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Cumplido-Mayoral I, Brugulat-Serrat A, Sánchez-Benavides G, González-Escalante A, Anastasi F, Milà-Alomà M, López-Martos D, Akinci M, Falcón C, Shekari M, Cacciaglia R, Arenaza-Urquijo EM, Minguillón C, Fauria K, Molinuevo JL, Suárez-Calvet M, Grau-Rivera O, Vilaplana V, Gispert JD. The mediating role of neuroimaging-derived biological brain age in the association between risk factors for dementia and cognitive decline in middle-aged and older individuals without cognitive impairment: a cohort study. Lancet Healthy Longev 2024; 5:e276-e286. [PMID: 38555920 DOI: 10.1016/s2666-7568(24)00025-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Neuroimaging-based brain-age delta has been shown to be a mediator linking cardiovascular risk factors to cognitive function. We aimed to assess the mediating role of brain-age delta in the association between modifiable risk factors of dementia and longitudinal cognitive decline in middle-aged and older individuals who are asymptomatic, stratified by Alzheimer's disease pathology. We also explored whether the mediation effect is specific to cognitive domain. METHODS In this cohort study, we included participants from the ALFA+ cohort aged between 45 years and 65 years who were cognitively unimpaired and who had available structural MRI, cerebrospinal fluid β-amyloid (Aβ)42 and Aβ40 measurements obtained within 1 year of each other, modifiable risk factors assessment, and cognitive evaluation over 3 years. Participants were recruited from the Barcelonaβeta Brain Research Center (Barcelona, Spain). Included individuals underwent a first assessment between Oct 25, 2016, and Jan 28, 2020, and a follow-up cognitive assessment 3·28 (SD 0·27) years later. We computed brain-age delta and composites of different cognitive function domains (preclinical Alzheimer's cognitive composite [PACC], attention, executive function, episodic memory, visual processing, and language). We used partial least squares path modelling to explore mediation effects in the associations between modifiable risk factors (including cardiovascular, mental health, mood, metabolic or endocrine history, and alcohol use) and changes in cognitive composites. To assess the role of Alzheimer's disease pathology, we computed separate models for Aβ-negative and Aβ-positive individuals. FINDINGS Of the 419 participants enrolled in ALFA+, 302 met our inclusion criteria, of which 108 participants were classified as Aβ-positive and 194 as Aβ-negative. In Aβ-positive individuals, brain-age delta partially mediated (percent mediation proportion 15·73% [95% CI 14·22-16·66]) the association between modifiable risk factors and decline in overall cognition (across cognitive domains). Brain-age delta fully mediated (mediation proportion 28·03% [26·25-29·21]) the effect of modifiable risk factors on the PACC, wherein increased values for risk factors correlated with an older brain-age delta, and, consequently, an older brain-age delta was linked to greater PACC decline. This effect appears to be primarily driven by memory decline. Mediation was not significant in Aβ-negative individuals (3·52% [0·072-4·17]) on PACC, although path coefficients were not significantly different from those in the Aβ-positive group. INTERPRETATION Our findings suggest that brain-age delta captures the association between modifiable risk factors and longitudinal cognitive decline in middle-aged and older people. In asymptomatic middle-aged and older individuals who are Aβ-positive, the pathology might be the strongest driver of cognitive decline, whereas the effect of risk factors is smaller. Our results highlight the potential of brain-age delta as an objective outcome measure for preventive lifestyle interventions targeting cognitive decline. FUNDING La Caixa Foundation, the TriBEKa Imaging Platform, and the Universities and Research Secretariat of the Catalan Government. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Irene Cumplido-Mayoral
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain; Global Brain Health Institute, San Francisco, CA, USA
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Armand González-Escalante
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain
| | - Federica Anastasi
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Marta Milà-Alomà
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA
| | - David López-Martos
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain
| | - Muge Akinci
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; Barcelona Institute of Global Health, Barcelona, Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Biomedicine, Universitat Pompeu Fabra, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Carolina Minguillón
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; H Lundbeck, Copenhagen, Denmark
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain; Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; CIBER Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain; Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Verónica Vilaplana
- Department of Signal Theory and Communications, Universitat Politècnica de Catalunya, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain; Neuroimagen de Enfermedades Neurodegenerativas y Envejecimiento Saludable, Hospital del Mar Research Institute, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
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Cacciaglia R, Operto G, Falcón C, de Echavarri-Gómez JMG, Sánchez-Benavides G, Brugulat-Serrat A, Milà-Alomà M, Blennow K, Zetterberg H, Molinuevo JL, Suárez-Calvet M, Gispert JD. Genotypic effects of APOE-ε4 on resting-state connectivity in cognitively intact individuals support functional brain compensation. Cereb Cortex 2023; 33:2748-2760. [PMID: 35753703 PMCID: PMC10016049 DOI: 10.1093/cercor/bhac239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/26/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 11/12/2022] Open
