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Gonzales MM, Vela G, Philip V, Trevino H, LaRoche A, Wang CP, Parent DM, Kautz T, Satizabal CL, Tanner J, O'Bryant S, Maestre G, Tracy RP, Seshadri S. Demographic and Clinical Characteristics Associated With Serum GFAP Levels in an Ethnically Diverse Cohort. Neurology 2023; 101:e1531-e1541. [PMID: 37813589 PMCID: PMC10585700 DOI: 10.1212/wnl.0000000000207706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 06/09/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Elevations in circulating glial fibrillary acidic protein (GFAP), a putative marker of reactive astrocytosis, have been found to associate with cognitive decline and dementia status. Further validation in diverse cohorts and evaluation of potential health disparities are necessary for broader generalization. The goal of this study was to examine the associations between demographics, cardiovascular risk factors, and APOE ε4 status with serum GFAP levels among Mexican American and non-Hispanic White older adults across the continuum from cognitively unimpaired to Alzheimer disease dementia. METHODS Serum GFAP levels were assayed using a Simoa HD-1 analyzer in older adults enrolled in the observational Texas Alzheimer Research and Care Consortium. Associations between demographic and clinical characteristics with serum GFAP levels were evaluated using linear regression. The diagnostic accuracy of serum GFAP was further examined using area under the receiver operating characteristic curves (AUROC) in univariate and adjusted models, and optimal cut points were derived using the maximum Kolmogorov-Smirnov metric. All models were also stratified by ethnicity and disease stage. RESULTS A total of 1,156 Mexican American and 587 non-Hispanic White participants were included (mean age = 68 years, standard deviation = 10; 65% female). Older age (β = 0.562 (95% CI 0.515-0.609), p < 0.001), apolipoprotein ε4 status (β = 0.139 (95% CI 0.092-0.186), p < 0.001), and cognitive impairment (β = 0.150 (95% CI 0.103-0.197), p < 0.001) were positively associated with serum GFAP. By contrast, higher body mass index (β = -0.181 (95% CI -0.228 to -0.134), p < 0.001), diabetes (β = -0.065 (95% CI -0.112 to -0.018), p < 0.001), and tobacco use (β = -0.059 (95% CI -0.106 to -0.012), p < 0.001) were inversely associated with serum GFAP. AUROC values were generally comparable across ethnicities and model fit improved with inclusion of additional covariates. However, optimal cut-off values were consistently lower in Mexican Americans relative to non-Hispanic White participants. DISCUSSION The study results highlight the importance of understanding the role of broader demographic and clinical factors on circulating GFAP levels within diverse cohorts to enhance precision across clinical, research, and community settings.
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Affiliation(s)
- Mitzi M Gonzales
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville.
| | - Gabriel Vela
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Vinu Philip
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Hector Trevino
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Ashley LaRoche
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Chen-Pin Wang
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Danielle M Parent
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Tiffany Kautz
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Claudia L Satizabal
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Jeremy Tanner
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Sid O'Bryant
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Gladys Maestre
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Russell P Tracy
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
| | - Sudha Seshadri
- From the Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases (M.M.G., G.V., V.P., H.T., A.L., C.-P.W., T.K., C.L.S., J.T., S.S.); Department of Neurology (M.M.G., J.T., S.S.); Department of Population Health Sciences (C.-P.W., C.L.S.), University of Texas Health Science Center, San Antonio; South Texas Veterans Health Care System (C.-P.W.), Geriatric Research, Education and Clinical Center, San Antonio; Departments of Pathology and Laboratory Medicine (D.M.P., R.P.T.), and Biochemistry, Larner College of Medicine, University of Vermont, Burlington; Department of Medicine (T.K.), University of Texas Health Science Center at San Antonio; Department of Neurology (C.L.S., S.S.), Boston University School of Medicine, MA; Institute for Translational Research and Department of Family Medicine (S.O.B.), University of North Texas Health Science Center, Fort Worth; Neurosciences Laboratory (G.M.), Biological Research Institute and Research Institute of Cardiovascular Diseases, Faculty of Medicine, Universidad del Zulia, Maracaibo, Venezuela; and Department of Biomedical Sciences (G.M.), Division of Neurosciences, University of Texas Rio Grande Valley School of Medicine, Brownsville
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Khan MJ, Chung NA, Hansen S, Dumitrescu L, Hohman TJ, Kamboh MI, Lopez OL, Robinson RAS. Targeted Lipidomics To Measure Phospholipids and Sphingomyelins in Plasma: A Pilot Study To Understand the Impact of Race/Ethnicity in Alzheimer's Disease. Anal Chem 2022; 94:4165-4174. [PMID: 35235294 PMCID: PMC9126486 DOI: 10.1021/acs.analchem.1c03821] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The number of people suffering from Alzheimer's disease (AD) is increasing rapidly every year. One aspect of AD that is often overlooked is the disproportionate incidence of AD among African American/Black populations. With the recent development of novel assays for lipidomics analysis in recent times, there has been a drastic increase in the number of studies focusing on changes of lipids in AD. However, very few of these studies have focused on or even included samples from African American/Black individuals samples. In this study, we aimed to determine if the lipidome in AD is universal across non-Hispanic White and African American/Black individuals. To accomplish this, a targeted mass spectrometry lipidomics analysis was performed on plasma samples (N = 113) obtained from cognitively normal (CN, N = 54) and AD (N = 59) individuals from African American/Black (N = 56) and non-Hispanic White (N = 57) backgrounds. Five lipids (PS 18:0_18:0, PS 18:0_20:0, PC 16:0_22:6, PC 18:0_22:6, and PS 18:1_22:6) were altered between AD and CN sample groups (p value < 0.05). Upon racial stratification, there were notable differences in lipids that were unique to African American/Black or non-Hispanic White individuals. PS 20:0_20:1 was reduced in AD in samples from non-Hispanic White but not African American/Black adults. We also tested whether race/ethnicity significantly modified the association between lipids and AD status by including a race × diagnosis interaction term in a linear regression model. PS 20:0_20:1 showed a significant interaction (p = 0.004). The discovery of lipid changes in AD in this study suggests that identifying relevant lipid biomarkers for diagnosis will require diversity in sample cohorts.
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Affiliation(s)
- Mostafa J Khan
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - Nadjali A Chung
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37235, United States
| | - Shania Hansen
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee 37212, United States
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee 37212, United States.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States.,Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States.,Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee 37212, United States
| | - M Ilyas Kamboh
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States.,Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States.,Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Oscar L Lopez
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States.,Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Renã A S Robinson
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37235, United States.,Vanderbilt Memory and Alzheimer's Center, Vanderbilt University Medical Center, Nashville, Tennessee 37212, United States.,Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States.,Vanderbilt Brain Institute, Vanderbilt University Medical Center, Nashville, Tennessee 37232, United States.,Vanderbilt Institute of Chemical Biology, Vanderbilt University, Nashville, Tennessee 37232, United States
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