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Koenig LN, LaMontagne P, Glasser MF, Bateman R, Holtzman D, Yakushev I, Chhatwal J, Day GS, Jack C, Mummery C, Perrin RJ, Gordon BA, Morris JC, Shimony JS, Benzinger TL. Regional age-related atrophy after screening for preclinical alzheimer disease. Neurobiol Aging 2022; 109:43-51. [PMID: 34655980 PMCID: PMC9009406 DOI: 10.1016/j.neurobiolaging.2021.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/15/2021] [Accepted: 09/07/2021] [Indexed: 01/03/2023]
Abstract
Brain atrophy occurs in aging even in the absence of dementia, but it is unclear to what extent this is due to undetected preclinical Alzheimer disease. Here we examine a cross-sectional cohort (ages 18-88) free from confounding influence of preclinical Alzheimer disease, as determined by amyloid PET scans and three years of clinical evaluation post-imaging. We determine the regional strength of age-related atrophy using linear modeling of brain volumes and cortical thicknesses with age. Age-related atrophy was seen in nearly all regions, with greatest effects in the temporal lobe and subcortical regions. When modeling age with the estimated derivative of smoothed aging curves, we found that the temporal lobe declined linearly with age, subcortical regions declined faster at later ages, and frontal regions declined slower at later ages than during midlife. This age-derivative pattern was distinct from the linear measure of age-related atrophy and significantly associated with a measure of myelin. Atrophy did not detectably differ from a preclinical Alzheimer disease cohort when age ranges were matched.
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Affiliation(s)
- Lauren N. Koenig
- Department of Radiology, Washington Universit, St Louis, MO, USA
| | | | - Matthew F. Glasser
- Department of Radiology, Washington Universit, St Louis, MO, USA,Department of Neuroscience, Washington University School of Medicine, St Louis, MO USA
| | - Randall Bateman
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA
| | - David Holtzman
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Jasmeer Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Catherine Mummery
- Dementia Research Center, UCL Queen Square Institute of Neurology, London, UK
| | - Richard J. Perrin
- Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Department of Psychological & Brain Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University, St. Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA
| | | | - Tammie L.S. Benzinger
- Department of Radiology, Washington Universit, St Louis, MO, USA,Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University, School of Medicine, St. Louis, MO, USA,Corresponding author at: University School of Medicine, 660 South Euclid, Campus 8131, St. Louis, MO 63110, Tel.: (314) 362-1558, fax: (314) 362-6110. (T.L.S. Benzinger)
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2
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Majumder A, Maiti T, Datta S. A Bayesian group lasso classification for ADNI volumetrics data. Stat Methods Med Res 2021; 30:2207-2220. [PMID: 34460337 DOI: 10.1177/09622802211022404] [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: 11/17/2022]
Abstract
The primary objective of this paper is to develop a statistically valid classification procedure for analyzing brain image volumetrics data obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) in elderly subjects with cognitive impairments. The Bayesian group lasso method thereby proposed for logistic regression efficiently selects an optimal model with the use of a spike and slab type prior. This method selects groups of attributes of a brain subregion encouraged by the group lasso penalty. We conduct simulation studies for high- and low-dimensional scenarios where our method is always able to select the true parameters that are truly predictive among a large number of parameters. The method is then applied on dichotomous response ADNI data which selects predictive atrophied brain regions and classifies Alzheimer's disease patients from healthy controls. Our analysis is able to give an accuracy rate of 80% for classifying Alzheimer's disease. The suggested method selects 29 brain subregions. The medical literature indicates that all these regions are associated with Alzheimer's patients. The Bayesian method of model selection further helps selecting only the subregions that are statistically significant, thus obtaining an optimal model.
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Affiliation(s)
- Atreyee Majumder
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Tapabrata Maiti
- Department of Statistics and Probability, Michigan State University, East Lansing, MI, USA
| | - Subha Datta
- Department of Mathematical Sciences, New Jersey Institute of Technology, Newark, NJ, USA
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de Flores R, Wisse LE, Das SR, Xie L, McMillan CT, Trojanowski JQ, Robinson JL, Grossman M, Lee E, Irwin DJ, Yushkevich PA, Wolk DA. Contribution of mixed pathology to medial temporal lobe atrophy in Alzheimer's disease. Alzheimers Dement 2020; 16:843-852. [PMID: 32323446 PMCID: PMC7715004 DOI: 10.1002/alz.12079] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/13/2020] [Accepted: 02/15/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION It is unclear how different proteinopathies (tau, transactive response DNA-binding protein 43 [TDP-43], amyloid β [Aβ], and α-synuclein) contribute to atrophy within medial temporal lobe (MTL) subregions in Alzheimer's disease (AD). METHODS We utilized antemortem structural magnetic resonance imaging (MRI) data to measure MTL substructures and examined the relative contribution of tau, TDP-43, Aβ, and α-synuclein measured in post-mortem tissue from 92 individuals with intermediate to high AD neuropathology. Receiver-operating characteristic (ROC) curves were analyzed for each subregion in order to discriminate TDP-43-negative and TDP-43-positive patients. RESULTS TDP-43 was strongly associated with anterior MTL regions, whereas tau was relatively more associated with the posterior hippocampus. Among the MTL regions, the anterior hippocampus showed the highest area under the ROC curve (AUC). DISCUSSION We found specific contributions of different pathologies on MTL substructure in this population with AD neuropathology. The anterior hippocampus may be a relevant region to detect concomitant TDP-43 pathology in the MTL of patients with AD.
