuclein levels in the cerebrospinal fluid (CSF) for the discrimination between LBD and other neurodegenerative disorders including AD, Parkinson disease (PD) dementia, progressive supranuclear palsy (PSP), multiple system atrophy (MSA) and frontotemporal dementia (FTD). RESULTS CSF alpha-synuclein levels were significantly different in LBD compared with AD, but no statistical difference was found between LBD, and dementia in PD, MSA, PSP, and FTD. CONCLUSION Alpha-synuclein levels in the CSF can be used for the discrimination between LBD and AD, but not LBD and other neurodegenerative disorders such as dementia in PD, MSA, FTD, and PSP.
Collapse
|
10
|
Combi R, Salsone M, Villa C, Ferini-Strambi L. Genetic Architecture and Molecular, Imaging and Prodromic Markers in Dementia with Lewy Bodies: State of the Art, Opportunities and Challenges. Int J Mol Sci 2021; 22:3960. [PMID: 33921279 PMCID: PMC8069386 DOI: 10.3390/ijms22083960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 04/03/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022] Open
Abstract
Dementia with Lewy bodies (DLB) is one of the most common causes of dementia and belongs to the group of α-synucleinopathies. Due to its clinical overlap with other neurodegenerative disorders and its high clinical heterogeneity, the clinical differential diagnosis of DLB from other similar disorders is often difficult and it is frequently underdiagnosed. Moreover, its genetic etiology has been studied only recently due to the unavailability of large cohorts with a certain diagnosis and shows genetic heterogeneity with a rare contribution of pathogenic mutations and relatively common risk factors. The rapid increase in the reported cases of DLB highlights the need for an easy, efficient and accurate diagnosis of the disease in its initial stages in order to halt or delay the progression. The currently used diagnostic methods proposed by the International DLB consortium rely on a list of criteria that comprises both clinical observations and the use of biomarkers. Herein, we summarize the up-to-now reported knowledge on the genetic architecture of DLB and discuss the use of prodromal biomarkers as well as recent promising candidates from alternative body fluids and new imaging techniques.
Collapse
Affiliation(s)
- Romina Combi
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Maria Salsone
- Institute of Molecular Bioimaging and Physiology, National Research Council, 20054 Segrate (MI), Italy;
- Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, 20127 Milan, Italy
| | - Chiara Villa
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Luigi Ferini-Strambi
- Department of Clinical Neurosciences, Neurology-Sleep Disorder Center, IRCCS San Raffaele Scientific Institute, 20127 Milan, Italy
- Department of Clinical Neurosciences, “Vita-Salute” San Raffaele University, 20127 Milan, Italy
| |
Collapse
|
11
|
Single-molecule studies of amyloid proteins: from biophysical properties to diagnostic perspectives. Q Rev Biophys 2020; 53:e12. [PMID: 33148356 DOI: 10.1017/s0033583520000086] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In neurodegenerative diseases, a wide range of amyloid proteins or peptides such as amyloid-beta and α-synuclein fail to keep native functional conformations, followed by misfolding and self-assembling into a diverse array of aggregates. The aggregates further exert toxicity leading to the dysfunction, degeneration and loss of cells in the affected organs. Due to the disordered structure of the amyloid proteins, endogenous molecules, such as lipids, are prone to interact with amyloid proteins at a low concentration and influence amyloid cytotoxicity. The heterogeneity of amyloid proteinscomplicates the understanding of the amyloid cytotoxicity when relying only on conventional bulk and ensemble techniques. As complementary tools, single-molecule techniques (SMTs) provide novel insights into the different subpopulations of a heterogeneous amyloid mixture as well as the cytotoxicity, in particular as involved in lipid membranes. This review focuses on the recent advances of a series of SMTs, including single-molecule fluorescence imaging, single-molecule force spectroscopy and single-nanopore electrical recording, for the understanding of the amyloid molecular mechanism. The working principles, benefits and limitations of each technique are discussed and compared in amyloid protein related studies.. We also discuss why SMTs show great potential and are worthy of further investigation with feasibility studies as diagnostic tools of neurodegenerative diseases and which limitations are to be addressed.
Collapse
|
12
|
Cerebrospinal fluid levels of alpha-synuclein, amyloid β, tau, phosphorylated tau, and neuron-specific enolase in patients with Parkinson's disease, dementia with Lewy bodies or other neurological disorders: Their relationships with cognition and nuclear medicine imaging findings. Neurosci Lett 2020; 715:134564. [PMID: 31733322 DOI: 10.1016/j.neulet.2019.134564] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 09/29/2019] [Accepted: 10/14/2019] [Indexed: 11/21/2022]
Abstract
Parkinson's disease (PD) and dementia with Lewy bodies (DLB) are common neurodegenerative disorders, but no established biochemical markers for these diseases have been identified. We enrolled 78 subjects (27 patients with PD/DLB, 34 patients with non-PD/DLB neurodegenerative disorders [non-PD/DLB], and 17 controls). Cerebrospinal fluid (CSF) was collected via the standard lumbar puncture technique. The CSF levels of alpha-synuclein, amyloid β40, amyloid β42, tau, phosphorylated tau (p-tau), neuron-specific enolase (NSE), and hemoglobin were measured with enzyme-linked immunosorbent assays. Dopamine transporter imaging with 123I-ioflupane was also performed. The PD/DLB patients exhibited significantly lower CSF alpha-synuclein levels than non-PD/DLB group. Significantly elevated CSF levels of tau, p-tau, and NSE were detected in the non-PD/DLB group. Multivariate analysis revealed that the mini-mental state examination score was correlated with the CSF amyloid β42 level. The specific binding ratio on 123I-ioflupane imaging was decreased in the PD/DLB group, but it was not correlated with the CSF alpha-synuclein level. These results indicate that (1) the CSF alpha-synuclein level is a useful biomarker of PD/DLB; (2) the CSF levels of tau, p-tau, and NSE can be used to discriminate PD/DLB from non-PD/DLB; and (3) the CSF amyloid β42 level is an independent predictor of cognitive decline in neurological disorders.
Collapse
|
13
|
Bougea A, Stefanis L, Emmanouilidou E, Vekrelis K, Kapaki E. High discriminatory ability of peripheral and CFSF biomarkers in Lewy body diseases. J Neural Transm (Vienna) 2020; 127:311-322. [PMID: 31912280 DOI: 10.1007/s00702-019-02137-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 12/27/2019] [Indexed: 11/30/2022]
Abstract
Differential diagnosis between Parkinson's disease (PD) Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), namely spectrum of Lewy bodies disorders (LBDs), may be challenging, and their common underlying pathophysiology is debated. Our aim was to examine relationships among neurodegenerative biomarkers [alpha-synuclein (α-Syn), Alzheimer's Disease (AD)-related (beta-amyloid Aβ42, tau [total τΤ and phosphorylated τp-181]), dopaminergic imaging (DATSCAN-SPECT)] and spectrum of LBD. This is a cross-sectional prospective study in 30 PD, 18 PDD, 29 DLB patients and 30 healthy controls. We compared α-Syn in CSF, plasma and serum and CSF Aβ42, τΤ and τp-181 across these groups. Correlations between such biomarkers and motor, cognitive/neuropsychiatric tests, and striatal asymmetry indexes were examined. CSF α-Syn was higher in DLB versus PD/PDD/controls, and lower in PD and PDD patients compared to controls (all p < 0.001). Serum α-Syn levels were higher in all patient groups compared to controls. After excluding those DLB patients with CSF AD profile, plasma and serum Syn levels were higher in the LBD group as a whole compared to controls. The combination of CSF α-Syn, serum α-Syn and Aβ42 for comparison between PD and DLB [AUC = 0.96 (95% CI 0.90-1.00)] was significantly better when compared to serum α-Syn alone (p < 0.001). Correlation analyses of biomarkers with cognitive/neuropsychiatric scales revealed some associations, but no consistent, cohesive picture. Peripheral biomarkers such as serum α-Syn, and CSF α-Syn and Aβ42 may contribute as potential biomarkers to separate LBDs from controls and to differentiate DLB from the other LBDs with high sensitivity and specificity among study groups.
Collapse
Affiliation(s)
- Anastasia Bougea
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece. .,Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
| | - Leonidas Stefanis
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece.,Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Evangelia Emmanouilidou
- Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Kostas Vekrelis
- Department of Neuroscience, Center for Basic Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Elisabeth Kapaki
- 1st Department of Neurology, Memory and Movement Disorder Clinic, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Vassilisis Sophias Avenue 72-74, 11528, Athens, Greece
| |
Collapse
|
14
|
Mavroudis I, Petridis F, Kazis D. Cerebrospinal Fluid, Imaging, and Physiological Biomarkers in Dementia With Lewy Bodies. Am J Alzheimers Dis Other Demen 2019; 34:421-432. [PMID: 31422676 PMCID: PMC10653361 DOI: 10.1177/1533317519869700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Dementia with Lewy bodies is a progressive neurodegenerative disorder, clinically characterized by gradual cognitive impairment and fluctuating cognition, behavioral changes and recurrent visual hallucinations, and autonomic function and movement symptoms in the type of parkinsonism. It is the second most common type of dementia in the Western world after Alzheimer disease. Over the last 20 years, many neurophysiological, neuroimaging, and cerebrospinal fluid (CSF) biomarkers have been described toward a better discrimination between dementia with Lewy bodies, Alzheimer disease, and other neurodegenerative conditions.In the present review, we aim to describe the neurophysiological, imaging, and CSF biomarkers in dementia with Lewy bodies and to question whether they could be reliable tools for the clinical practice.