Abstract
The investigation of resting-state functional connectivity (rsFC) in asymptomatic individuals at genetic risk for Alzheimer's disease (AD) enables discovering the earliest brain alterations in preclinical stages of the disease. The APOE-ε4 variant is the major genetic risk factor for AD, and previous studies have reported rsFC abnormalities in carriers of the ε4 allele. Yet, no study has assessed APOE-ε4 gene-dose effects on rsFC measures, and only a few studies included measures of cognitive performance to aid a clinical interpretation. We assessed the impact of APOE-ε4 on rsFC in a sample of 429 cognitively unimpaired individuals hosting a high number of ε4 homozygotes (n = 58), which enabled testing different models of genetic penetrance. We used independent component analysis and found a reduced rsFC as a function of the APOE-ε4 allelic load in the temporal default-mode and the medial temporal networks, while recessive effects were found in the extrastriate and limbic networks. Some of these results were replicated in a subsample with negative amyloid markers. Interaction with cognitive data suggests that such a network reorganization may support cognitive performance in the ε4-homozygotes. Our data indicate that APOE-ε4 shapes the functional architecture of the resting brain and favor the idea of a network-based functional compensation.
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Affiliation(s)
- Raffaele Cacciaglia
- Corresponding author: Raffaele Cacciaglia and Juan Domingo Gispert López, Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain. ;
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), 28089 Madrid, Spain
| | - José Maria González de Echavarri-Gómez
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
- Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 41390 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 41390 Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 41390 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 41390 Mölndal, Sweden
- UK Dementia Research Institute at UCL, WC1E 6BT London, United Kingdom
- Department of Neurodegenerative Disease, UCL Institute of Neurology, WC1N 3BG London, United Kingdom
- Honk Kong Center for Neurodegenerative Diseases, Hong Kong, China
| | | | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Juan Domingo Gispert
- Corresponding author: Raffaele Cacciaglia and Juan Domingo Gispert López, Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain. ;
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3
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Brugulat-Serrat A, Sánchez-Benavides G, Cacciaglia R, Salvadó G, Shekari M, Collij LE, Buckley C, van Berckel BNM, Perissinotti A, Niñerola-Baizán A, Milà-Alomà M, Vilor-Tejedor N, Operto G, Falcon C, Grau-Rivera O, Arenaza-Urquijo EM, Minguillón C, Fauria K, Molinuevo JL, Suárez-Calvet M, Gispert JD. APOE-ε4 modulates the association between regional amyloid deposition and cognitive performance in cognitively unimpaired middle-aged individuals. EJNMMI Res 2023; 13:18. [PMID: 36856866 PMCID: PMC9978048 DOI: 10.1186/s13550-023-00967-6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 02/10/2023] [Indexed: 03/02/2023] Open
Abstract
PURPOSE To determine whether the APOE-ε4 allele modulates the relationship between regional β-amyloid (Aβ) accumulation and cognitive change in middle-aged cognitively unimpaired (CU) participants. METHODS The 352 CU participants (mean aged 61.1 [4.7] years) included completed two cognitive assessments (average interval 3.34 years), underwent [18F]flutemetamol Aβ positron emission tomography (PET), T1w magnetic resonance imaging (MRI), as well as APOE genotyping. Global and regional Aβ PET positivity was assessed across five regions-of-interest by visual reading (VR) and regional Centiloids. Linear regression models were developed to examine the interaction between regional and global Aβ PET positivity and APOE-ε4 status on longitudinal cognitive change assessed with the Preclinical Alzheimer's Cognitive Composite (PACC), episodic memory, and executive function, after controlling for age, sex, education, cognitive baseline scores, and hippocampal volume. RESULTS In total, 57 participants (16.2%) were VR+ of whom 41 (71.9%) were APOE-ε4 carriers. No significant APOE-ε4*global Aβ PET interactions were associated with cognitive change for any cognitive test. However, APOE-ε4 carriers who were VR+ in temporal areas (n = 19 [9.81%], p = 0.04) and in the striatum (n = 8 [4.14%], p = 0.01) exhibited a higher decline in the PACC. The temporal areas findings were replicated when regional PET positivity was determined with Centiloid values. Regionally, VR+ in the striatum was associated with higher memory decline. As for executive function, interactions between APOE-ε4 and regional VR+ were found in temporal and parietal regions, and in the striatum. CONCLUSION CU APOE-ε4 carriers with a positive Aβ PET VR in regions known to accumulate amyloid at later stages of the Alzheimer's disease (AD) continuum exhibited a steeper cognitive decline. This work supports the contention that regional VR of Aβ PET might convey prognostic information about future cognitive decline in individuals at higher risk of developing AD. CLINICALTRIALS gov Identifier: NCT02485730. Registered 20 June 2015 https://clinicaltrials.gov/ct2/show/NCT02485730 and ClinicalTrials.gov Identifier:NCT02685969. Registered 19 February 2016 https://clinicaltrials.gov/ct2/show/NCT02685969 .