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Affiliation(s)
- Robin de Flores
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura E.M. Wisse
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sandhitsu R. Das
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Long Xie
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Corey T. McMillan
- Penn FTD Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John Q. Trojanowski
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - John L. Robinson
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Penn FTD Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Edward Lee
- Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David J. Irwin
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Penn FTD Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Paul A. Yushkevich
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Yaddaden A, Couture M, Gagnon-Roy M, Belchior P, Lussier M, Bottari C, Giroux S, Pigot H, Bier N. Using a cognitive orthosis to support older adults during meal preparation: Clinicians' perspective on COOK technology. J Rehabil Assist Technol Eng 2020; 7:2055668320909074. [PMID: 32435504 PMCID: PMC7223197 DOI: 10.1177/2055668320909074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 01/31/2020] [Indexed: 11/17/2022] Open
Abstract
Introduction Occupational therapists promote safety and autonomy of older adults with cognitive impairments. A technology, named COOK, offers support on a touch screen installed next to the stove to support task performance while correcting risky behaviors. We aimed to document (1) the functional profiles according the diagnosis (2) the types of interventions used to increase autonomy in the kitchen (3) the facilitators and obstacles to the implementation of COOK with this clientele. Methods Four focus groups were conducted with occupational therapists (n = 24) and were transcribed and analyzed using thematic analysis, including coding and matrix building. Results Occupational therapists identified different (1) functional profiles and (2) interventions for both diagnoses. The use of COOK (3) could be more beneficial in mild cognitive impairment, as many barriers occur for the use in Alzheimer's disease. Some parameters, such as digital control of the stove and complex information management, need to be simplified. Discussion According to occupational therapists, this technology is particularly applicable to people with mild cognitive impairment, because this population has better learning abilities. Conclusion This study documented the specific needs of older adults with cognitive impairments as well as interventions used by occupational therapists. The perspectives of caregivers should be captured in future research.
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Affiliation(s)
- Amel Yaddaden
- École de réadaptation,Université de Montréal, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire en Gériatrie de Montréal, Montreal, Canada
| | - Mélanie Couture
- Centre de Recherche et d'Expertise en Gérontologie Sociale, Côte St-Luc, Canada
| | - Mireille Gagnon-Roy
- École de réadaptation,Université de Montréal, Montreal, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - Patricia Belchior
- Centre de Recherche de l'Institut Universitaire en Gériatrie de Montréal, Montreal, Canada.,School of Physical and Occupational Therapy, McGill University, School of Physical & Occupational Therapy, Montreal, Canada
| | - Maxime Lussier
- École de réadaptation,Université de Montréal, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire en Gériatrie de Montréal, Montreal, Canada
| | - Carolina Bottari
- École de réadaptation,Université de Montréal, Montreal, Canada.,Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain (CRIR), Montreal, Canada
| | - Sylvain Giroux
- Laboratoire DOMUS, Université de Sherbrooke, Laboratoire DOMUS, Sherbrooke, Canada
| | - Hélène Pigot
- Laboratoire DOMUS, Université de Sherbrooke, Laboratoire DOMUS, Sherbrooke, Canada
| | - Nathalie Bier
- École de réadaptation,Université de Montréal, Montreal, Canada.,Centre de Recherche de l'Institut Universitaire en Gériatrie de Montréal, Montreal, Canada
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Montandon ML, Herrmann FR, Garibotto V, Rodriguez C, Haller S, Giannakopoulos P. Determinants of mesial temporal lobe volume loss in older individuals with preserved cognition: a longitudinal PET amyloid study. Neurobiol Aging 2019; 87:108-114. [PMID: 32057528 DOI: 10.1016/j.neurobiolaging.2019.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/03/2019] [Accepted: 12/05/2019] [Indexed: 12/11/2022]
Abstract
Mesial temporal lobe (MTL) is prominently affected in normal aging and associated with neurodegeneration in AD. Whether or not MTL atrophy is dependent on increasing amyloid load before the emergence of cognitive deficits is still disputed. We performed a 4.5-year longitudinal study in 75 older community dwellers (48 women, mean age: 79.3 years) including magnetic resonance imaging at baseline and follow-up, positron emission tomography amyloid during follow-up, neuropsychological assessment at 18 and 55 months, and APOE genotyping. Linear regression models were used to identify predictors of the MTL volume loss. Amyloid load was negatively associated with bilateral MTL volume at baseline explaining almost 10.5% of its variability. In multivariate models including time of follow-up and demographic variables (older age, male gender), this percentage exceeded 35%. The APOE4 allele independently contributed another 6%. Cognitive changes had a modest but still significant negative association with MTL volume loss. Our data support a multifactorial model including amyloid deposition, older age, male gender, APOE4 allele, and slight decline of cognitive abilities as independent predictors of MTL volume loss in brain aging.
