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Padrela B, Mahroo A, Tee M, Sneve MH, Moyaert P, Geier O, Kuijer JPA, Beun S, Nordhøy W, Zhu YD, Buck MA, Hoinkiss DC, Konstandin S, Huber J, Wiersinga J, Rikken R, de Leeuw D, Grydeland H, Tippett L, Cawston EE, Ozturk-Isik E, Linn J, Brandt M, Tijms BM, van de Giessen EM, Muller M, Fjell A, Walhovd K, Bjørnerud A, Pålhaugen L, Selnes P, Clement P, Achten E, Anazodo U, Barkhof F, Hilal S, Fladby T, Eickel K, Morgan C, Thomas DL, Petr J, Günther M, Mutsaerts HJMM. Developing blood-brain barrier arterial spin labelling as a non-invasive early biomarker of Alzheimer's disease (DEBBIE-AD): a prospective observational multicohort study protocol. BMJ Open 2024; 14:e081635. [PMID: 38458785 DOI: 10.1136/bmjopen-2023-081635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024] Open
Abstract
INTRODUCTION Loss of blood-brain barrier (BBB) integrity is hypothesised to be one of the earliest microvascular signs of Alzheimer's disease (AD). Existing BBB integrity imaging methods involve contrast agents or ionising radiation, and pose limitations in terms of cost and logistics. Arterial spin labelling (ASL) perfusion MRI has been recently adapted to map the BBB permeability non-invasively. The DEveloping BBB-ASL as a non-Invasive Early biomarker (DEBBIE) consortium aims to develop this modified ASL-MRI technique for patient-specific and robust BBB permeability assessments. This article outlines the study design of the DEBBIE cohorts focused on investigating the potential of BBB-ASL as an early biomarker for AD (DEBBIE-AD). METHODS AND ANALYSIS DEBBIE-AD consists of a multicohort study enrolling participants with subjective cognitive decline, mild cognitive impairment and AD, as well as age-matched healthy controls, from 13 cohorts. The precision and accuracy of BBB-ASL will be evaluated in healthy participants. The clinical value of BBB-ASL will be evaluated by comparing results with both established and novel AD biomarkers. The DEBBIE-AD study aims to provide evidence of the ability of BBB-ASL to measure BBB permeability and demonstrate its utility in AD and AD-related pathologies. ETHICS AND DISSEMINATION Ethics approval was obtained for 10 cohorts, and is pending for 3 cohorts. The results of the main trial and each of the secondary endpoints will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Beatriz Padrela
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Amnah Mahroo
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Mervin Tee
- National University Health System, Singapore
| | - Markus H Sneve
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Paulien Moyaert
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Oliver Geier
- Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
| | - Joost P A Kuijer
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Soetkin Beun
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Wibeke Nordhøy
- Department of Physics and Computational Radiology, Oslo University Hospital, Oslo, Norway
| | - Yufei David Zhu
- Biomedical Engineering, University of California Davis, Davis, California, USA
| | - Mareike A Buck
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Bremen, Bremen, Germany
| | | | - Simon Konstandin
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Jörn Huber
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
| | - Julia Wiersinga
- Department of Internal Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Roos Rikken
- Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | | | - Håkon Grydeland
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
| | - Lynette Tippett
- The University of Auckland School of Psychology, Auckland, New Zealand
| | - Erin E Cawston
- The University of Auckland Department of Pharmacology and Clinical Pharmacology, Auckland, New Zealand
| | - Esin Ozturk-Isik
- Bogazici University Institute of Biomedical Engineering, Istanbul, Turkey
| | - Jennifer Linn
- Department of Neurology, Faculty of Medicine, Babylon, Iraq
- Department of Neurology, Technische Universität Dresden, Dresden, Germany
| | - Moritz Brandt
- Department of Neurology, Faculty of Medicine, Babylon, Iraq
- Department of Neurology, Technische Universität Dresden, Dresden, Germany
| | - Betty M Tijms
- Neurology, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | | | - Majon Muller
- Department of Internal Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Anders Fjell
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Kristine Walhovd
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Atle Bjørnerud
- Center for Lifespan Changes in Brain and Cognition, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Lene Pålhaugen
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
- University of Oslo, Oslo, Norway
| | - Per Selnes
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Patricia Clement
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Eric Achten
- Department of Diagnostic Sciences, University Hospital Ghent, Gent, Belgium
| | - Udunna Anazodo
- Lawson Health Research Institute, London, Ontario, Canada
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
- University College London, London, UK
| | - Saima Hilal
- National University Health System, Singapore
- Department of Pharmacology, National University of Singapore, Singapore
| | - Tormod Fladby
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
- University of Oslo, Oslo, Norway