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Affiliation(s)
- Anna Brugulat-Serrat
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain ,grid.512357.7Global Brain Health Institute, San Francisco, CA USA
| | - Gonzalo Sánchez-Benavides
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Raffaele Cacciaglia
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Gemma Salvadó
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.4514.40000 0001 0930 2361Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Mahnaz Shekari
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Barcelona, Spain
| | - Lyduine E. Collij
- grid.12380.380000 0004 1754 9227Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, The Netherlands
| | - Christopher Buckley
- grid.83440.3b0000000121901201Center for Medical Image Computing, and Queen Square Institute of Neurology, UCL, London, UK
| | - Bart N. M. van Berckel
- grid.12380.380000 0004 1754 9227Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan, Amsterdam, The Netherlands
| | - Andrés Perissinotti
- grid.410458.c0000 0000 9635 9413Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Aida Niñerola-Baizán
- grid.410458.c0000 0000 9635 9413Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Milà-Alomà
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Barcelona, Spain
| | - Natàlia Vilor-Tejedor
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.5612.00000 0001 2172 2676Universitat Pompeu Fabra, Barcelona, Spain ,grid.473715.30000 0004 6475 7299Centre for Genomic Regulation (CRG), The Barcelona Institute for Science and Technology, Barcelona, Spain
| | - Grégory Operto
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Carles Falcon
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.411142.30000 0004 1767 8811Neurologia Department, Hospital del Mar, Barcelona, Spain
| | - Oriol Grau-Rivera
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411142.30000 0004 1767 8811Neurologia Department, Hospital del Mar, Barcelona, Spain
| | - Eider M. Arenaza-Urquijo
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Carolina Minguillón
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Karine Fauria
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - José Luis Molinuevo
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.424580.f0000 0004 0476 7612H. Lundbeck A/S, Copenhagen, Denmark
| | - Marc Suárez-Calvet
- grid.430077.7Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain ,grid.411142.30000 0004 1767 8811IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain ,grid.413448.e0000 0000 9314 1427Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain ,grid.411142.30000 0004 1767 8811Neurologia Department, Hospital del Mar, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Biomedical Research Networking Center of Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III, Madrid, Spain.