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Affiliation(s)
- Marie-Louise Montandon
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland; Department of Psychiatry, University of Geneva, Thônex, Switzerland
| | - François R Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Thônex, Switzerland.
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cristelle Rodriguez
- Department of Psychiatry, University of Geneva, Thônex, Switzerland; Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
| | - Sven Haller
- CIRD - Centre d'Imagerie Rive Droite, Geneva, Switzerland; Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden; Department of Neuroradiology, Faculty of Medicine of the University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Department of Psychiatry, University of Geneva, Thônex, Switzerland; Medical Direction, University of Geneva Hospitals, Geneva, Switzerland
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Ali JI, Smart CM, Gawryluk JR. Subjective Cognitive Decline and APOE ɛ4: A Systematic Review. J Alzheimers Dis 2019; 65:303-320. [PMID: 30040718 DOI: 10.3233/jad-180248] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Individuals with subjective cognitive decline (SCD) report self-perceived declines in cognitive function but perform within normal limits on standardized tests. However, for some, these self-perceived changes may herald eventual decline to Alzheimer's disease (AD). In light of this, the relationship between SCD and APOE ɛ4, a known genetic risk factor for AD, has garnered interest; however, no systematic review of this literature exists. The current review (n = 36 articles) examined the prevalence of APOE ɛ4 in SCD samples relative to healthy and objectively impaired samples, and summarized APOE ɛ4-related risk of conversion from SCD to AD. Univariate ANOVA indicated that APOE ɛ4 frequency was comparable between healthy control and SCD samples, yet significantly higher in objectively impaired samples (i.e., MCI, AD) relative to either of these groups. Narrative review provided mixed evidence linking coincident APOE ɛ4-positive genotype and SCD to structural neuropathology. Though there was little evidence to suggest that APOE ɛ4 predisposes individuals to developing SCD, both APOE ɛ4 and SCD were found to confer individual and multiplicative risk of conversion to objective cognitive impairment. Combined, it is likely that a relationship between APOE ɛ4, SCD, and AD exists, though its exact nature remains undetermined. A clearer understanding of these relationships is hindered by a lack of standardization in SCD classification and a dearth of longitudinal outcome research. Wide-scale adoption of genetic screening for dementia risk in persons with SCD is considered premature at this time. Ethical considerations and clinical implications of genetic testing for dementia risk are discussed.
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Affiliation(s)
- Jordan I Ali
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Colette M Smart
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
| | - Jodie R Gawryluk
- Department of Psychology, University of Victoria, Victoria, BC, Canada.,Institute on Aging & Lifelong Health, University of Victoria, Victoria, BC, Canada
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7
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Shah-Basak PP, Kielar A, Deschamps T, Verhoeff NP, Jokel R, Meltzer J. Spontaneous oscillatory markers of cognitive status in two forms of dementia. Hum Brain Mapp 2018; 40:1594-1607. [PMID: 30421472 DOI: 10.1002/hbm.24470] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/09/2018] [Accepted: 11/01/2018] [Indexed: 01/23/2023] Open
Abstract
Abnormal oscillatory brain activity in dementia may indicate incipient neuronal/synaptic dysfunction, rather than frank structural atrophy. Leveraging a potential link between the degree of abnormal oscillatory activity and cognitive symptom severity, one could localize brain regions in a diseased but pre-atrophic state, which may be more amenable to interventions. In the current study, we evaluated the relationships among cognitive deficits, regional volumetric changes, and resting-state magnetoencephalography abnormalities in patients with mild cognitive impairment (MCI; N = 10; age: 75.9 ± 7.3) or primary progressive aphasia (PPA; N = 12; 69.7 ± 8.0), and compared them to normal aging [young (N = 18; 24.6 ± 3.5), older controls (N = 24; 67.2 ± 9.7]. Whole-brain source-level resting-state estimates of relative oscillatory power in the delta (1-4 Hz), theta (4-7 Hz), alpha (8-12 Hz), and beta (15-30 Hz) bands were combined with gray matter volumes and cognitive scores to examine between-group differences and brain-behavior correlations. Language and executive function (EF) abilities were impaired in patients with PPA, while episodic memory was impaired in MCI. Widespread oscillatory speeding and volumetric shrinkage was associated with normal aging, whereas the trajectory in PPA indicated widespread oscillatory slowing with additional volumetric reductions. Increases in delta and decreases in alpha power uniquely predicted group membership to PPA. Beyond volumetric reductions, more delta predicted poorer memory. In patients with MCI, no consistent group difference among oscillatory measures was found. The contributions of delta/alpha power on memory abilities were larger than volumetric differences. Spontaneous oscillatory abnormalities in association with cognitive symptom severity can serve as a marker of neuronal dysfunction in dementia, providing targets for promising treatments.