Collapse
Affiliation(s)
- Ioannis Mavroudis
- Department of Neurology, Leeds Teaching Hospitals, Leeds, United Kingdom
| | - Foivos Petridis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- Third Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
15
|
Schaeffer MJ, Callahan BL. Investigating the Association Between Verbal Forgetting and Pathological Markers of Alzheimer's and Lewy Body Diseases. J Alzheimers Dis 2019; 70:877-887. [PMID: 31282412 DOI: 10.3233/jad-180962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The percentage of verbal forgetting (VF%) measure of the Rey Auditory Verbal Learning Test (RAVLT) has been proposed to differentiate patients diagnosed clinically with Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). OBJECTIVE To determine if VF% aligns with gold-standard biomarker and autopsy evidence of AD and DLB neuropathology. METHODS Clinical, cognitive, sociodemographic, and biomarker data were collected from 315 patients with baseline cognitive impairment and 485 normal controls from the Alzheimer's Disease Neuroimaging Initiative (ADNI). AD markers included reduced cerebrospinal fluid (CSF) amyloid-β, elevated total-tau and phosphorylated-tau, hippocampal atrophy, and the presence of amyloid plaques and neurofibrillary tangles at autopsy. DLB markers included reduced CSF α-synuclein, preserved hippocampus, atrophied putamen, occipital glucose metabolism, and the presence of Lewy bodies at autopsy. Cognitively impaired participants were classified as ADVF% (n = 190) or DLBVF% (n = 125) based on their RAVLT VF% scores using a 75% cut-off (≥75% = ADVF%, <75% = DLBVF%). Postmortem data were available for 13 ADVF% participants, 13 DLBVF% patients, and six healthy controls. RESULTS ADVF% and DLBVF% participants did not differ on CSF or neuroimaging biomarkers, with the exception of total tau levels which were higher in ADVF%. In the subset of participants with autopsy data, comorbid AD and DLB pathology was most frequent in ADVF% participants, and pure DLB pathology was most frequent in DLBVF% participants, however, these differences were not statistically significant. CONCLUSION The RAVLT VF% measure does not reliably align with AD and DLB neuropathology in ADNI participants.
Collapse
Affiliation(s)
| | - Brandy L Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Calgary, AB, Canada.,Mathison Centre for Mental Health Research & Education, Calgary, AB, Canada
| | | |
Collapse
|
16
|
García‐Ayllón M, Monge‐Argilés J, Monge‐García V, Navarrete F, Cortés‐Gómez M, Sánchez‐Payá J, Manzanares J, Gasparini‐Berenguer R, Leiva‐Santana C, Sáez‐Valero J. Measurement of CSF α‐synuclein improves early differential diagnosis of mild cognitive impairment due to Alzheimer’s disease. J Neurochem 2019; 150:218-230. [DOI: 10.1111/jnc.14719] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/18/2019] [Accepted: 05/03/2019] [Indexed: 12/13/2022]
Affiliation(s)
- María‐Salud García‐Ayllón
- Unidad de Investigación, Hospital General Universitario de Elche, FISABIO Elche Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández‐CSIC Sant Joan d’Alacant Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Sant Joan d’Alacant Spain
| | - José‐Antonio Monge‐Argilés
- Neurology Department University General Hospital of Alicante Alicante Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante Spain
| | | | - Francisco Navarrete
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández‐CSIC Sant Joan d’Alacant Spain
| | - Maria‐Angeles Cortés‐Gómez
- Unidad de Investigación, Hospital General Universitario de Elche, FISABIO Elche Spain
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández‐CSIC Sant Joan d’Alacant Spain
| | - José Sánchez‐Payá
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante Spain
- Preventive Medicine Service University General Hospital of Alicante Alicante Spain
| | - Jorge Manzanares
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández‐CSIC Sant Joan d’Alacant Spain
| | | | | | - Javier Sáez‐Valero
- Instituto de Neurociencias de Alicante, Universidad Miguel Hernández‐CSIC Sant Joan d’Alacant Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) Sant Joan d’Alacant Spain
- Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL) Alicante Spain
| |
Collapse
|
17
|
Twohig D, Nielsen HM. α-synuclein in the pathophysiology of Alzheimer's disease. Mol Neurodegener 2019; 14:23. [PMID: 31186026 PMCID: PMC6558879 DOI: 10.1186/s13024-019-0320-x] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 04/26/2019] [Indexed: 02/07/2023] Open
Abstract
The Alzheimer’s disease (AD) afflicted brain is neuropathologically defined by extracellular amyloid-β (Aβ) plaques and intraneuronal neurofibrillary tangles composed of hyperphosphorylated tau protein. However, accumulating evidence suggests that the presynaptic protein α-synuclein (αSyn), mainly associated with synucleinopathies like Parkinson’s disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), is involved in the pathophysiology of AD. Lewy-related pathology (LRP), primarily comprised of αSyn, is present in a majority of autopsied AD brains, and higher levels of αSyn in the cerebrospinal fluid (CSF) of patients with mild cognitive impairment (MCI) and AD have been linked to cognitive decline. Recent studies also suggest that the asymptomatic accumulation of Aβ plaques is associated with higher CSF αSyn levels in subjects at risk of sporadic AD and in individuals carrying autosomal dominant AD mutations. Experimental evidence has further linked αSyn mainly to tau hyperphosphorylation, but also to the pathological actions of Aβ and the APOEε4 allele, the latter being a major genetic risk factor for both AD and DLB. In this review, we provide a summary of the current evidence proposing an involvement of αSyn either as an active or passive player in the pathophysiological ensemble of AD, and furthermore describe in detail the current knowledge of αSyn structure and inferred function.
Collapse
Affiliation(s)
- Daniel Twohig
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 10691, Stockholm, Sweden
| | - Henrietta M Nielsen
- Department of Biochemistry and Biophysics, Stockholm University, Svante Arrhenius Väg 16B, 10691, Stockholm, Sweden.
| |
Collapse
|
18
|
Bousiges O, Blanc F. Diagnostic value of cerebro-spinal fluid biomarkers in dementia with lewy bodies. Clin Chim Acta 2019; 490:222-228. [DOI: 10.1016/j.cca.2018.11.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 12/17/2022]
|
19
|
Ishiguro M, Baba H, Maeshima H, Shimano T, Inoue M, Ichikawa T, Yasuda S, Shukuzawa H, Suzuki T, Arai H. Increased Serum Levels of α-Synuclein in Patients With Major Depressive Disorder. Am J Geriatr Psychiatry 2019; 27:280-286. [PMID: 30503177 DOI: 10.1016/j.jagp.2018.10.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 10/03/2018] [Accepted: 10/24/2018] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Epidemiologic studies have demonstrated that depression is a risk factor for dementia. In particular, dementia with Lewy bodies (DLB) has been noted to be highly relevant to depression. It has been suggested that α-synuclein (α-syn), a major component of Lewy bodies, is related to the onset and progression of DLB. To investigate the relationship between depression and DLB, we compared serum α-syn levels of patients with depression to those of healthy subjects. METHODS The subjects were 103 inpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or DSM-5 major depressive disorder (MDD) and 132 healthy comparisons. Patients were recruited from Juntendo Koshigaya Hospital, Saitama, Japan, between June 2010 and November 2016. Serum α-syn levels were measured using an enzyme-linked immunosorbent assay kit. Serum α-syn levels were compared using a 2 (age group [<60 years versus ≥60 years]) × 2 (diagnosis [MDD versus comparison]) analysis of variance. RESULTS There was no significant main effect of age (F = 1.167, df = 1, 231, p = 0.281). There was a significant main effect of diagnosis (F = 44.657, df = 1, 231, p <0.001), with higher α-syn levels in the MDD group versus the healthy comparison group, regardless of age. CONCLUSION The present results suggest that depression may affect the metabolism of α-syn; there is a possibility that depression is not only a prodromal symptom of DLB but also a causal risk factor for DLB.
Collapse
Affiliation(s)
- Mei Ishiguro
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hajime Baba
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan; the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan.
| | - Hitoshi Maeshima
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan; the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
| | - Takahisa Shimano
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan; the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
| | - Megumi Inoue
- the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
| | - Tomoya Ichikawa
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Seita Yasuda
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroko Shukuzawa
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan; the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
| | - Toshihito Suzuki
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan; the Juntendo University Mood Disorder Project (HB, HM, TS, MI, HS, TS), Department of Psychiatry, Juntendo Koshigaya Hospital, Saitama, Japan
| | - Heii Arai
- Department of Psychiatry & Behavioral Science (MI, HB, HM, TI, SY, HS, TS, HA), Juntendo University Graduate School of Medicine, Tokyo, Japan
| |
Collapse
|
20
|
Yoshino Y, Mori T, Yoshida T, Yamazaki K, Ozaki Y, Sao T, Funahashi Y, Iga JI, Ueno SI. Elevated mRNA Expression and Low Methylation of SNCA in Japanese Alzheimer's Disease Subjects. J Alzheimers Dis 2018; 54:1349-1357. [PMID: 27567856 DOI: 10.3233/jad-160430] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Despite the continuing debate about the amyloid hypothesis in Alzheimer's disease (AD), the precise pathogenesis is still unclear. Mixed pathology is common and multiple different protein aggregates are seen in human postmortem brains. Aggregates consisting of the alpha-synuclein protein encoded by the Synuclein Alpha gene (SCNA) are common in both dementia with Lewy bodies and AD. We examined SNCA mRNA expression and methylation rates of the CpG island at intron 1 of SNCA in peripheral leukocytes in 50 AD and age- and sex-matched control subjects to verify whether alpha-synuclein pathology affects the AD pathogenesis. SNCA mRNA expression in AD subjects was significantly higher than that in control subjects (1.62±0.73 versus 0.98±0.50, p < 0.001). We found significant differences between AD and control subjects at seven CpG sites (average rate; 8.8±2.7 versus 9.5±2.5, respectively: p = 0.027). The methylation rates tended to be lower in AD subjects at all CpG sites. We conclude that mRNA expression and methylation of SNCA intron 1 are altered in AD, which may be caused by Lewy body pathology in AD.