| | - Klaus Eickel
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Applied Sciences Bremerhaven, Bremerhaven, Germany
| | - Catherine Morgan
- The University of Auckland School of Psychology, Auckland, New Zealand
| | - David L Thomas
- Department of Brain Repair and Rehabilitation, University College London, London, UK
| | - Jan Petr
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Matthias Günther
- Fraunhofer Institute for Digital Medicine MEVIS, Bremen, Germany
- University of Bremen, Bremen, Germany
| | - Henk J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
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Chia RSL, Minta K, Wu LY, Salai KHT, Chai YL, Hilal S, Venketasubramanian N, Chen CP, Chong JR, Lai MKP. Serum Brevican as a Biomarker of Cerebrovascular Disease in an Elderly Cognitively Impaired Cohort. Biomolecules 2024; 14:75. [PMID: 38254675 PMCID: PMC10813026 DOI: 10.3390/biom14010075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/23/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
In the brain, the extracellular matrix (ECM) composition shapes the neuronal microenvironment and can undergo substantial changes with cerebral pathology. Brevican is integral to the formation of the ECM's neuroprotective perineuronal nets (PNNs). Decreased brevican levels were reported in vascular dementia (VaD) but not in Alzheimer's disease (AD). However, the status of brevican in clinical cohorts with high concomitance of AD pathological burden and cerebrovascular disease (CeVD) is unclear. In this study, 32 non-cognitively impaired (NCI), 97 cognitively impaired no dementia (CIND), 46 AD, and 23 VaD participants recruited from memory clinics based in Singapore underwent neuropsychological and neuroimaging assessments, together with measurements of serum brevican. Association analyses were performed between serum brevican and neuroimaging measures of CeVDs, including white matter hyperintensities (WMHs), lacunes, cortical infarcts, and cerebral microbleeds. Using an aggregated score for CeVD burden, only CIND participants showed lower brevican levels with higher CeVD compared to those with lower CeVD burden (p = 0.006). Among the CeVD subtypes assessed, only elevated WMH burden was associated with lower brevican levels (OR = 2.7; 95% CI = 1.3-5.5). Our findings suggest that brevican deficits may play a role in early cerebrovascular damage in participants at risk of developing dementia.
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Affiliation(s)
- Rachel S. L. Chia
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
| | - Karolina Minta
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Future Health Technologies, Singapore–ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore 138602, Singapore
| | - Liu-Yun Wu
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
| | - Kaung H. T. Salai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
| | - Yuek Ling Chai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
| | - Saima Hilal
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117597, Singapore
- Departments of Epidemiology and Radiology & Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands
| | | | - Christopher P. Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
| | - Joyce R. Chong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
| | - Mitchell K. P. Lai
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117600, Singapore
- Memory Aging and Cognition Centre, National University Health System, Singapore 117600, Singapore
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Frentz I, van Arendonk J, Leeuwis AE, Vernooij MW, van der Flier WM, Bos D, De Deyn PP, Wolters FJ, Ikram MA. Interaction Between Arteriosclerosis and Amyloid-β on Cognitive Function. J Alzheimers Dis 2024; 97:953-961. [PMID: 38217596 PMCID: PMC10836547 DOI: 10.3233/jad-230604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Dementia is a multifactorial disease, with Alzheimer's disease (AD) and vascular pathology often co-occurring in many individuals with dementia. Yet, the interplay between AD and vascular pathology in cognitive decline is largely undetermined. OBJECTIVE The aim of the present study was to examine the joint effect of arteriosclerosis and AD pathology on cognition in the general population without dementia. METHODS We determined the interaction between blood-based AD biomarkers and CT-defined arteriosclerosis on cognition in 2,229 dementia-free participants of the population-based Rotterdam Study (mean age: 68.9 years, 52% women) cross-sectionally. RESULTS Amyloid-β (Aβ)42 and arterial calcification were associated with cognitive performance. After further adjustment for confounders in a model that combined all biomarkers, only arterial calcification remained independently associated with cognition. There was a significant interaction between arterial calcification and Aβ42 and between arterial calcification and the ratio of Aβ42/40. Yet, estimates attenuated, and interactions were no longer statistically significant after adjustment for cardio metabolic risk factors. CONCLUSIONS Arteriosclerosis and AD display additive interaction-effects on cognition in the general population, that are due in part to cardio metabolic risk factors. These findings suggest that joint assessment of arteriosclerosis and AD pathology is important for understanding of disease etiology in individuals with cognitive impairment.