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Affiliation(s)
- Priyanka P Shah-Basak
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada
| | - Aneta Kielar
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.,Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson, Arizona
| | - Tiffany Deschamps
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada
| | - Nicolaas Paul Verhoeff
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Baycrest Health Sciences, North York, Ontario, Canada
| | - Regina Jokel
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Department of Psychiatry, Baycrest Health Sciences, North York, Ontario, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Jed Meltzer
- Rotman Research Institute, Baycrest Health Sciences Centre, Toronto, Ontario, Canada.,Canadian Partnership for Stroke Recovery, Ottawa, Ontario, Canada.,Department of Speech-Language Pathology, University of Toronto, Toronto, Ontario, Canada.,Department of Psychology, University of Toronto, Toronto, Ontario, Canada
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8
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Nelson PT, Abner EL, Patel E, Anderson S, Wilcock DM, Kryscio RJ, Van Eldik LJ, Jicha GA, Gal Z, Nelson RS, Nelson BG, Gal J, Azam MT, Fardo DW, Cykowski MD. The Amygdala as a Locus of Pathologic Misfolding in Neurodegenerative Diseases. J Neuropathol Exp Neurol 2018; 77:2-20. [PMID: 29186501 DOI: 10.1093/jnen/nlx099] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Indexed: 12/14/2022] Open
Abstract
Over the course of most common neurodegenerative diseases the amygdala accumulates pathologically misfolded proteins. Misfolding of 1 protein in aged brains often is accompanied by the misfolding of other proteins, suggesting synergistic mechanisms. The multiplicity of pathogenic processes in human amygdalae has potentially important implications for the pathogenesis of Alzheimer disease, Lewy body diseases, chronic traumatic encephalopathy, primary age-related tauopathy, and hippocampal sclerosis, and for the biomarkers used to diagnose those diseases. Converging data indicate that the amygdala may represent a preferential locus for a pivotal transition from a relatively benign clinical condition to a more aggressive disease wherein multiple protein species are misfolded. Thus, understanding of amygdalar pathobiology may yield insights relevant to diagnoses and therapies; it is, however, a complex and imperfectly defined brain region. Here, we review aspects of amygdalar anatomy, connectivity, vasculature, and pathologic involvement in neurodegenerative diseases with supporting data from the University of Kentucky Alzheimer's Disease Center autopsy cohort. Immunohistochemical staining of amygdalae for Aβ, Tau, α-synuclein, and TDP-43 highlight the often-coexisting pathologies. We suggest that the amygdala may represent an "incubator" for misfolded proteins and that it is possible that misfolded amygdalar protein species are yet to be discovered.