Collapse
|
21
|
Llorens F, Kruse N, Schmitz M, Gotzmann N, Golanska E, Thüne K, Zejneli O, Kanata E, Knipper T, Cramm M, Lange P, Zafar S, Sikorska B, Liberski PP, Mitrova E, Varges D, Schmidt C, Sklaviadis T, Mollenhauer B, Zerr I. Evaluation of α‐synuclein as a novel cerebrospinal fluid biomarker in different forms of prion diseases. Alzheimers Dement 2016; 13:710-719. [DOI: 10.1016/j.jalz.2016.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 08/15/2016] [Accepted: 09/29/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Franc Llorens
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Niels Kruse
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
| | - Matthias Schmitz
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Nadine Gotzmann
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Ewa Golanska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Katrin Thüne
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Orgeta Zejneli
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Eirini Kanata
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Tobias Knipper
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Maria Cramm
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Peter Lange
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Saima Zafar
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| | - Beata Sikorska
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Pawel P. Liberski
- Department of Molecular Pathology and Neuropathology Medical University of Lodz Lodz Poland
| | - Eva Mitrova
- Department of Prion Diseases Slovak Medical University Bratislava Bratislava Slovakia
| | - Daniela Varges
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Christian Schmidt
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
| | - Theodoros Sklaviadis
- Laboratory of Pharmacology, School of Health Sciences, Department of Pharmacy Aristotle University of Thessaloniki Thessaloniki Greece
| | - Brit Mollenhauer
- Institute for Neuropathology University Medical Center Göttingen Göttingen Germany
- Paracelsus‐Elena Klinik Center for Parkinsonism and Movement Disorders Kassel Germany
- Department of Neurosurgery University Medical Center Göttingen Göttingen Germany
| | - Inga Zerr
- Department of Neurology, Clinical Dementia Center University Medical Center Göttingen Göttingen Germany
- German Center for Neurodegenerative Diseases (DZNE) Site Göttingen Germany
| |
Collapse
|
22
|
Cerebrospinal α-synuclein in α-synuclein aggregation disorders: tau/α-synuclein ratio as potential biomarker for dementia with Lewy bodies. J Neurol 2016; 263:2271-2277. [DOI: 10.1007/s00415-016-8259-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 01/20/2023]
|
23
|
Halbgebauer S, Nagl M, Klafki H, Haußmann U, Steinacker P, Oeckl P, Kassubek J, Pinkhardt E, Ludolph AC, Soininen H, Herukka SK, Wiltfang J, Otto M. Modified serpinA1 as risk marker for Parkinson's disease dementia: Analysis of baseline data. Sci Rep 2016; 6:26145. [PMID: 27184740 PMCID: PMC4868992 DOI: 10.1038/srep26145] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 04/28/2016] [Indexed: 11/09/2022] Open
Abstract
Early detection of dementia in Parkinson disease is a prerequisite for preventive therapeutic approaches. Modified serpinA1 in cerebrospinal fluid (CSF) was suggested as an early biomarker for differentiation between Parkinson patients with (PDD) or without dementia (PD). Within this study we aimed to further explore the diagnostic value of serpinA1. We applied a newly developed nanoscale method for the detection of serpinA1 based on automated capillary isoelectric focusing (CIEF). A clinical sample of 102 subjects including neurologically healthy controls (CON), PD and PDD patients was investigated. Seven serpinA1 isoforms of different charge were detected in CSF from all three diagnostic groups. The mean CSF signals of the most acidic serpinA1 isoform differed significantly (p < 0.01) between PDD (n = 29) and PD (n = 37) or CON (n = 36). Patients above the cut-off of 6.4 have a more than six times higher risk for an association with dementia compared to patients below the cut off. We propose this serpinA1 CIEF-immunoassay as a novel tool in predicting cognitive impairment in PD patients and therefore for patient stratification in therapeutic trials.
Collapse
Affiliation(s)
| | | | - Hans Klafki
- LVR-Klinikum Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - Ute Haußmann
- LVR-Klinikum Essen, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Duisburg-Essen, Germany
| | | | | | - Jan Kassubek
- Department of Neurology, University of Ulm, Germany
| | | | | | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Sanna-Kaisa Herukka
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August-University, Göttingen, Germany
| | - Markus Otto
- Department of Neurology, University of Ulm, Germany
| |
Collapse
|
24
|
Halbgebauer S, Öckl P, Wirth K, Steinacker P, Otto M. Protein biomarkers in Parkinson's disease: Focus on cerebrospinal fluid markers and synaptic proteins. Mov Disord 2016; 31:848-60. [PMID: 27134134 DOI: 10.1002/mds.26635] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/06/2016] [Accepted: 03/09/2016] [Indexed: 01/06/2023] Open
Abstract
Despite extensive research, to date, no validated biomarkers for PD have been found. This review seeks to summarize studies approaching the detection of biomarker candidates for PD and introduce promising ones in more detail, with special attention to synaptic proteins. To this end, we performed a PubMed search and included studies using proteomic tools (2-dimensional difference in gel electrophoresis and/or mass spectrometry) for the comparison of samples from PD and control patients. We found 27 studies reporting more than 500 differentially expressed proteins in which a total of 28 were detected in 2 and 17 in 3 or more independent studies, including posttranslationally modified proteins. In addition, of these 500 proteins, 25 were found to be brain specific, and 14 were enriched in synapses. Special attention was given to the applicability of the biomarker regarding sampling procedures, that is, using CSF/serum material for diagnosis. Furthermore, presynaptic proteins involved in vesicle membrane fusion seem to be interesting candidates for future analyses. Nonetheless, even though such promising biomarker candidates for PD exist, validation of these biomarkers in large-scale clinical studies is necessary to evaluate the diagnostic potential. © 2016 International Parkinson and Movement Disorder Society.
Collapse
Affiliation(s)
| | - Patrick Öckl
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | | | - Markus Otto
- Department of Neurology, University of Ulm, Ulm, Germany
| |
Collapse
|
25
|
Horrocks MH, Lee SF, Gandhi S, Magdalinou NK, Chen SW, Devine MJ, Tosatto L, Kjaergaard M, Beckwith JS, Zetterberg H, Iljina M, Cremades N, Dobson CM, Wood NW, Klenerman D. Single-Molecule Imaging of Individual Amyloid Protein Aggregates in Human Biofluids. ACS Chem Neurosci 2016; 7:399-406. [PMID: 26800462 PMCID: PMC4800427 DOI: 10.1021/acschemneuro.5b00324] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
![]()
The misfolding and aggregation of
proteins into amyloid fibrils
characterizes many neurodegenerative disorders such as Parkinson’s
and Alzheimer’s diseases. We report here a method, termed SAVE
(single aggregate visualization by enhancement) imaging, for the ultrasensitive
detection of individual amyloid fibrils and oligomers using single-molecule
fluorescence microscopy. We demonstrate that this method is able to
detect the presence of amyloid aggregates of α-synuclein, tau,
and amyloid-β. In addition, we show that aggregates can also
be identified in human cerebrospinal fluid (CSF). Significantly, we
see a twofold increase in the average aggregate concentration in CSF
from Parkinson’s disease patients compared to age-matched controls.
Taken together, we conclude that this method provides an opportunity
to characterize the structural nature of amyloid aggregates in a key
biofluid, and therefore has the potential to study disease progression
in both animal models and humans to enhance our understanding of neurodegenerative
disorders.