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Affiliation(s)
- Ingeborg Frentz
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Neurology, UMCG, Groningen, The Netherlands
| | - Joyce van Arendonk
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, GD Rotterdam, The Netherlands
| | - Anna E. Leeuwis
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Meike W. Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, GD Rotterdam, The Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Department of Epidemiology, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Daniel Bos
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, GD Rotterdam, The Netherlands
| | - Peter Paul De Deyn
- Department of Neurology, UMCG, Groningen, The Netherlands
- Alzheimer Centre Groningen, UMCG, Groningen, The Netherlands
| | - Frank J. Wolters
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, GD Rotterdam, The Netherlands
| | - M. Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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Lalwani RC, Volmar CH, Wahlestedt C, Webster KA, Shehadeh LA. Contextualizing the Role of Osteopontin in the Inflammatory Responses of Alzheimer's Disease. Biomedicines 2023; 11:3232. [PMID: 38137453 PMCID: PMC10741223 DOI: 10.3390/biomedicines11123232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/01/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by progressive accumulations of extracellular amyloid-beta (Aβ) aggregates from soluble oligomers to insoluble plaques and hyperphosphorylated intraneuronal tau, also from soluble oligomers to insoluble neurofibrillary tangles (NFTs). Tau and Aβ complexes spread from the entorhinal cortex of the brain to interconnected regions, where they bind pattern recognition receptors on microglia and astroglia to trigger inflammation and neurotoxicity that ultimately lead to neurodegeneration and clinical AD. Systemic inflammation is initiated by Aβ's egress into the circulation, which may be secondary to microglial activation and can confer both destructive and reparative actions. Microglial activation pathways and downstream drivers of Aβ/NFT neurotoxicity, including inflammatory regulators, are primary targets for AD therapy. Osteopontin (OPN), an inflammatory cytokine and biomarker of AD, is implicated in Aβ clearance and toxicity, microglial activation, and inflammation, and is considered to be a potential therapeutic target. Here, using the most relevant works from the literature, we review and contextualize the evidence for a central role of OPN and associated inflammation in AD.
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Affiliation(s)
- Roshni C. Lalwani
- Interdisciplinary Stem Cell Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
| | - Claude-Henry Volmar
- Department of Psychiatry, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (C.-H.V.); (C.W.)
- Center for Therapeutic Innovation, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Claes Wahlestedt
- Department of Psychiatry, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA; (C.-H.V.); (C.W.)