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López-Martos D, Brugulat-Serrat A, Cañas-Martínez A, Canals-Gispert L, Marne P, Gramunt N, Suárez-Calvet M, Milà-Alomà M, Minguillon C, Fauria K, Zetterberg H, Blennow K, Gispert JD, Molinuevo JL, Grau-Rivera O, Sánchez-Benavides G. Reference Data for Attentional, Executive, Linguistic, and Visual Processing Tests Obtained from Cognitively Healthy Individuals with Normal Alzheimer's Disease Cerebrospinal Fluid Biomarker Levels. J Alzheimers Dis 2023; 95:237-249. [PMID: 37483000 PMCID: PMC10578268 DOI: 10.3233/jad-230290] [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: 06/21/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Conventional neuropsychological norms likely include cognitively unimpaired (CU) individuals with preclinical Alzheimer's disease (AD) pathology (amyloid-β, tau, and neurodegeneration) since they are based on cohorts without AD biomarkers data. Due to this limitation, population-based norms would lack sensitivity for detecting subtle cognitive decline due to AD, the transitional stage between healthy cognition and mild cognitive impairment. We have recently published norms for memory tests in individuals with normal cerebrospinal fluid (CSF) AD biomarker levels. OBJECTIVE The aim of the present study was to provide further AD biomarker-based cognitive references covering attentional, executive function, linguistic, and visual processing tests. METHODS We analyzed 248 CU individuals aged between 50-70 years old with normal CSF Aβ, p-tau, and neurodegeneration (t-tau) biomarker levels. The tests included were the Trail Making Test (TMT), Semantic Fluency Test, Digit and Symbol Span, Coding, Matrix Reasoning, Judgement of Line Orientation and Visual Puzzles. Normative data were developed based on regression models adjusted for age, education, and sex when needed. We present equations to calculate z-scores, the corresponding normative percentile tables, and online calculators. RESULTS Age, education, and sex were associated with performance in all tests, except education for the TMT-A, and sex for the TMT-B, Coding, and Semantic Fluency. Cut-offs derived from the current biomarker-based reference data were higher and more sensitive than standard norms. CONCLUSION We developed reference data obtained from individuals with evidence of non-pathologic AD biomarker levels that may improve the objective characterization of subtle cognitive decline in preclinical AD.
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Affiliation(s)
- David López-Martos
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Global Brain Health Institute, San Francisco, CA, USA
| | - Alba Cañas-Martínez
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Lidia Canals-Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Paula Marne
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | | | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Department of Veterans Affairs Medical Center, Northern California Institute for Research and Education (NCIRE), San Francisco, CA, USA
- Department of Radiology, University of California, San Francisco, San Francisco, CA, USA
| | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), Instituto de Salud Carlos III, Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
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5
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Poudevida S, de Sola S, Brugulat-Serrat A, Mas-Vall Llosera G, Castillo A, Huesa G, Piromalli D, Gramunt-Fombuena N. [Effectiveness of a psychotherapeutic intervention group program in the improvement of caregiver well-being in Alzheimer's disease patients' family caregivers: the CuiDem study]. Rev Neurol 2022; 75:203-211. [PMID: 36218251 DOI: 10.33588/rn.7508.2022180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Caregivers of patients with Alzheimer's Disease experience physical and emotional burnout that can be treated with non-pharmacological interventions. AIM Assess the efficacy of a group cognitive behavioural psychotherapeutic intervention, for improving well-being perception in caregivers, compared to a support group. Also, we assessed its efficacy after a follow-up period of 1-year post-intervention. SUBJECTS AND METHODS A multicentre, open, quasi experimental study with control group was conducted. 221 caregivers of patients with Alzheimer's Disease, with mild to moderate-severe dementia, were non-randomly assigned to either IG-intervention group: psychotherapeutic program without active follow-up period (n = 80); IGF-intervention group: psychotherapeutic program with active follow-up period (n = 78); or CG-control group: support program with active follow-up period (n = 63). The psychotherapeutic intervention (IG and IGF) is a structured cognitive behavioural group program, of one weekly session over four months. The CG had the same duration. Caregiver's burden, mood disorders, resilience, perceived functional social support and quality of life were measured at baseline, post-intervention and after 1-year follow-up. RESULTS At post-intervention, statistically significant improvements were observed in the IG and IGF compared to CG in caregiver burden (p = 0,0216). After one year follow-up, significant improvements were found in IGF compared to IG in emotional state (p = 0,0271), resilience (p = 0,0018), perceived social support (p = 0,014); quality of life (p = 0,0001) and mental health (p = 0,0002); and in CG versus GI in emotional state and social support (p < 0,05). CONCLUSIONS These results support the efficacy of this psychotherapeutic intervention for improving well-being (burden), and the supportive follow-up period for increasing its efficacy.