Collapse
Affiliation(s)
- Mathew H. Horrocks
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Steven F. Lee
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Sonia Gandhi
- Department
of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London WC1N
3BG, United Kingdom
| | - Nadia K. Magdalinou
- Reta
Lila Weston Institute of Neurological Studies, University College London, 1 Wakefield Street, London WC1N 1PJ, United Kingdom
| | - Serene W. Chen
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Michael J. Devine
- Division
of Brain Sciences, Imperial College of London, Hammersmith Hospital, Du Cane Road, London W12
0NN, United Kingdom
| | - Laura Tosatto
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Magnus Kjaergaard
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Joseph S. Beckwith
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Henrik Zetterberg
- Department
of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London WC1N
3BG, United Kingdom
- Clinical
Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry,
Institute of Neuroscience and Physiology, the Sahlgrenska Academy, University College University of Gothenburg, Mölndal, Sweden
| | - Marija Iljina
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Nunilo Cremades
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Christopher M. Dobson
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| | - Nicholas W. Wood
- Department
of Molecular Neuroscience, Institute of Neurology, University College London, Queen Square, London WC1N
3BG, United Kingdom
| | - David Klenerman
- Department
of Chemistry, University of Cambridge, Lensfield Road, Cambridge CB2 1EW, United Kingdom
| |
Collapse
|
26
|
CSF biomarkers in neurodegenerative and vascular dementias. Prog Neurobiol 2016; 138-140:36-53. [DOI: 10.1016/j.pneurobio.2016.03.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 03/12/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022]
|
27
|
Mollenhauer B, Parnetti L, Rektorova I, Kramberger MG, Pikkarainen M, Schulz-Schaeffer WJ, Aarsland D, Svenningsson P, Farotti L, Verbeek MM, Schlossmacher MG. Biological confounders for the values of cerebrospinal fluid proteins in Parkinson's disease and related disorders. J Neurochem 2016; 139 Suppl 1:290-317. [DOI: 10.1111/jnc.13390] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 09/11/2015] [Accepted: 09/21/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Brit Mollenhauer
- Paracelsus-Elena-Klinik; Kassel Germany
- University Medical Center (Department of Neuropathology); Georg-August University Goettingen; Goettingen Germany
| | - Lucilla Parnetti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer; Clinica Neurologica; Università di Perugia; Perugia Italy
| | - Irena Rektorova
- Applied Neuroscience Group; CEITEC MU; Masaryk University; Brno Czech Republic
| | - Milica G. Kramberger
- Department of Neurology; University Medical Center Ljubljana; Ljubljana Slovenia
- Division for Neurogeriatrics; Department of NVS; Karolinska Institutet; Center for Alzheimer Research; Stockholm Sweden
- Centre for Age-Related Medicine; Stavanger University Hospital; Stavanger Norway
| | - Maria Pikkarainen
- Institute of Clinical Medicine / Neurology; University of Eastern Finland; Kuopio Finland
| | - Walter J. Schulz-Schaeffer
- University Medical Center (Department of Neuropathology); Georg-August University Goettingen; Goettingen Germany
| | - Dag Aarsland
- Division for Neurogeriatrics; Department of NVS; Karolinska Institutet; Center for Alzheimer Research; Stockholm Sweden
- Centre for Age-Related Medicine; Stavanger University Hospital; Stavanger Norway
| | - Per Svenningsson
- Department for Clinical Neuroscience; Karolinska Institute; Stockholm Sweden
| | - Lucia Farotti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer; Clinica Neurologica; Università di Perugia; Perugia Italy
| | - Marcel M. Verbeek
- Department of Neurology; Department of Laboratory Medicine; Donders Institute for Brain, Cognition and Behaviour; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Michael G. Schlossmacher
- Program in Neuroscience and Division of Neurology; The Ottawa Hospital; University of Ottawa Brain & Mind Research Institute; Ottawa Ontario Canada
| |
Collapse
|
28
|
Alpha-Synuclein as a Diagnostic Biomarker for Parkinson’s Disease. METHODS IN PHARMACOLOGY AND TOXICOLOGY 2016. [DOI: 10.1007/978-1-4939-3560-4_14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
|
29
|
Simonsen AH, Kuiperij B, El-Agnaf OMA, Engelborghs S, Herukka SK, Parnetti L, Rektorova I, Vanmechelen E, Kapaki E, Verbeek M, Mollenhauer B. The utility of α-synuclein as biofluid marker in neurodegenerative diseases: a systematic review of the literature. Biomark Med 2016; 10:19-34. [DOI: 10.2217/bmm.14.105] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The discovery of α-synuclein (α-syn) as a major component of Lewy bodies, neuropathological hallmark of Parkinson's disease (PD), dementia with Lewy bodies and of glial inclusions in multiple system atrophy initiated the investigation of α-syn as a biomarker in cerebrospinal fluid (CSF). Due to the involvement of the periphery in PD the quantification of α-syn in peripheral fluids such as serum, plasma and saliva has been investigated as well. We review how the development of multiple assays for the quantification of α-syn has yielded novel insights into the variety of α-syn species present in the different fluids; the optimal preanalytical conditions required for robust quantification and the potential clinical value of α-syn as biomarker. We also suggest future approaches to use of CSF α-syn in neurodegenerative diseases.
Collapse
Affiliation(s)
- Anja Hviid Simonsen
- Memory Disorders Research Group, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Bea Kuiperij
- Department of Neurology, Department of Laboratory Medicine, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Omar Mukhtar Ali El-Agnaf
- College of Science and Engineering, Hamid Bin Khalifa University, Qatar Foundation, Education City, PO Box 5825 Doha, Qatar
| | - Sebastian Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp & Department of Neurology & Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium
| | - Sanna-Kaisa Herukka
- Institute of Clinical Medicine – Neurology University of Eastern Finland School of Medicine, Kuopio, Finland
| | - Lucilla Parnetti
- Centro Disturbi della Memoria- Unità Valutativa Alzheimer, Clinica Neurologica, Università di Perugia, Italy
| | - Irena Rektorova
- Applied Neuroscience Research Group, CEITEC MU, Masaryk University, Brno, Czech Republic
| | - Eugeen Vanmechelen
- ADx NeuroSciences, VIB-Bioincubator, Technologiepark Zwijnaarde 4, 9052 Ghent, Belgium
| | - Elisabeth Kapaki
- National & Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Marcel Verbeek
- Department of Neurology, Department of Laboratory Medicine, Donders Institute for Brain, Cognition & Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Brit Mollenhauer
- Paracelsus-Elena-Klinik, Kassel & University Medical Center (Departments of Neuropathology & Neurosurgery), Georg-August University Goettingen, Germany
| |
Collapse
|
30
|
Wennström M, Hall S, Nägga K, Londos E, Minthon L, Hansson O. Cerebrospinal fluid levels of IL-6 are decreased and correlate with cognitive status in DLB patients. ALZHEIMERS RESEARCH & THERAPY 2015; 7:63. [PMID: 26434635 PMCID: PMC4593189 DOI: 10.1186/s13195-015-0145-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/04/2015] [Indexed: 11/24/2022]
Abstract
Introduction Inflammatory processes have previously been shown to influence cognition and progression of dementia. An involvement of interleukin (IL)-6 has in particular been suggested as altered levels of IL-6 in cerebrospinal fluid (CSF) have been found in patients with Alzheimer’s disease (AD). Also, an association between cognitive decline and levels of IL-6 in CSF have been reported. The aim of the present study was to investigate whether patients clinically diagnosed with dementia with Lewy bodies (DLB) display altered CSF IL-6 levels in comparison with patients with AD and control subjects without dementia and whether the IL-6 levels are correlated with cognitive status and biomarkers for AD and synucleinopathy. Methods To analyse CSF of patients with AD (n = 45), patients with DLB (n = 29) and control subjects without dementia (n = 36), we used immunoassays to measure levels of IL-6 (multiplex electrochemiluminescence); AD markers phosphorylated tau, total tau and amyloid-β1–42 (enzyme-linked immunosorbent assay [ELISA]); and α-synuclein (ELISA). Cognitive status was evaluated using the Mini Mental State Examination (MMSE). Results Our analysis showed significantly lower levels of IL-6 in CSF from patients with DLB than in CSF from patients with AD and control subjects without dementia. The IL-6 levels were also negatively correlated with MMSE and positively correlated with α-synuclein CSF levels. Conclusions Our findings support previous studies by demonstrating a link between inflammatory processes and dementia progression and further strengthen the hypothesis that IL-6 is involved in dementia pathology and cognitive decline.
Collapse
Affiliation(s)
- Malin Wennström
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| | - Sara Hall
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| | - Katarina Nägga
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| | - Elisabet Londos
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Wallenberg Laboratory, floor 2, Inga-Marie Nilssons gata 53, 205 02, Malmö, Sweden.
| |
Collapse
|
31
|
Use of CSF α-synuclein in the differential diagnosis between Alzheimer's disease and other neurodegenerative disorders. Int Psychogeriatr 2015; 27:1429-38. [PMID: 25851548 DOI: 10.1017/s1041610215000447] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The etiology and pathogenesis of neurodegenerative disorders has yet to be elucidated, so their differential diagnosis is a challenge. This is especially true in differentiating Alzheimer's disease (AD), dementia with Lewy bodies (DLB), Parkinson disease (PD), and multiple system atrophy (MSA). METHODS A total of 11 eligible articles were identified by search of electronic databases including PubMed, Springer Link, Elsevier, and the Cochrane Library, up to June 2014. In meta-analyses, standardized mean differences (SMD), with 95% confidence intervals (CI), comparing cerebrospinal fluid (CSF) measures of α-synuclein between the above conditions were calculated using random-effects models. RESULTS CSF α-synuclein concentrations were significantly higher in AD compared to DLB [SMD: 0.32, 95% CI: (0.02, 0.62), z = 2.07, P = 0.038]; PD [SMD: 0.87, 95% CI: (0.15, 1.58), z = 2.38, P = 0.017]; or MSA [SMD: 1.14, 95% CI: (0.15, 2.14), z = 2.25, P = 0.025]. However, no significant difference was found between patients with AD and neurological cognitively normal controls [SMD: 0.02, 95% CI: (-0.21, 0.24), z = 0.13, P = 0.894]. CONCLUSIONS Results of these meta-analysis suggest that quantification of CSF α-synuclein could help distinguish AD from other neurodegenerative disorders such as DLB, PD, or MSA.
Collapse
|
32
|
Sancesario GM, Bernardini S. How many biomarkers to discriminate neurodegenerative dementia? Crit Rev Clin Lab Sci 2015; 52:314-26. [PMID: 26292074 DOI: 10.3109/10408363.2015.1051658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A number of cerebrospinal fluid (CSF) biomarkers are currently used for the diagnosis of dementia. Opposite changes in the level of amyloid-β(1-42) versus total tau and phosphorylated-tau181 in the CSF reflect the specific pathology of Alzheimer's disease (AD) in the brain. This panel of biomarkers has proven to be effective to differentiate AD from controls and from the major types of neurodegenerative dementia, and to evaluate the progression from mild cognitive impairment to AD. In the absence of specific biomarkers reflecting the pathologies of the other most common forms of dementia, such as Lewy Body disease, Frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, etc., the evaluation of biomarkers of AD pathology is used, attempting to exclude rather than to confirm AD. Other biomarkers included in the common clinical practice do not clearly relate to the underlying pathology: progranulin (PGRN) is a selective marker of frontotemporal dementia with mutations in the PGRN gene; the 14-3-3 protein is a highly sensitive and specific marker for Creutzfeldt-Jakob disease, but has to be used carefully in differentiating rapid progressive dementia; and α-synuclein is an emerging candidate biomarker of the different forms of synucleinopathy. This review summarizes several biomarkers of neurodegenerative dementia validated based on the neuropathological processes occurring in brain tissue. Notwithstanding the paucity of pathologically validated biomarkers and their high analytical variability, the combinations of these biomarkers may well represent a key and more precise analytical and diagnostic tool in the complex plethora of degenerative dementia.