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Affiliation(s)
- Peter T Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Erin L Abner
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Ela Patel
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Sonya Anderson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Donna M Wilcock
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Richard J Kryscio
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Linda J Van Eldik
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Gregory A Jicha
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Zsombor Gal
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Ruth S Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Bela G Nelson
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Jozsef Gal
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Md Tofial Azam
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - David W Fardo
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
| | - Matthew D Cykowski
- Division of Neuropathology; Sanders-Brown Center on Aging; Department of Pathology; Department of Epidemiology; Department of Physiology; Department of Statistics; Department of Neurology; Department of Neuroscience; Department of Molecular and Cellular Biochemistry; Department of Biostatistics, University of Kentucky, Lexington, Kentucky; and Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas
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9
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Collin PG, Oskouian RJ, Loukas M, D'Antoni AV, Tubbs RS. Five common clinical presentations in the elderly: An anatomical review. Clin Anat 2017; 30:168-174. [DOI: 10.1002/ca.22771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/22/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Peter G. Collin
- Department of Pathobiology; CUNY School of Medicine/The Sophie Davis School of Biomedical Education, The City College of New York, CUNY; New York New York
| | | | - Marios Loukas
- Department of Anatomical Sciences; St. George's University; Grenada
| | - Anthony V. D'Antoni
- Department of Pathobiology; CUNY School of Medicine/The Sophie Davis School of Biomedical Education, The City College of New York, CUNY; New York New York
| | - R. Shane Tubbs
- Seattle Science Foundation; Seattle, Washington
- Department of Anatomical Sciences; St. George's University; Grenada
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Perrotin A, La Joie R, de La Sayette V, Barré L, Mézenge F, Mutlu J, Guilloteau D, Egret S, Eustache F, Chételat G. Subjective cognitive decline in cognitively normal elders from the community or from a memory clinic: Differential affective and imaging correlates. Alzheimers Dement 2016; 13:550-560. [PMID: 27693187 DOI: 10.1016/j.jalz.2016.08.011] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/05/2016] [Accepted: 08/17/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Subjective cognitive decline (SCD) could indicate preclinical Alzheimer's disease, but the existing literature is confounded by heterogeneous approaches to studying SCD. We assessed the differential cognitive, affective, and neuroimaging correlates of two aspects of SCD: reporting high cognitive difficulties on a self-rated questionnaire versus consulting at a memory clinic. METHODS We compared 28 patients from a memory clinic with isolated SCD, 35 community-recruited elders with similarly high levels of self-reported cognitive difficulties, and 35 community-recruited controls with low self-reported cognitive difficulties. RESULTS Increased anxiety and amyloid β deposition were observed in both groups with high self-reported difficulties, whereas subclinical depression and (hippocampal) atrophy were specifically associated with medical help seeking. Cognitive tests showed no group differences. DISCUSSION These results further validate the concept of SCD in both community- and clinic-based groups. Yet, recruitment methods influence associated biomarkers and affective symptomatology, highlighting the heterogeneous nature of SCD depending on study characteristics.
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Affiliation(s)
- Audrey Perrotin
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Renaud La Joie
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
| | - Vincent de La Sayette
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, Service de Neurologie, Caen, France
| | - Louisa Barré
- Université de Caen Normandie, UMR-S1077, Caen, France; CEA, DRF/I2BM, LDM-TEP Group, Caen, France; CNRS, UMR ISTCT 6301, LDM-TEP Group, Caen, France
| | - Florence Mézenge
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Justine Mutlu
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Denis Guilloteau
- INSERM U930, Université François Rabelais de Tours, CHRU de Tours, Tours, France
| | - Stéphanie Egret
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Francis Eustache
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Gaël Chételat
- INSERM, U1077, Caen, France; Université de Caen Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
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11
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Pini L, Pievani M, Bocchetta M, Altomare D, Bosco P, Cavedo E, Galluzzi S, Marizzoni M, Frisoni GB. Brain atrophy in Alzheimer's Disease and aging. Ageing Res Rev 2016; 30:25-48. [PMID: 26827786 DOI: 10.1016/j.arr.2016.01.002] [Citation(s) in RCA: 409] [Impact Index Per Article: 51.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/15/2016] [Accepted: 01/20/2016] [Indexed: 01/22/2023]
Abstract
Thanks to its safety and accessibility, magnetic resonance imaging (MRI) is extensively used in clinical routine and research field, largely contributing to our understanding of the pathophysiology of neurodegenerative disorders such as Alzheimer's disease (AD). This review aims to provide a comprehensive overview of the main findings in AD and normal aging over the past twenty years, focusing on the patterns of gray and white matter changes assessed in vivo using MRI. Major progresses in the field concern the segmentation of the hippocampus with novel manual and automatic segmentation approaches, which might soon enable to assess also hippocampal subfields. Advancements in quantification of hippocampal volumetry might pave the way to its broader use as outcome marker in AD clinical trials. Patterns of cortical atrophy have been shown to accurately track disease progression and seem promising in distinguishing among AD subtypes. Disease progression has also been associated with changes in white matter tracts. Recent studies have investigated two areas often overlooked in AD, such as the striatum and basal forebrain, reporting significant atrophy, although the impact of these changes on cognition is still unclear. Future integration of different MRI modalities may further advance the field by providing more powerful biomarkers of disease onset and progression.
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Affiliation(s)
- Lorenzo Pini
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Michela Pievani
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy
| | - Martina Bocchetta
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy; Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, University College London, London, UK
| | - Daniele Altomare
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Paolo Bosco
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy
| | - Enrica Cavedo
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy; Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) Hôpital de la Pitié-Salpétrière & Institut du Cerveau et de la Moelle épinière (ICM), UMR S 1127, Hôpital de la Pitié-Salpétrière Paris & CATI Multicenter Neuroimaging Platform, France
| | - Samantha Galluzzi
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy
| | - Moira Marizzoni
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory Alzheimer's Neuroimaging & Epidemiology, IRCCS Fatebenefratelli, Brescia, Italy; Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland.