- Center for Therapeutic Innovation, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
| | - Keith A. Webster
- Integene International Holdings, LLC, Miami, FL 33137, USA;
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030, USA
- Everglades BioPharma, Houston, TX 77098, USA
| | - Lina A. Shehadeh
- Interdisciplinary Stem Cell Institute, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA;
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL 33136, USA
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Marcolini S, Mondragón JD, Bron EE, Biessels GJ, Claassen JA, Papma JM, Middelkoop H, Dierckx RA, Borra RJ, Ramakers IH, van der Flier WM, Maurits NM, De Deyn PP. Small vessel disease burden and functional brain connectivity in mild cognitive impairment. Cereb Circ Cogn Behav 2023; 6:100192. [PMID: 38174052 PMCID: PMC10758699 DOI: 10.1016/j.cccb.2023.100192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 01/05/2024]
Abstract
Background The role of small vessel disease in the development of dementia is not yet completely understood. Functional brain connectivity has been shown to differ between individuals with and without cerebral small vessel disease. However, a comprehensive measure of small vessel disease quantifying the overall damage on the brain is not consistently used and studies using such measure in mild cognitive impairment individuals are missing. Method Functional brain connectivity differences were analyzed between mild cognitive impairment individuals with absent or low (n = 34) and high (n = 34) small vessel disease burden using data from the Parelsnoer Institute, a Dutch multicenter study. Small vessel disease was characterized using an ordinal scale considering: lacunes, microbleeds, perivascular spaces in the basal ganglia, and white matter hyperintensities. Resting state functional MRI data using 3 Tesla scanners was analyzed with group-independent component analysis using the CONN toolbox. Results Functional connectivity between areas of the cerebellum and between the cerebellum and the thalamus and caudate nucleus was higher in the absent or low small vessel disease group compared to the high small vessel disease group. Conclusion These findings might suggest that functional connectivity of mild cognitive impairment individuals with low or absent small vessel disease burden is more intact than in mild cognitive impairment individuals with high small vessel disease. These brain areas are mainly responsible for motor, attentional and executive functions, domains which in previous studies were found to be mostly associated with small vessel disease markers. Our results support findings on the involvement of the cerebellum in cognitive functioning.
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Affiliation(s)
- Sofia Marcolini
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, the Netherlands
| | - Jaime D. Mondragón
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, the Netherlands
- Universidad Nacional Autónoma de México, Instituto de Neurobiología, Departamento de Neurobiología Conductual y Cognitiva, Laboratorio de Psicofisiología, Querétaro 76230, Mexico
- San Diego State University, Department of Psychology, Life-Span Human Senses Lab, San Diego, California 92182, USA
| | - Esther E. Bron
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam 3015 GD, the Netherlands
| | - Geert J. Biessels
- Department of Neurology, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht 3584 CX, the Netherlands
| | - Jurgen A.H.R. Claassen
- Department of Geriatrics, Radboud University Medical Center and Donders Institute, Nijmegen 6525 GD, the Netherlands
- Department of Cardiovascular Sciences, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Janne M. Papma
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam 3015 GD, the Netherlands
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC University Medical Center, Rotterdam 3015 GD, the Netherlands
| | - Huub Middelkoop
- Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden 2316 XC, the Netherlands
- Department of Neurology, Leiden University Medical Centre, Leiden 2333 ZA, the Netherlands
| | - Rudi A.J.O. Dierckx
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Ronald J.H. Borra
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen 9713 GZ, the Netherlands
| | - Inez H.G.B. Ramakers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht 6229 ER, the Netherlands
| | - Wiesje M. van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam 1081 HZ, the Netherlands
- Department of Epidemiology & Data Sciences, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam 1117, the Netherlands
| | - Natasha M. Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, the Netherlands
| | - Peter P. De Deyn
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen 9713 GZ, the Netherlands
- Laboratory of Neurochemistry and Behavior, University of Antwerp, Antwerp 2610, Belgium
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Kang SH, Kang M, Han JH, Lee ES, Lee KJ, Chung SJ, Suh SI, Koh SB, Eo JS, Kim CK, Oh K. Independent effect of Aβ burden on cognitive impairment in patients with small subcortical infarction. Alzheimers Res Ther 2023; 15:178. [PMID: 37838715 PMCID: PMC10576878 DOI: 10.1186/s13195-023-01307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 09/17/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The effect of amyloid-β (Aβ) on cognitive impairment in patients with small subcortical infarction remains controversial, although a growing body of evidence shows a substantial overlap between Alzheimer's disease (AD) and subcortical ischemic vascular dementia, another form of cerebral small vessel disease (cSVD). Therefore, we investigated the relationships between Aβ positivity and the development of post-stroke cognitive impairment (PSCI) in patients with small subcortical infarction. METHODS We prospectively recruited 37 patients aged ≥ 50 years, with first-ever small subcortical infarction, who underwent amyloid positron emission tomography, 3 months after stroke at Korea University Guro Hospital. We also enrolled CU participants matched for age and sex with stroke patients for comparison of Aβ positivity. Patients were followed up at 3 and 12 months after the stroke to assess cognitive decline. Logistic and linear mixed-effect regression analyses were performed to identify the effect of Aβ positivity on PSCI development and long-term cognitive trajectories. RESULTS At 3 months after stroke, 12/37 (32.4%) patients developed PSCI, and 11/37 (29.7%) patients had Aβ deposition. Aβ positivity (odds ratio [OR] = 72.2, p = 0.024) was predictive of PSCI development regardless of cSVD burden. Aβ positivity (β = 0.846, p = 0.014) was also associated with poor cognitive trajectory, assessed by the Clinical Dementia Rating-Sum of Box, for 1 year after stroke. CONCLUSIONS Our findings highlight that Aβ positivity is an important predictor for PSCI development and cognitive decline over 1 year. Furthermore, our results provide evidence that anti-AD medications may be a strategy for preventing cognitive decline in patients with small subcortical infarctions.