Collapse
Affiliation(s)
- Giulia M Sancesario
- a Department of Clinical and Behavioural Neurology , Santa Lucia Foundation, IRCCS , Rome , Italy and
| | - Sergio Bernardini
- b Department of Experimental Medicine and Surgery , Tor Vergata University of Rome , Rome , Italy
| |
Collapse
|
33
|
Antonelou RC, Emmanouilidou E, Gasparinatos G, Velona T, Voumvourakis KI, Stefanis L. Decreased levels of alpha-synuclein in cerebrospinal fluid of patients with clinically isolated syndrome and multiple sclerosis. J Neurochem 2015; 134:748-55. [DOI: 10.1111/jnc.13163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/04/2015] [Accepted: 05/04/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Roubina Ch. Antonelou
- Second Department of Neurology; Hospital «Attikon», University of Athens Medical School; Haidari Greece
| | - Evangelia Emmanouilidou
- Center for Neuroscience; Biomedical Research Foundation of the Academy of Athens; Athens Greece
| | - Gerasimos Gasparinatos
- Second Department of Neurology; Hospital «Attikon», University of Athens Medical School; Haidari Greece
| | - Theodora Velona
- Center for Neuroscience; Biomedical Research Foundation of the Academy of Athens; Athens Greece
| | | | - Leonidas Stefanis
- Second Department of Neurology; Hospital «Attikon», University of Athens Medical School; Haidari Greece
- Center for Neuroscience; Biomedical Research Foundation of the Academy of Athens; Athens Greece
| |
Collapse
|
34
|
Kruse N, Persson S, Alcolea D, Bahl JMC, Baldeiras I, Capello E, Chiasserini D, Bocchio Chiavetto L, Emersic A, Engelborghs S, Eren E, Fladby T, Frisoni G, García-Ayllón MS, Genc S, Gkatzima O, Heegaard NHH, Janeiro AM, Kováčech B, Kuiperij HB, Leitão MJ, Lleó A, Martins M, Matos M, Mollergard HM, Nobili F, Öhrfelt A, Parnetti L, de Oliveira CR, Rot U, Sáez-Valero J, Struyfs H, Tanassi JT, Taylor P, Tsolaki M, Vanmechelen E, Verbeek MM, Zilka N, Blennow K, Zetterberg H, Mollenhauer B. Validation of a quantitative cerebrospinal fluid alpha-synuclein assay in a European-wide interlaboratory study. Neurobiol Aging 2015; 36:2587-96. [PMID: 26093515 DOI: 10.1016/j.neurobiolaging.2015.05.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 03/17/2015] [Accepted: 05/10/2015] [Indexed: 11/30/2022]
Abstract
Decreased levels of alpha-synuclein (aSyn) in cerebrospinal fluid (CSF) in Parkinson's disease and related synucleinopathies have been reported, however, not consistently in all cross-sectional studies. To test the performance of one recently released human-specific enzyme-linked immunosorbent assay (ELISA) for the quantification of aSyn in CSF, we carried out a round robin trial with 18 participating laboratories trained in CSF ELISA analyses within the BIOMARKAPD project in the EU Joint Program - Neurodegenerative Disease Research. CSF samples (homogeneous aliquots from pools) and ELISA kits (one lot) were provided centrally and data reported back to one laboratory for data analysis. Our study showed that although factors such as preanalytical sample handling and lot-to-lot variability were minimized by our study design, we identified high variation in absolute values of CSF aSyn even when the same samples and same lots of assays were applied. We further demonstrate that although absolute concentrations differ between laboratories the quantitative results are comparable. With further standardization this assay may become an attractive tool for comparing aSyn measurements in diverse settings. Recommendations for further validation experiments and improvement of the interlaboratory results obtained are given.
Collapse
Affiliation(s)
- Niels Kruse
- Department of Neuropathology, University Medical Center, Göttingen, Germany.
| | - Staffan Persson
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Daniel Alcolea
- Department of Neurology, Institut Investigacions Biomediques, Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain
| | - Justyna M C Bahl
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark
| | - Ines Baldeiras
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Elisabetta Capello
- Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa, Italy
| | - Davide Chiasserini
- Centre for Memory Disturbances and Alzheimer's Centre-Laboratory of Clinical Neurochemistry, Department of Medicine, Section of Neurology, University of Perugia, Perugia, Italy
| | - Luisella Bocchio Chiavetto
- Neuropsychopharmacology Unit, IRCCS Cento S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Faculty of Psychology, eCampus University, Novedrate (Como), Italy
| | - Andreja Emersic
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Sebastiaan Engelborghs
- Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Erden Eren
- Department of Neuroscience, Health Science Institute, Dokuz Eylül University, Izmir, Turkey
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Giovanni Frisoni
- Laboratory of Alzheimer´s Neuroimaging and Epidemiology, IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy; Departments of Psychiatry and Internal Medicine, University Hospitals and University of Geneva, Geneva, Switzerland
| | - María-Salud García-Ayllón
- Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain; Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d´Alcant, Spain
| | - Sermin Genc
- Department of Neuroscience, Health Science Institute, Dokuz Eylül University, Izmir, Turkey
| | - Olymbia Gkatzima
- 3rd Neurology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Niels H H Heegaard
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense C, Denmark
| | - André M Janeiro
- Genomed, Diagnósticos de Medicina Molecular, Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal
| | - Branislav Kováčech
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - H Bea Kuiperij
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Maria J Leitão
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Alberto Lleó
- Department of Neurology, Institut Investigacions Biomediques, Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain
| | - Madalena Martins
- Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal; Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Mafalda Matos
- Instituto de Medicina Molecular, Edificio Egas Moniz, Lisbon, Portugal
| | - Hanne M Mollergard
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), Clinical Neurology Unit, Genoa, Italy
| | - Annika Öhrfelt
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Lucilla Parnetti
- Centre for Memory Disturbances and Alzheimer's Centre-Laboratory of Clinical Neurochemistry, Department of Medicine, Section of Neurology, University of Perugia, Perugia, Italy
| | - Catarina Resende de Oliveira
- Neurochemistry Laboratory, Department of Neurology, Faculty of Medicine, CHUC-Centro Hospitalar e Universitário de Coimbra, CNC-Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Uros Rot
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Javier Sáez-Valero
- Centro de Investigación Biomédica en Red en enfermedades Neurodegenerativas-CIBERNED, Madrid, Spain; Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-CSIC, Sant Joan d´Alcant, Spain
| | - Hanne Struyfs
- Reference Centre for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Julia T Tanassi
- Department of Autoimmunology & Biomarkers, Statens Serum Institut, Copenhagen S, Denmark
| | | | - Magda Tsolaki
- 3rd Neurology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Marcel M Verbeek
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Laboratory Medicine, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Norbert Zilka
- Institute of Neuroimmunology, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden; Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Brit Mollenhauer
- Department of Neuropathology, University Medical Center, Göttingen, Germany; Paracelsus-Elena-Klinik, Kassel, Germany; Department of Neurosurgery, University Medical Center, Göttingen, Germany
| |
Collapse
|
35
|
Inekci D, Jonesco DS, Kennard S, Karsdal MA, Henriksen K. The potential of pathological protein fragmentation in blood-based biomarker development for dementia - with emphasis on Alzheimer's disease. Front Neurol 2015; 6:90. [PMID: 26029153 PMCID: PMC4426721 DOI: 10.3389/fneur.2015.00090] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/10/2015] [Indexed: 12/12/2022] Open
Abstract
The diagnosis of dementia is challenging and early stages are rarely detected limiting the possibilities for early intervention. Another challenge is the overlap in the clinical features across the different dementia types leading to difficulties in the differential diagnosis. Identifying biomarkers that can detect the pre-dementia stage and allow differential diagnosis could provide an opportunity for timely and optimal intervention strategies. Also, such biomarkers could help in selection and inclusion of the right patients in clinical trials of both Alzheimer’s disease and other dementia treatment candidates. The cerebrospinal fluid (CSF) has been the most investigated source of biomarkers and several candidate proteins have been identified. However, looking solely at protein levels is too simplistic to provide enough detailed information to differentiate between dementias, as there is a significant crossover between the proteins involved in the different types of dementia. Additionally, CSF sampling makes these biomarkers challenging for presymptomatic identification. We need to focus on disease-specific protein fragmentation to find a fragment pattern unique for each separate dementia type – a form of protein fragmentology. Targeting protein fragments generated by disease-specific combinations of proteins and proteases opposed to detecting the intact protein could reduce the overlap between diagnostic groups as the extent of processing as well as which proteins and proteases constitute the major hallmark of each dementia type differ. In addition, the fragments could be detectable in blood as they may be able to cross the blood–brain barrier due to their smaller size. In this review, the potential of the fragment-based biomarker discovery for dementia diagnosis and prognosis is discussed, especially highlighting how the knowledge from CSF protein biomarkers can be used to guide blood-based biomarker development.