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12
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Montagne A, Nation DA, Pa J, Sweeney MD, Toga AW, Zlokovic BV. Brain imaging of neurovascular dysfunction in Alzheimer's disease. Acta Neuropathol 2016; 131:687-707. [PMID: 27038189 PMCID: PMC5283382 DOI: 10.1007/s00401-016-1570-0] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Revised: 03/21/2016] [Accepted: 03/23/2016] [Indexed: 11/29/2022]
Abstract
Neurovascular dysfunction, including blood-brain barrier (BBB) breakdown and cerebral blood flow (CBF) dysregulation and reduction, are increasingly recognized to contribute to Alzheimer's disease (AD). The spatial and temporal relationships between different pathophysiological events during preclinical stages of AD, including cerebrovascular dysfunction and pathology, amyloid and tau pathology, and brain structural and functional changes remain, however, still unclear. Recent advances in neuroimaging techniques, i.e., magnetic resonance imaging (MRI) and positron emission tomography (PET), offer new possibilities to understand how the human brain works in health and disease. This includes methods to detect subtle regional changes in the cerebrovascular system integrity. Here, we focus on the neurovascular imaging techniques to evaluate regional BBB permeability (dynamic contrast-enhanced MRI), regional CBF changes (arterial spin labeling- and functional-MRI), vascular pathology (structural MRI), and cerebral metabolism (PET) in the living human brain, and examine how they can inform about neurovascular dysfunction and vascular pathophysiology in dementia and AD. Altogether, these neuroimaging approaches will continue to elucidate the spatio-temporal progression of vascular and neurodegenerative processes in dementia and AD and how they relate to each other.
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Affiliation(s)
- Axel Montagne
- Zilkha Neurogenetic Institute and Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Daniel A Nation
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089, USA
| | - Judy Pa
- Department of Neurology, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, 90089, USA
| | - Melanie D Sweeney
- Zilkha Neurogenetic Institute and Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA
| | - Arthur W Toga
- Department of Neurology, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA, 90089, USA
| | - Berislav V Zlokovic
- Zilkha Neurogenetic Institute and Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, USA.
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de Flores R, La Joie R, Chételat G. Structural imaging of hippocampal subfields in healthy aging and Alzheimer’s disease. Neuroscience 2015; 309:29-50. [DOI: 10.1016/j.neuroscience.2015.08.033] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 08/08/2015] [Accepted: 08/17/2015] [Indexed: 01/20/2023]
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14
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Risacher SL, Kim S, Nho K, Foroud T, Shen L, Petersen RC, Jack CR, Beckett LA, Aisen PS, Koeppe RA, Jagust WJ, Shaw LM, Trojanowski JQ, Weiner MW, Saykin AJ. APOE effect on Alzheimer's disease biomarkers in older adults with significant memory concern. Alzheimers Dement 2015; 11:1417-1429. [PMID: 25960448 DOI: 10.1016/j.jalz.2015.03.003] [Citation(s) in RCA: 132] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 03/01/2015] [Accepted: 03/21/2015] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study assessed apolipoprotein E (APOE) ε4 carrier status effects on Alzheimer's disease imaging and cerebrospinal fluid (CSF) biomarkers in cognitively normal older adults with significant memory concerns (SMC). METHODS Cognitively normal, SMC, and early mild cognitive impairment participants from Alzheimer's Disease Neuroimaging Initiative were divided by APOE ε4 carrier status. Diagnostic and APOE effects were evaluated with emphasis on SMC. Additional analyses in SMC evaluated the effect of the interaction between APOE and [(18)F]Florbetapir amyloid positivity on CSF biomarkers. RESULTS SMC ε4+ showed greater amyloid deposition than SMC ε4-, but no hypometabolism or medial temporal lobe (MTL) atrophy. SMC ε4+ showed lower amyloid beta 1-42 and higher tau/p-tau than ε4-, which was most abnormal in APOE ε4+ and cerebral amyloid positive SMC. DISCUSSION SMC APOE ε4+ show abnormal changes in amyloid and tau biomarkers, but no hypometabolism or MTL neurodegeneration, reflecting the at-risk nature of the SMC group and the importance of APOE in mediating this risk.
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Affiliation(s)
- Shannon L Risacher
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sungeun Kim
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tatiana Foroud
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Li Shen
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | | | - Laurel A Beckett
- Department of Public Health Sciences, Division of Biostatistics, University of California-Davis, Davis, CA, USA
| | - Paul S Aisen
- Department of Neurology, University of California-San Diego, San Diego, CA, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - William J Jagust
- Department of Neurology, University of California-Berkeley, Berkeley, CA, USA
| | - Leslie M Shaw
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - John Q Trojanowski
- Department of Pathology and Laboratory Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Michael W Weiner
- Departments of Radiology, Medicine and Psychiatry, University of California-San Francisco, San Francisco, CA, USA; Department of Veterans Affairs Medical Center, San Francisco, CA, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA; Center for Computational Biology and Bioinformatics, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA.