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Affiliation(s)
- S Poudevida
- Fundación Pasqual Maragall, Barcelona, España
| | - S de Sola
- Fundación Pasqual Maragall, Barcelona, España
| | - A Brugulat-Serrat
- Hospital del Mar Medical Research Institute, Barcelona, España
- BarcelonaBeta Brain Research Center, Barcelona, España
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) , Madrid, España
| | | | - A Castillo
- Fundación Pasqual Maragall, Barcelona, España
| | - G Huesa
- BarcelonaBeta Brain Research Center, Barcelona, España
| | - D Piromalli
- Fundación Pasqual Maragall, Barcelona, España
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6
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Akinci M, Sánchez-Benavides G, Brugulat-Serrat A, Peña-Gómez C, Palpatzis E, Shekari M, Deulofeu C, Fuentes-Julian S, Salvadó G, González-de-Echávarri JM, Suárez-Calvet M, Minguillón C, Fauria K, Molinuevo JL, Gispert JD, Grau-Rivera O, Arenaza-Urquijo EM, Beteta A, Cacciaglia R, Cañas A, Cumplido I, Dominguez R, Emilio M, Falcon C, Hernandez L, Huesa G, Huguet J, Marne P, Menchón T, Operto G, Polo A, Rodríguez-Fernández B, Pradas S, Sadeghi I, Soteras A, Stankeviciute L, Vilanova M, Vilor-Tejedor N. Subjective cognitive decline and anxious/depressive symptoms during the COVID-19 pandemic: what is the role of stress perception, stress resilience, and β-amyloid? Alzheimers Res Ther 2022; 14:126. [PMID: 36068641 PMCID: PMC9446623 DOI: 10.1186/s13195-022-01068-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/28/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The COVID-19 pandemic may worsen the mental health of people reporting subjective cognitive decline (SCD) and therefore their clinical prognosis. We aimed to investigate the association between the intensity of SCD and anxious/depressive symptoms during confinement and the underlying mechanisms.
Methods
Two hundred fifty cognitively unimpaired participants completed the Hospital Anxiety and Depression Scale (HADS) and SCD-Questionnaire (SCD-Q) and underwent amyloid-β positron emission tomography imaging with [18F] flutemetamol (N = 205) on average 2.4 (± 0.8) years before the COVID-19 confinement. During the confinement, participants completed the HADS, Perceived Stress Scale (PSS), Brief Resilience Scale (BRS), and an ad hoc questionnaire on worries (access to primary products, self-protection materials, economic situation) and lifestyle changes (sleep duration, sleep quality, eating habits). We investigated stress-related measurements, worries, and lifestyle changes in relation to SCD. We then conducted an analysis of covariance to investigate the association of SCD-Q with HADS scores during the confinement while controlling for pre-confinement anxiety/depression scores and demographics. Furthermore, we introduced amyloid-β positivity, PSS, and BRS in the models and performed mediation analyses to explore the mechanisms explaining the association between SCD and anxiety/depression.
Results
In the whole sample, the average SCD-Q score was 4.1 (± 4.4); 70 (28%) participants were classified as SCD, and 26 (12.7%) were amyloid-β-positive. During the confinement, participants reporting SCD showed higher PSS (p = 0.035) but not BRS scores (p = 0.65) than those that did not report SCD. No differences in worries or lifestyle changes were observed. Higher SCD-Q scores showed an association with greater anxiety/depression scores irrespective of pre-confinement anxiety/depression levels (p = 0.002). This association was not significant after introducing amyloid-β positivity and stress-related variables in the model (p = 0.069). Amyloid-β positivity and PSS were associated with greater HADS irrespective of pre-confinement anxiety/depression scores (p = 0.023; p < 0.001). The association of SCD-Q with HADS was mediated by PSS (p = 0.01).
Conclusions
Higher intensity of SCD, amyloid-β positivity, and stress perception showed independent associations with anxious/depressive symptoms during the COVID-19 confinement irrespective of pre-confinement anxiety/depression levels. The association of SCD intensity with anxiety/depression was mediated by stress perception, suggesting stress regulation as a potential intervention to reduce affective symptomatology in the SCD population in the face of stressors.
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7
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Lorenzini L, Ansems LT, Lopes Alves I, Ingala S, Vállez García D, Tomassen J, Sudre C, Salvadó G, Shekari M, Operto G, Brugulat-Serrat A, Sánchez-Benavides G, ten Kate M, Tijms B, Wink AM, Mutsaerts HJMM, den Braber A, Visser PJ, van Berckel BNM, Gispert JD, Barkhof F, Collij LE, Beteta A, Brugulat A, Cacciaglia R, Cañas A, Deulofeu C, Cumplido I, Dominguez R, Emilio M, Fauria K, Fuentes S, Hernandez L, Huesa G, Huguet J, Marne P, Menchón T, Polo A, Pradas S, Rodriguez-Fernandez B, Sala-Vila A, Sánchez-Benavides G, Soteras A, Vilanova M. Regional associations of white matter hyperintensities and early cortical amyloid pathology. Brain Commun 2022; 4:fcac150. [PMID: 35783557 PMCID: PMC9246276 DOI: 10.1093/braincomms/fcac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/11/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
White matter hyperintensities (WMHs) have a heterogeneous aetiology, associated with both vascular risk factors and amyloidosis due to Alzheimer’s disease. While spatial distribution of both amyloid and WM lesions carry important information for the underlying pathogenic mechanisms, the regional relationship between these two pathologies and their joint contribution to early cognitive deterioration remains largely unexplored.