Collapse
Affiliation(s)
- Dilek Inekci
- Nordic Bioscience, Biomarkers and Research , Herlev , Denmark ; Systems Biology, Technical University of Denmark , Lyngby , Denmark
| | | | - Sophie Kennard
- Nordic Bioscience, Biomarkers and Research , Herlev , Denmark
| | | | - Kim Henriksen
- Nordic Bioscience, Biomarkers and Research , Herlev , Denmark
| |
Collapse
|
36
|
MS-based methods for biomarkers of Parkinson's disease: what is the future? Bioanalysis 2015; 7:149-51. [DOI: 10.4155/bio.14.273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
37
|
Gore RL, Vardy ERLC, O'Brien JT. Delirium and dementia with Lewy bodies: distinct diagnoses or part of the same spectrum? J Neurol Neurosurg Psychiatry 2015; 86:50-9. [PMID: 24860139 DOI: 10.1136/jnnp-2013-306389] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Dementia with Lewy bodies (DLB) is recognised as the second most common form of dementia in older people. Delirium is a condition of acute brain dysfunction for which a pre-existing diagnosis of dementia is a risk factor. Conversely delirium is associated with an increased risk of developing dementia. The reasons for this bidirectional relationship are not well understood. Our aim was to review possible similarities in the clinical presentation and pathophysiology between delirium and DLB, and explore possible links between these diagnoses. A systematic search using Medline, Embase and Psychinfo was performed. References were scanned for relevant articles, supplemented by articles identified from reference lists and those known to the authors. 94 articles were selected for inclusion in the review. Delirium and DLB share a number of clinical similarities, including global impairment of cognition, fluctuations in attention and perceptual abnormalities. Delirium is a frequent presenting feature of DLB. In terms of pathophysiological mechanisms, cholinergic dysfunction and genetics may provide a common link. Neuroimaging studies suggest a brain vulnerability in delirium which may also occur in dementia. The basal ganglia, which play a key role in DLB, have also been implicated in delirium. The role of Cerebrospinal fluid (CSF) and serum biomarkers for both diagnoses is an interesting area although some results are conflicting and further work in this area is needed. Delirium and DLB share a number of features and we hypothesise that delirium may, in some cases, represent early or 'prodromal' DLB. Further research is needed to test the novel hypothesis that delirium may be an early marker for future DLB, which would aid early diagnosis of DLB and identify those at high risk.
Collapse
Affiliation(s)
- Rachel L Gore
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK Department of Old Age Psychiatry, Northumberland Tyne and Wear NHS Trust, Morpeth, Northumberland, UK
| | - Emma R L C Vardy
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK Department of Older Peoples Medicine, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Hospital, Newcastle upon Tyne, UK
| | - John T O'Brien
- Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK Department of Psychiatry, University of Cambridge, Cambridgeshire and Peterborough NHS Foundation Trust, Level E4 Cambridge Biomedical Campus, Cambridge, UK
| |
Collapse
|
38
|
Oeckl P, Steinacker P, Feneberg E, Otto M. Cerebrospinal fluid proteomics and protein biomarkers in frontotemporal lobar degeneration: Current status and future perspectives. BIOCHIMICA ET BIOPHYSICA ACTA-PROTEINS AND PROTEOMICS 2014; 1854:757-68. [PMID: 25526887 DOI: 10.1016/j.bbapap.2014.12.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 11/18/2014] [Accepted: 12/11/2014] [Indexed: 12/13/2022]
Abstract
Frontotemporal lobar degeneration (FTLD) comprises a spectrum of rare neurodegenerative diseases with an estimated prevalence of 15-22 cases per 100,000 persons including the behavioral variant of frontotemporal dementia (bvFTD), progressive non-fluent aphasia (PNFA), semantic dementia (SD), FTD with motor neuron disease (FTD-MND), progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS). The pathogenesis of the diseases is still unclear and clinical diagnosis of FTLD is hampered by overlapping symptoms within the FTLD subtypes and with other neurodegenerative diseases such as Alzheimer's disease (AD) and Parkinson's disease (PD). Intracellular protein aggregates in the brain are a major hallmark of FTLD and implicate alterations in protein metabolism or function in the disease's pathogenesis. Cerebrospinal fluid (CSF) which surrounds the brain can be used to study changes in neurodegenerative diseases and to identify disease-related mechanisms or neurochemical biomarkers for diagnosis. In the present review, we will give an overview of the current literature on proteomic studies in CSF of FTLD patients. Reports of targeted and unbiased proteomic approaches are included and the results are discussed in regard of their informative value about disease pathology and the suitability to be used as diagnostic biomarkers. Finally, we will give some future perspectives on CSF proteomics and a list of candidate biomarkers which might be interesting for validation in further studies. This article is part of a Special Issue entitled: Neuroproteomics: Applications in neuroscience and neurology.
Collapse
Affiliation(s)
- Patrick Oeckl
- Department of Neurology, Ulm University Hospital, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Petra Steinacker
- Department of Neurology, Ulm University Hospital, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Emily Feneberg
- Department of Neurology, Ulm University Hospital, Oberer Eselsberg 45, 89081 Ulm, Germany.
| | - Markus Otto
- Department of Neurology, Ulm University Hospital, Oberer Eselsberg 45, 89081 Ulm, Germany.
| |
Collapse
|
39
|
Abstract
Alzheimer disease (AD) and Parkinson disease (PD) are the most common neurodegenerative disorders. For both diseases, early intervention is thought to be essential to the success of disease-modifying treatments. Cerebrospinal fluid (CSF) can reflect some of the pathophysiological changes that occur in the brain, and the number of CSF biomarkers under investigation in neurodegenerative conditions has grown rapidly in the past 20 years. In AD, CSF biomarkers are increasingly being used in clinical practice, and have been incorporated into the majority of clinical trials to demonstrate target engagement, to enrich or stratify patient groups, and to find evidence of disease modification. In PD, CSF biomarkers have not yet reached the clinic, but are being studied in patients with parkinsonism, and are being used in clinical trials either to monitor progression or to demonstrate target engagement and downstream effects of drugs. CSF biomarkers might also serve as surrogate markers of clinical benefit after a specific therapeutic intervention, although additional data are required. It is anticipated that CSF biomarkers will have an important role in trials aimed at disease modification in the near future. In this Review, we provide an overview of CSF biomarkers in AD and PD, and discuss their role in clinical trials.
Collapse
|
40
|
Ahmed RM, Paterson RW, Warren JD, Zetterberg H, O'Brien JT, Fox NC, Halliday GM, Schott JM. Biomarkers in dementia: clinical utility and new directions. J Neurol Neurosurg Psychiatry 2014; 85:1426-34. [PMID: 25261571 PMCID: PMC4335455 DOI: 10.1136/jnnp-2014-307662] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 08/27/2014] [Accepted: 09/03/2014] [Indexed: 12/12/2022]
Abstract
Imaging, cerebrospinal fluid (CSF) and blood-based biomarkers have the potential to improve the accuracy by which specific causes of dementia can be diagnosed in vivo, provide insights into the underlying pathophysiology, and may be used as inclusion criteria and outcome measures for clinical trials. While a number of imaging and CSF biomarkers are currently used for each of these purposes, this is an evolving field, with numerous potential biomarkers in varying stages of research and development. We review the currently available biomarkers for the three most common forms of neurodegenerative dementia, and give an overview of research techniques that may in due course make their way into the clinic.
Collapse
Affiliation(s)
- R M Ahmed
- Neuroscience Research Australia and the University of NSW, Sydney, New South Wales, Australia
| | - R W Paterson
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - J D Warren
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - H Zetterberg
- Department of Molecular Neuroscience, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Institute of Neuroscience and Physiology, Mölndal, Sweden
| | - J T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - N C Fox
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - G M Halliday
- Neuroscience Research Australia and the University of NSW, Sydney, New South Wales, Australia
| | - J M Schott
- Dementia Research Centre, University College London Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| |
Collapse
|
41
|
Magdalinou N, Lees AJ, Zetterberg H. Cerebrospinal fluid biomarkers in parkinsonian conditions: an update and future directions. J Neurol Neurosurg Psychiatry 2014; 85:1065-75. [PMID: 24691581 PMCID: PMC4173749 DOI: 10.1136/jnnp-2013-307539] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Parkinsonian diseases comprise a heterogeneous group of neurodegenerative disorders, which show significant clinical and pathological overlap. Accurate diagnosis still largely relies on clinical acumen; pathological diagnosis remains the gold standard. There is an urgent need for biomarkers to diagnose parkinsonian disorders, particularly in the early stages when diagnosis is most difficult. In this review, several of the most promising cerebrospinal fluid candidate markers will be discussed. Their strengths and limitations will be considered together with future developments in the field.