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15
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Heinzel S, Liepelt-Scarfone I, Roeben B, Nasi-Kordhishti I, Suenkel U, Wurster I, Brockmann K, Fritsche A, Niebler R, Metzger FG, Eschweiler GW, Fallgatter AJ, Maetzler W, Berg D. A neurodegenerative vascular burden index and the impact on cognition. Front Aging Neurosci 2014; 6:161. [PMID: 25071568 PMCID: PMC4088338 DOI: 10.3389/fnagi.2014.00161] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 06/20/2014] [Indexed: 12/21/2022] Open
Abstract
A wide range of vascular burden factors has been identified to impact vascular function and structure as indicated by carotid intima–media thickness (IMT). On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI). Since many vascular factors increase the risk of Alzheimer’s disease (AD), a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages. We investigated an elderly cohort at risk for neurodegeneration (TREND study, n = 1102) for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication, and/or blood marker data) were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT) and the consortium to establish a registry for Alzheimer’s disease (CERAD) neuropsychological battery. IMT was significantly predicted by age (standardized β = 0.26), sex (0.09; males > females) and the factors included in the VBI: obesity (0.18), hypertension (0.14), smoking (0.08), diabetes (0.07), and atherosclerosis (0.05), whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT ( ≥ 1.0 mm). The VBI showed an impact on executive control [log(TMT B−A), p = 0.047] and a trend toward decreased global cognitive function (CERAD total score, p = 0.057) independent of age, sex, and education. A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and AD.
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Affiliation(s)
- Sebastian Heinzel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
| | - Benjamin Roeben
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabella Nasi-Kordhishti
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Ulrike Suenkel
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Isabel Wurster
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Kathrin Brockmann
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Andreas Fritsche
- Department of Internal Medicine IV, University of Tübingen , Tübingen , Germany
| | - Raphael Niebler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Florian G Metzger
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Gerhard W Eschweiler
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany ; Geriatric Center, University Hospital Tübingen , Tübingen , Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany
| | - Walter Maetzler
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany
| | - Daniela Berg
- Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany
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16
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Braskie MN, Thompson PM. A focus on structural brain imaging in the Alzheimer's disease neuroimaging initiative. Biol Psychiatry 2014; 75:527-33. [PMID: 24367935 PMCID: PMC4019004 DOI: 10.1016/j.biopsych.2013.11.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 01/18/2023]
Abstract
In recent years, numerous laboratories and consortia have used neuroimaging to evaluate the risk for and progression of Alzheimer's disease (AD). The Alzheimer's Disease Neuroimaging Initiative is a longitudinal, multicenter study that is evaluating a range of biomarkers for use in diagnosis of AD, prediction of patient outcomes, and clinical trials. These biomarkers include brain metrics derived from magnetic resonance imaging (MRI) and positron emission tomography scans as well as metrics derived from blood and cerebrospinal fluid. We focus on Alzheimer's Disease Neuroimaging Initiative studies published between 2011 and March 2013 for which structural MRI was a major outcome measure. Our main goal was to review key articles offering insights into progression of AD and the relationships of structural MRI measures to cognition and to other biomarkers in AD. In Supplement 1, we also discuss genetic and environmental risk factors for AD and exciting new analysis tools for the efficient evaluation of large-scale structural MRI data sets such as the Alzheimer's Disease Neuroimaging Initiative data.
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Affiliation(s)
- Meredith N Braskie
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California; Department of Neurology, University of Southern California, Los Angeles, California
| | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, California; Department of Neurology, University of Southern California, Los Angeles, California; Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California; Department of Radiology, University of Southern California, Los Angeles, California; Department of Pediatrics, University of Southern California, Los Angeles, California; Department of Ophthalmology, University of Southern California, Los Angeles, California; Keck School of Medicine, and Viterbi School of Engineering, University of Southern California, Los Angeles, California.