We included 662 non-demented participants from three Amyloid Imaging to Prevent Alzheimer’s disease (AMYPAD)-affiliated cohorts: EPAD-LCS (N = 176), ALFA+ (N = 310), and EMIF-AD PreclinAD Twin60++ (N = 176). Using PET imaging, cortical amyloid burden was assessed regionally within early accumulating regions (medial orbitofrontal, precuneus, and cuneus) and globally, using the Centiloid method. Regional WMH volume was computed using Bayesian Model Selection. Global associations between WMH, amyloid, and cardiovascular risk scores (Framingham and CAIDE) were assessed using linear models. Partial least square (PLS) regression was used to identify regional associations. Models were adjusted for age, sex, and APOE-e4 status. Individual PLS scores were then related to cognitive performance in 4 domains (attention, memory, executive functioning, and language).
While no significant global association was found, the PLS model yielded two components of interest. In the first PLS component, a fronto-parietal WMH pattern was associated with medial orbitofrontal–precuneal amyloid, vascular risk, and age. Component 2 showed a posterior WMH pattern associated with precuneus-cuneus amyloid, less related to age or vascular risk. Component 1 was associated with lower performance in all cognitive domains, while component 2 only with worse memory.
In a large pre-dementia population, we observed two distinct patterns of regional associations between WMH and amyloid burden, and demonstrated their joint influence on cognitive processes. These two components could reflect the existence of vascular-dependent and -independent manifestations of WMH-amyloid regional association that might be related to distinct primary pathophysiology.
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Affiliation(s)
- Luigi Lorenzini
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Loes T Ansems
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Isadora Lopes Alves
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Silvia Ingala
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - David Vállez García
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Jori Tomassen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
| | - Carole Sudre
- Centre for Medical Image Computing (CMIC), Departments of Medical Physics & Biomedical Engineering and Computer Science, University College London , UK
- MRC Unit for Lifelong Health and Ageing - University College London , UK
- School of Biomedical Engineering , King’s College London UK
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
- Universitat Pompeu Fabra , Barcelona , Spain
| | - Gregory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES) , Madrid , Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES) , Madrid , Spain
- Atlantic Fellow for Equity in Brain Health at the University of California San Francisco , SanFrancisco, California , USA
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
- Centro de Investigación Biomédica en Red de Fragilidad Y Envejecimiento Saludable (CIBERFES) , Madrid , Spain
| | - Mara ten Kate
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
| | - Betty Tijms
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
| | - Alle Meije Wink
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Henk J M M Mutsaerts
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Anouk den Braber
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
- Department. of Biological Psychology, Vrije Universiteit Amsterdam, Neuroscience Amsterdam , Amsterdam , The Netherlands
| | - Pieter Jelle Visser
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC , Amsterdam , The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University , Maastricht , The Netherlands
| | - Bart N M van Berckel
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation , Barcelona , Spain
- IMIM (Hospital del Mar Medical Research Institute) , Barcelona , Spain
- Universitat Pompeu Fabra , Barcelona , Spain
- Centro de Investigación Biomédica en Red Bioingeniería, Biomateriales Y Nanomedicina , Madrid , Spain
| | - Frederik Barkhof
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing, University College London , London , UK
| | - Lyduine E Collij
- Dept. of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam Neuroscience , Amsterdam , The Netherlands
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8
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Brugulat-Serrat A, Chen Y, Demnitz N, Ashour A, Adrion E, Ilinca S, Kinchin I, Almirall-Sanchez A, Öz D, Karanja W, Pintado M, Rogers N, Browning A, Petkuté I, Lawlor B. Roadmap for change in sex and gender inequities in brain health: A global perspective. Int J Geriatr Psychiatry 2022; 37. [PMID: 35393642 DOI: 10.1002/gps.5710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anna Brugulat-Serrat