Collapse
Affiliation(s)
- Nadia Magdalinou
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Andrew J Lees
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| |
Collapse
|
42
|
Hansson O, Hall S, Ohrfelt A, Zetterberg H, Blennow K, Minthon L, Nägga K, Londos E, Varghese S, Majbour NK, Al-Hayani A, El-Agnaf OM. Levels of cerebrospinal fluid α-synuclein oligomers are increased in Parkinson's disease with dementia and dementia with Lewy bodies compared to Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2014; 6:25. [PMID: 24987465 PMCID: PMC4075410 DOI: 10.1186/alzrt255] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 04/08/2014] [Indexed: 11/16/2022]
Abstract
Introduction The objective was to study whether α-synuclein oligomers are altered in the cerebrospinal fluid (CSF) of patients with dementia, including Parkinson disease with dementia (PDD), dementia with Lewy bodies (DLB), and Alzheimer disease (AD), compared with age-matched controls. Methods In total, 247 CSF samples were assessed in this study, including 71 patients with DLB, 30 patients with PDD, 48 patients with AD, and 98 healthy age-matched controls. Both total and oligomeric α-synuclein levels were evaluated by using well-established immunoassays. Results The levels of α-synuclein oligomers in the CSF were increased in patients with PDD compared with the controls (P < 0.05), but not in patients with DLB compared with controls. Interestingly, the levels of α-synuclein oligomers in the CSF were also significantly higher in patients with PDD (P < 0.01) and DLB (P < 0.05) compared with patients with AD. The levels of CSF α-synuclein oligomers and the ratio of oligomeric/total-α-synuclein could distinguish DLB or PDD patients from AD patients, with areas under the curves (AUCs) of 0.64 and 0.75, respectively. In addition, total-α-synuclein alone could distinguish DLB or PDD patients from AD patients, with an AUC of 0.80. Conclusions The levels of α-synuclein oligomers were increased in the CSF from α-synucleinopathy patients with dementia compared with AD cases.
Collapse
Affiliation(s)
- Oskar Hansson
- Department of Clinical Sciences, Lund University, Lund, Sweden ; Memory clinic, Skåne University Hospital, Lund, Sweden
| | - Sara Hall
- Department of Clinical Sciences, Lund University, Lund, Sweden ; Neurology clinic, Skåne University Hospital, Lund, Sweden
| | - Annika Ohrfelt
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Lennart Minthon
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Katarina Nägga
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Elisabet Londos
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Shiji Varghese
- Department of Biochemistry, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nour K Majbour
- Department of Biochemistry, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Abdulmonem Al-Hayani
- Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar Ma El-Agnaf
- Department of Biochemistry, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates ; Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
43
|
Parnetti L, Farotti L, Eusebi P, Chiasserini D, De Carlo C, Giannandrea D, Salvadori N, Lisetti V, Tambasco N, Rossi A, Majbour NK, El-Agnaf O, Calabresi P. Differential role of CSF alpha-synuclein species, tau, and Aβ42 in Parkinson's Disease. Front Aging Neurosci 2014; 6:53. [PMID: 24744728 PMCID: PMC3978246 DOI: 10.3389/fnagi.2014.00053] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 03/05/2014] [Indexed: 11/21/2022] Open
Abstract
There is a great interest in developing cerebrospinal fluid (CSF) biomarkers for diagnosis and prognosis of Parkinson's disease (PD). CSF alpha synuclein (α-syn) species, namely total and oligomeric α-syn (t-α-syn and o-α-syn), have shown to be of help for PD diagnosis. Preliminary evidences show that the combination of CSF t-α-syn and classical Alzheimer's disease (AD) biomarkers—β-amyloid 1–42 (Aβ42), total tau (t-tau), phosphorylated tau (p-tau)—differentiate PD patients from controls, and that reduced levels of Aβ42 represent a predictive factor for development of cognitive deterioration in PD. In this prospective study carried out in 44 PD patients and 25 neurological controls we wanted to verify whether the combination of CSF α-synuclein species—t-α-syn and o-α-syn—and classical AD biomarkers may help in differentiating PD from neurological controls, and if these biomarkers may predict cognitive decline. The median of follow-up duration was 3 years (range: 2–6 years). Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used for monitoring cognitive changes along time, being administered once a year. Oligo/total α-syn ratio (o/t-α-syn ratio) confirmed its diagnostic value, significantly contributing to the discrimination of PD from neurological controls. A greater diagnostic accuracy was reached when combining o/t-α-syn and Aβ42/tau ratios (Sens = 0.70, Spec = 0.84, AUC = 0.82; PPV = 0.89, NPV = 0.62, LR+ = 4.40, DOR = 12.52). Low CSF Aβ42 level was associated with a higher rate of MMSE and MoCA decline, confirming its role as independent predictive factor for cognitive decline in PD. None of the other biomarkers assessed (t-tau, p-tau, t-α-syn and o-α-syn) showed to have prognostic value. We conclude that combination of CSF o/t-α-syn and Aβ42/tau ratios improve the diagnostic accuracy of PD. PD patients showing low CSF Aβ42 levels at baseline are more prone to develop cognitive decline.
Collapse
Affiliation(s)
- Lucilla Parnetti
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Lucia Farotti
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Paolo Eusebi
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy ; Dipartimento di Epidemiologia, Regione Umbria Perugia, Italy
| | - Davide Chiasserini
- Dipartimento di Scienze Farmaceutiche, Sezione di Biochimica, Università degli Studi di Perugia Perugia, Italy
| | - Claudia De Carlo
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - David Giannandrea
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Nicola Salvadori
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Viviana Lisetti
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Nicola Tambasco
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Aroldo Rossi
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy
| | - Nour K Majbour
- Department of Biochemistry, Faculty of Medicine and Health Sciences, United Arab Emirates University Al Ain, United Arab Emirates
| | - Omar El-Agnaf
- Department of Biochemistry, Faculty of Medicine and Health Sciences, United Arab Emirates University Al Ain, United Arab Emirates ; Faculty of Medicine, King Abdulaziz University Jeddah, Saudi Arabia
| | - Paolo Calabresi
- Clinica Neurologica, Università degli Studi di Perugia Perugia, Italy ; IRCCS Fondazione S. Lucia Roma, Italy
| |
Collapse
|
44
|
Kokkinou M, Smailagic N, Noel-Storr AH, Hyde C, Ukoumunne O, Worrall RE, Hayen A, Desai M, Ritchie C. Plasma and Cerebrospinal fluid (CSF) Abeta42 for the differential diagnosis of Alzheimer's disease dementia in participants diagnosed with any dementia subtype in a specialist care setting. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2014. [DOI: 10.1002/14651858.cd010945] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Nadja Smailagic
- University of Cambridge; Institute of Public Health; Forvie Site Robinson Way Cambridge UK CB2 0SR
| | - Anna H Noel-Storr
- University of Oxford; Radcliffe Department of Medicine; Room 4401c (4th Floor) John Radcliffe Hospital, Headington Oxford UK OX3 9DU
| | - Chris Hyde
- University of Exeter Medical School, University of Exeter; Peninsula Technology Assessment Group (PenTAG); Veysey Building Salmon Pool Lane Exeter UK EX2 4SG
| | - Obioha Ukoumunne
- University of Exeter Medical School, University of Exeter; Peninsula CLAHRC; Veysey Building Salmon Pool Lane Exeter Devon UK EX2 4SG
| | - Rosie E Worrall
- Oxford University Medical School; Keble College, Parks Road Oxford UK OX13PG
| | - Anja Hayen
- University of Oxford, John Radcliffe Hospital; Nuffield Department of Clinical Neurosciences; Headley Way Oxford UK OX3 9DU
| | - Meera Desai
- University of Oxford; Department of Experimental Psychology; South Parks Road Oxford Oxfordshire UK OX1 3UD
| | | |
Collapse
|
45
|
Slaets S, Vanmechelen E, Le Bastard N, Decraemer H, Vandijck M, Martin JJ, De Deyn PP, Engelborghs S. Increased CSF α-synuclein levels in Alzheimer's disease: correlation with tau levels. Alzheimers Dement 2014; 10:S290-8. [PMID: 24439167 DOI: 10.1016/j.jalz.2013.10.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/20/2013] [Accepted: 10/21/2013] [Indexed: 11/25/2022]
Abstract
BACKGROUND Given the difficult clinical differential diagnosis between Alzheimer's disease (AD) and dementia with Lewy bodies (DLB), growing interest resulted in research on α-synuclein as a potential cerebrospinal fluid biomarker (CSF) for synucleinopathies. METHODS CSF α-synuclein-140 concentrations were determined by a prototype xMAP™ bead-based assay (Innogenetics NV, Belgium). In addition, CSF amyloid β1-42 (Aβ1-42), total tau (T-tau), and phosphorylated tau (P-tau181P) levels were determined. RESULTS CSF α-synuclein levels were higher in AD patients as compared with cognitively healthy controls (P=.019) and patients with synucleinopathies (P<.001). CSF α-synuclein levels were correlated with T-tau (P<.001) and P-tau181P (P<.001) levels in autopsy-confirmed AD patients. A diagnostic algorithm using α-synuclein and P-tau181P discriminated neuropathologically confirmed AD from DLB patients, resulting in sensitivity and specificity values of 85% and 81%, respectively. CONCLUSION Because CSF α-synuclein levels were significantly higher in AD as compared with synucleinopathies, α-synuclein might have a value as a biomarker for differential dementia diagnosis.