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Affiliation(s)
- Sung Hoon Kang
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Minwoong Kang
- Department of Biomedical Research Center, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Jung Hoon Han
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Eun Seong Lee
- Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Su Jin Chung
- Department of Neurology, Myongji Hospital, Hanyang University College of Medicine, Goyang, South Korea
| | - Sang-Il Suh
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Seong-Beom Koh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.
| | - Chi Kyung Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.
| | - Kyungmi Oh
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, 148 Gurodong-ro, Guro-gu, Seoul, 08308, South Korea
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Bennett J, van Dinther M, Voorter P, Backes W, Barnes J, Barkhof F, Captur G, Hughes AD, Sudre C, Treibel TA. Assessment of Microvascular Disease in Heart and Brain by MRI: Application in Heart Failure with Preserved Ejection Fraction and Cerebral Small Vessel Disease. Medicina (Kaunas) 2023; 59:1596. [PMID: 37763715 PMCID: PMC10534635 DOI: 10.3390/medicina59091596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/18/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023]
Abstract
The objective of this review is to investigate the commonalities of microvascular (small vessel) disease in heart failure with preserved ejection fraction (HFpEF) and cerebral small vessel disease (CSVD). Furthermore, the review aims to evaluate the current magnetic resonance imaging (MRI) diagnostic techniques for both conditions. By comparing the two conditions, this review seeks to identify potential opportunities to improve the understanding of both HFpEF and CSVD.
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Affiliation(s)
- Jonathan Bennett
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Department of Cardiology, Barts Heart Centre, London EC1A 7BE, UK
| | - Maud van Dinther
- Department of Neurology, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LX Maastricht, The Netherlands
| | - Paulien Voorter
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Walter Backes
- School for Cardiovascular Diseases, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 LX Maastricht, The Netherlands
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands
- School for Mental Health & Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Josephine Barnes
- Dementia Research Centre, UCL Queens Square Institute of Neurology, University College London, London WC1E 6BT, UK
| | - Frederick Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, Vrije University, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
- Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK
- Centre for Medical Image Computing, University College London, London WC1E 6BT, UK
| | - Gabriella Captur
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Medical Research Council Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London WC1E 6BT, UK
- Centre for Inherited Heart Muscle Conditions, Cardiology Department, The Royal Free Hospital, London NW3 2QG, UK
| | - Alun D. Hughes
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Medical Research Council Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London WC1E 6BT, UK
| | - Carole Sudre
- Dementia Research Centre, UCL Queens Square Institute of Neurology, University College London, London WC1E 6BT, UK
- Centre for Medical Image Computing, University College London, London WC1E 6BT, UK
- Medical Research Council Unit for Lifelong Health and Ageing, Department of Population Science and Experimental Medicine, University College London, London WC1E 6BT, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London WC2R 2LS, UK
| | - Thomas A. Treibel
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Department of Cardiology, Barts Heart Centre, London EC1A 7BE, UK
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