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Yaohua Chen
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- University.Lille, Inserm UMR-S1172, Lille Neurosciences & Cognition, Degenerative and Vascular Cognitive Disorders, CHU Lille, LiCEND, Lille, France
- Department of Geriatrics, CHU Lille, Lille, France
| | - Naiara Demnitz
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hvidovre Hospital, Hvidovre, Denmark
| | - Aya Ashour
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Department of Neurology, Ain Shams University, Cairo, Egypt
| | - Emily Adrion
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- Global Health Policy Unit, University of Edinburgh, Scotland, UK
| | - Stefania Ilinca
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- European Centre for Social Welfare Policy and Research, Vienna, Austria
- World Health Organization Regional Office for Europe, Copenhagen, Europe
| | - Irina Kinchin
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- University of Technology Sydney, Ultimo, Sydney, New South Wales, Australia
| | | | - Didem Öz
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Dokuz Eylul University Hospital, İzmir, Turkey
| | - Wambui Karanja
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Maritza Pintado
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Cognitive impairment diagnostic unit and dementia prevention, Peruvian Institute of Neurosciences, Lima, Peru
- Research Department, Peruvian Institute of Neurosciences, Lima, Peru
| | - Nicole Rogers
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Departamento de Neurociencia, Universidad de Chile, Santiago, Chile
| | - Anne Browning
- Global Brain Health Institute, University of California, San Francisco, California, USA
- University of Washington School of Medicine, Seattle, Washington, USA
| | - Ieva Petkuté
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
- NGO "Socialiniai meno projektai", Vilnius, Lithuania
- Association "Dementia Lithuania", Vilnius, Lithuania
| | - Brian Lawlor
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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9
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Brugulat-Serrat A, Cañas-Martínez A, Canals-Gispert L, Marne P, Gramunt N, Milà-Alomà M, Suárez-Calvet M, Arenaza-Urquijo EM, Grau-Rivera O, González-de-Echávarri JM, Minguillon C, Fauria K, Kollmorgen G, Suridjan I, Zetterberg H, Blennow K, Gispert JD, Molinuevo JL, Sánchez-Benavides G. Enhancing the Sensitivity of Memory Tests: Reference Data for the Free and Cued Selective Reminding Test and the Logical Memory Task from Cognitively Healthy Subjects with Normal Alzheimer's Disease Cerebrospinal Fluid Biomarker Levels. J Alzheimers Dis 2021; 84:119-128. [PMID: 34569957 PMCID: PMC8609690 DOI: 10.3233/jad-210640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive performance of a given individual should be interpreted in the context of reference standards obtained in cognitively healthy populations. Recent evidence has shown that removing asymptomatic individuals with biomarker evidence of Alzheimer's disease pathology from normative samples increases the sensitivity of norms to detect memory impairments. These kind of norms may be useful for defining subtle cognitive decline, the transitional cognitive decline between normal cognition and mild cognitive impairment. OBJECTIVE The present study aims to provide norms for the Free and Cued Selective Reminding Test (FCSRT) and the Logical Memory subtest of the Wechsler Memory Scale-IV in a sample of individuals aged 50-70 years with normal levels of amyloid-β and tau cerebrospinal fluid (CSF) biomarkers. METHODS The sample was composed of 248 individuals from the ALFA+ study with negative amyloid-β and tau CSF biomarker levels. Regression-based norms were developed, including adjustments for age, education, and sex when applicable. RESULTS We found that education was associated with the performance in all the variables of both tests while age had a marginal effect only in the delayed free recall of the FCSRT. Sex was also related to the performance in the FCSRT, with women outperforming men. Equations to calculate z-scores and normative percentile tables were created. As compared with previously published norms the reference data presented were more sensitive but less specific, as expected. CONCLUSION The use of the norms provided in this work, in combination with the already published conventional norms, may contribute to detecting subtle memory impairment.