Collapse
Affiliation(s)
- Sylvie Slaets
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Nathalie Le Bastard
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | | | - Manu Vandijck
- Innogenetics NV (Miraca/Fujirebio Group), Ghent, Belgium
| | | | - Peter Paul De Deyn
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Biobank, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium; Department of Neurology and Alzheimer Research Center, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
| | - Sebastiaan Engelborghs
- Reference Center for Biological Markers of Dementia (BIODEM), Laboratory of Neurochemistry and Behavior, Institute Born-Bunge, University of Antwerp, Antwerp, Belgium; Department of Neurology and Memory Clinic, Hospital Network Antwerp (ZNA) Middelheim and Hoge Beuken, Antwerp, Belgium.
| |
Collapse
|
46
|
Kapaki E, Paraskevas GP, Emmanouilidou E, Vekrellis K. The diagnostic value of CSF α-synuclein in the differential diagnosis of dementia with Lewy bodies vs. normal subjects and patients with Alzheimer's disease. PLoS One 2013; 8:e81654. [PMID: 24282614 PMCID: PMC3840054 DOI: 10.1371/journal.pone.0081654] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 10/15/2013] [Indexed: 01/20/2023] Open
Abstract
The detection of α-synuclein (α-syn) in the cerebrospinal fluid (CSF) of patients with synucleinopathy has yielded promising but inconclusive results. The aim of the present study was to determine the diagnostic value of α-syn as a biological marker for Dementia with Lewy bodies (DLB) vs. normal subjects and patients with Alzheimer’s disease (AD), after strict control of several recognized confounders. Sixteen patients with DLB, 18 patients with AD and 22 age- and sex-matched normal controls (CTRL) were recruited. The levels of total α-syn in CSF were measured using a novel enzyme-linked immunosorbent assay. There was a significant increase of CSF α-syn levels in DLB patients as compared to the CTRL and AD groups (P= 0.049 and 0.01 respectively). ROC analysis revealed that increased α-syn was 81.8% specific for the discrimination of DLB vs. CTRL and 90% vs. AD. However, sensitivity was lower (56.2 % and 50% respectively). These findings provide evidence for a possible diagnostic role of α-syn as a surrogate biomarker for DLB.
Collapse
Affiliation(s)
- Elisabeth Kapaki
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
- * E-mail:
| | - George P. Paraskevas
- National and Kapodistrian University of Athens, School of Medicine, 1st Department of Neurology, Eginition Hospital, Athens, Greece
| | - Evangelia Emmanouilidou
- Division of Basic Neurosciences, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Kostas Vekrellis
- Division of Basic Neurosciences, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| |
Collapse
|
47
|
Toledo JB, Korff A, Shaw LM, Trojanowski JQ, Zhang J. CSF α-synuclein improves diagnostic and prognostic performance of CSF tau and Aβ in Alzheimer's disease. Acta Neuropathol 2013; 126:683-97. [PMID: 23812319 PMCID: PMC3812407 DOI: 10.1007/s00401-013-1148-z] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 06/15/2013] [Accepted: 06/18/2013] [Indexed: 11/26/2022]
Abstract
Alzheimer's disease (AD) and Lewy body diseases (LBD), e.g., Parkinson's disease (PD) dementia and dementia with Lewy bodies (DLB), are common causes of geriatric cognitive impairments. In addition, AD and LBD are often found in the same patients at autopsy; therefore, biomarkers that can detect the presence of both pathologies in living subjects are needed. In this investigation, we report the assessment of α-synuclein (α-syn) in cerebrospinal fluid (CSF) and its association with CSF total tau (t-tau), phosphorylated tau181 (p-tau181), and amyloid beta1-42 (Aβ1-42) in subjects of the Alzheimer's Disease Neuroimaging Initiative (ADNI; n = 389), with longitudinal clinical assessments. A strong correlation was noted between α-syn and t-tau in controls, as well as in patients with AD and mild cognitive impairment (MCI). However, the correlation is not specific to subjects in the ADNI cohort, as it was also seen in PD patients and controls enrolled in the Parkinson's Progression Markers Initiative (PPMI; n = 102). A bimodal distribution of CSF α-syn levels was observed in the ADNI cohort, with high levels of α-syn in the subjects with abnormally increased t-tau values. Although a correlation was also noted between α-syn and p-tau181, there was a mismatch (α-syn-p-tau181-Mis), i.e., higher p-tau181 levels accompanied by lower α-syn levels in a subset of ADNI patients. We hypothesize that this α-syn-p-tau181-Mis is a CSF signature of concomitant LBD pathology in AD patients. Hence, we suggest that inclusion of measures of CSF α-syn and calculation of α-syn-p-tau181-Mis improves the diagnostic sensitivity/specificity of classic CSF AD biomarkers and better predicts longitudinal cognitive changes.
Collapse
Affiliation(s)
- Jon B. Toledo
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Ane Korff
- Department of Pathology, University of Washington School of Medicine, Seattle, WA
| | - Leslie M. Shaw
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - John Q. Trojanowski
- Department of Pathology & Laboratory Medicine, Institute on Aging, Center for Neurodegenerative Disease Research, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Jing Zhang
- Department of Pathology, University of Washington School of Medicine, Seattle, WA
| | | | | |
Collapse
|
48
|
Tsuruoka M, Hara J, Hirayama A, Sugimoto M, Soga T, Shankle WR, Tomita M. Capillary electrophoresis-mass spectrometry-based metabolome analysis of serum and saliva from neurodegenerative dementia patients. Electrophoresis 2013; 34:2865-72. [PMID: 23857558 DOI: 10.1002/elps.201300019] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Revised: 03/12/2013] [Accepted: 03/31/2013] [Indexed: 11/09/2022]
Abstract
Despite increasing global prevalence, the precise pathogenesis and terms for objective diagnosis of neurodegenerative dementias remain controversial, and comprehensive understanding of the disease remains lacking. Here, we conducted metabolomic analysis of serum and saliva obtained from patients with neurodegenerative dementias (n = 10), including Alzheimer's disease, frontotemporal lobe dementia, and Lewy body disease, as well as from age-matched healthy controls (n = 9). Using CE-TOF-MS, six metabolites in serum (β-alanine, creatinine, hydroxyproline, glutamine, iso-citrate, and cytidine) and two in saliva (arginine and tyrosine) were significantly different between dementias and controls. Using multivariate analysis, serum was confirmed as a more efficient biological fluid for diagnosis compared to saliva; additionally, 45 metabolites in total were identified as candidate markers that could discriminate at least one pair of diagnostic groups from the healthy control group. These metabolites possibly provide an objective method for diagnosing dementia-type by multiphase screening. Moreover, diagnostic-type-dependent differences were observed in several tricarboxylic acid cycle compounds detected in serum, indicating that some pathways in glucose metabolism may be altered in dementia patients. This pilot study revealed novel alterations in metabolomic profiles between various neurodegenerative dementias, which would contribute to etiological investigations.
Collapse
Affiliation(s)
- Mayuko Tsuruoka
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Yamagata, Japan; Faculty of Environment and Information Studies, Keio University, Fujisawa, Kanagawa, Japan
| | | | | | | | | | | | | |
Collapse
|
49
|
Schmid AW, Fauvet B, Moniatte M, Lashuel HA. Alpha-synuclein post-translational modifications as potential biomarkers for Parkinson disease and other synucleinopathies. Mol Cell Proteomics 2013; 12:3543-58. [PMID: 23966418 DOI: 10.1074/mcp.r113.032730] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The development of novel therapies against neurodegenerative disorders requires the ability to detect their early, presymptomatic manifestations in order to enable treatment before irreversible cellular damage occurs. Precocious signs indicative of neurodegeneration include characteristic changes in certain protein levels, which can be used as diagnostic biomarkers when they can be detected in fluids such as blood plasma or cerebrospinal fluid. In the case of synucleinopathies, cerebrospinal alpha-synuclein (α-syn) has attracted great interest as a potential biomarker; however, there is ongoing debate regarding the association between cerebrospinal α-syn levels and neurodegeneration in Parkinson disease and synucleinopathies. Post-translational modifications (PTMs) have emerged as important determinants of α-syn's physiological and pathological functions. Several PTMs are enriched within Lewy bodies and exist at higher levels in α-synucleinopathy brains, suggesting that certain modified forms of α-syn might be more relevant biomarkers than the total α-syn levels. However, the quantification of PTMs in bodily fluids poses several challenges. This review describes the limitations of current immunoassay-based α-syn quantification methods and highlights how these limitations can be overcome using novel mass-spectrometry-based assays. In addition, we describe how advances in chemical synthesis, which have enabled the preparation of α-syn proteins that are site-specifically modified at single or multiple residues, can facilitate the development of more accurate assays for detecting and quantifying α-syn PTMs in health and disease.
Collapse
Affiliation(s)
- Adrien W Schmid
- Proteomics Core Facility, School of Life Sciences, Station 19, Ecole Polytechnique Fédérale de Lausanne, CH-1015 Lausanne, Switzerland
| | | | | | | |
Collapse
|
50
|
Lim X, Yeo JM, Green A, Pal S. The diagnostic utility of cerebrospinal fluid alpha-synuclein analysis in dementia with Lewy bodies - a systematic review and meta-analysis. Parkinsonism Relat Disord 2013; 19:851-8. [PMID: 23886935 DOI: 10.1016/j.parkreldis.2013.06.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 05/30/2013] [Accepted: 06/15/2013] [Indexed: 11/18/2022]
Abstract
BACKGROUND Dementia with Lewy Bodies (DLB) can be difficult to distinguish clinically from other dementias. OBJECTIVE To investigate the diagnostic utility of CSF alpha-synuclein in differentiating between DLB and other dementias. METHODS Electronic databases were systematically searched for studies investigating reproducible alpha synuclein quantification methods. Random effects model was used to calculate weighted mean difference (WMD) and 95% confidence intervals between DLB and other groups. RESULTS A total of 13 studies, comprising 2728 patients were included. Mean CSF alpha-synuclein concentration was significantly lower in DLB patients compared to those with Alzheimers disease (AD) [WMD -0.24; 95% CI, -0.45, -0.03; p = 0.02]. No significant difference was found between patients with DLB compared to Parkinsons disease [WMD 0.05; 95% CI, -0.17, 0.28; p = 0.65] or other neurodegenerative conditions. CONCLUSION CSF alpha synuclein may be of diagnostic use in differentiating between DLB and AD. We propose several recommendations to guide better design of future studies.
Collapse
Affiliation(s)
- Xuxin Lim
- College of Medicine and Veterinary Medicine, University of Edinburgh, UK.
| | | | | | | |
Collapse
|