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17
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Menéndez-González M, López-Muñiz A, Vega JA, Salas-Pacheco JM, Arias-Carrión O. MTA index: a simple 2D-method for assessing atrophy of the medial temporal lobe using clinically available neuroimaging. Front Aging Neurosci 2014; 6:23. [PMID: 24715861 PMCID: PMC3970022 DOI: 10.3389/fnagi.2014.00023] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Accepted: 02/11/2014] [Indexed: 01/11/2023] Open
Abstract
Background and purpose: Despite a strong correlation to severity of AD pathology, the measurement of medial temporal lobe atrophy (MTA) is not being widely used in daily clinical practice as a criterion in the diagnosis of prodromal and probable AD. This is mainly because the methods available to date are sophisticated and difficult to implement for routine use in most hospitals—volumetric methods—or lack objectivity—visual rating scales. In this pilot study we aim to describe a new, simple and objective method for measuring the rate of MTA in relation to the global atrophy using clinically available neuroimaging and describe the rationale behind this method. Description: This method consists of calculating a ratio with the area of 3 regions traced manually on one single coronal MRI slide at the level of the interpeduncular fossa: (1) the medial temporal lobe (MTL) region (A); (2) the parenchima within the medial temporal region, that includes the hippocampus and the parahippocampal gyrus—the fimbria taenia and plexus choroideus are excluded—(B); and (3) the body of the ipsilateral lateral ventricle (C). Therefrom we can compute the ratio “Medial Temporal Atrophy index” at both sides as follows: MTAi = (A − B)× 10/C. Conclusions: The MTAi is a simple 2D-method for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. This method can be useful for a more accurate diagnosis of AD in routine clinical practice. Further studies are needed to assess the usefulness of MTAi in the diagnosis of early AD, in tracking the progression of AD and in the differential diagnosis of AD with other dementias.
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Affiliation(s)
- Manuel Menéndez-González
- Unidad de Neurología, Hospital Álvarez-Buylla Mieres, Spain ; Departamento de Morfología y Biología Celular, Universidad de Oviedo Oviedo, Spain ; Instituto de Neurociencias, Universidad de Oviedo Oviedo, Spain
| | - Alfonso López-Muñiz
- Departamento de Morfología y Biología Celular, Universidad de Oviedo Oviedo, Spain ; Instituto de Neurociencias, Universidad de Oviedo Oviedo, Spain
| | - José A Vega
- Departamento de Morfología y Biología Celular, Universidad de Oviedo Oviedo, Spain
| | - José M Salas-Pacheco
- Instituto de Investigación Científica, Universidad Juárez del Estado de Durango Durango, México
| | - Oscar Arias-Carrión
- Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Dr. Manuel Gea González/UNAM México DF, Mexico ; Unidad de Trastornos del Movimiento y Sueño (TMS), Hospital General Ajusco Medio México DF, Mexico
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18
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Stoub TR, Detoledo-Morrell L, Dickerson BC. Parahippocampal white matter volume predicts Alzheimer's disease risk in cognitively normal old adults. Neurobiol Aging 2014; 35:1855-61. [PMID: 24656833 DOI: 10.1016/j.neurobiolaging.2014.01.153] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2013] [Revised: 01/14/2014] [Accepted: 01/17/2014] [Indexed: 11/27/2022]
Abstract
An in vivo marker of the underlying pathology in Alzheimer's disease (AD) is atrophy in select brain regions detected with quantitative magnetic resonance imaging (MRI). Although gray matter changes have been documented to be predictive of cognitive decline culminating in AD among healthy older adults, very little attention has been given to alterations in white matter as a possible MRI biomarker predictive of AD. In this investigation, we examined parahippocampal white matter (PWM) volume derived from baseline MRI scans in 2 independent samples of 65 cognitively normal older adults, followed longitudinally, to determine if it was predictive of AD risk. The average follow-up period for the 2 samples was 8.5 years. Comparisons between the stable participants (N = 50) and those who declined to AD (N = 15) over time revealed a significant difference in baseline PWM volume (p < 0.001). Furthermore, baseline PWM volume was predictive not only of time to AD (hazard ratio = 3.1, p < 0.05), but also of baseline episodic memory performance (p = 0.041). These results demonstrate that PWM atrophy provides a sensitive MRI biomarker of AD dementia risk among those with normal cognitive function.
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Affiliation(s)
- Travis R Stoub
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | | | - Bradford C Dickerson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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19
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Understanding cognitive deficits in Alzheimer's disease based on neuroimaging findings. Trends Cogn Sci 2013; 17:510-6. [PMID: 24029445 DOI: 10.1016/j.tics.2013.08.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 08/07/2013] [Indexed: 01/21/2023]
Abstract
Brain amyloid can be measured using positron emission tomography (PET). There are mixed reports regarding whether amyloid measures are correlated with measures of cognition (in particular memory), depending on the cohorts and cognitive domains assessed. In Alzheimer's disease (AD) patients and those at heightened risk for AD, cognitive performance may be related to the level and extent of classical AD pathology (amyloid plaques and neurofibrillary angles), but it is also influenced by neurodegeneration, neurocognitive reserve, and vascular health. We discuss what recent neuroimaging research has discovered about cognitive deficits in AD and offer suggestions for future research.
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