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Affiliation(s)
- Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Alba Cañas-Martínez
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Lidia Canals-Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Paula Marne
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | | | - Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Eider M Arenaza-Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | | | | | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, (CIBERBBN), Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
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10
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Ingala S, Mazzai L, Sudre CH, Salvadó G, Brugulat-Serrat A, Wottschel V, Falcon C, Operto G, Tijms B, Gispert JD, Molinuevo JL, Barkhof F. The relation between APOE genotype and cerebral microbleeds in cognitively unimpaired middle- and old-aged individuals. Neurobiol Aging 2020; 95:104-114. [PMID: 32791423 DOI: 10.1016/j.neurobiolaging.2020.06.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/05/2019] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 01/10/2023]
Abstract
Positive associations between cerebral microbleeds (CMBs) and APOE-ε4 (apolipoprotein E) genotype have been reported in Alzheimer's disease, but show conflicting results. We investigated the effect of APOE genotype on CMBs in a cohort of cognitively unimpaired middle- and old-aged individuals enriched for APOE-ε4 genotype. Participants from ALFA (Alzheimer and Families) cohort were included and their magnetic resonance scans assessed (n = 564, 50% APOE-ε4 carriers). Quantitative magnetic resonance analyses included visual ratings, atrophy measures, and white matter hyperintensity (WMH) segmentations. The prevalence of CMBs was 17%, increased with age (p < 0.05), and followed an increasing trend paralleling APOE-ε4 dose. The number of CMBs was significantly higher in APOE-ε4 homozygotes compared to heterozygotes and non-carriers (p < 0.05). This association was driven by lobar CMBs (p < 0.05). CMBs co-localized with WMH (p < 0.05). No associations between CMBs and APOE-ε2, gray matter volumes, and cognitive performance were found. Our results suggest that cerebral vessels of APOE-ε4 homozygous are more fragile, especially in lobar locations. Co-occurrence of CMBs and WMH suggests that such changes localize in areas with increased vascular vulnerability.
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Affiliation(s)
- Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.
| | - Linda Mazzai
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Medicine (DiMED), Institute of Radiology, University of Padua, Padua, Italy
| | - Carole H Sudre
- Engineering and Imaging Sciences, King's College London, London, UK; Dementia Research Centre, University College London, London, UK; Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
| | - Viktor Wottschel
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain
| | - Betty Tijms
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain; Pompeu Fabra University, Barcelona, Spain.
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Institutes of Neurology and Healthcare Engineering, UCL, London, UK
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11
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Cacciaglia R, Molinuevo JL, Falcón C, Arenaza-Urquijo EM, Sánchez-Benavides G, Brugulat-Serrat A, Blennow K, Zetterberg H, Gispert JD. APOE-ε4 Shapes the Cerebral Organization in Cognitively Intact Individuals as Reflected by Structural Gray Matter Networks. Cereb Cortex 2020; 30:4110-4120. [PMID: 32163130 PMCID: PMC7264689 DOI: 10.1093/cercor/bhaa034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/28/2020] [Accepted: 01/30/2020] [Indexed: 11/19/2022] Open
Abstract
Gray matter networks (GMn) provide essential information on the intrinsic organization of the brain and appear to be disrupted in Alzheimer’s disease (AD). Apolipoprotein E (APOE)-ε4 represents the major genetic risk factor for AD, yet the association between APOE-ε4 and GMn has remained unexplored. Here, we determine the impact of APOE-ε4 on GMn in a large sample of cognitively unimpaired individuals, which was enriched for the genetic risk of AD. We used independent component analysis to retrieve sources of structural covariance and analyzed APOE group differences within and between networks. Analyses were repeated in a subsample of amyloid-negative subjects. Compared with noncarriers and heterozygotes, APOE-ε4 homozygotes showed increased covariance in one network including primarily right-lateralized, parietal, inferior frontal, as well as inferior and middle temporal regions, which mirrored the formerly described AD-signature. This result was confirmed in a subsample of amyloid-negative individuals. APOE-ε4 carriers showed reduced covariance between two networks encompassing frontal and temporal regions, which constitute preferential target of amyloid deposition. Our data indicate that, in asymptomatic individuals, APOE-ε4 shapes the cerebral organization in a way that recapitulates focal morphometric alterations observed in AD patients, even in absence of amyloid pathology. This suggests that structural vulnerability in neuronal networks associated with APOE-ε4 may be an early event in AD pathogenesis, possibly upstream of amyloid deposition.
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Affiliation(s)
- Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain.,Universitat Pompeu Fabra, 08002 Barcelona, Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), 28089 Madrid, Spain
| | - Eider M Arenaza-Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), 28089 Madrid, Spain.,Global Brain Health Institute, University of California San Francisco, San Francisco, CA 94115, USA
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 41390 Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 41390 Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, 41390 Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 41390 Mölndal, Sweden.,UK Dementia Research Institute at UCL, WC1E 6BT London, UK.,Department of Neurodegenerative Disease, UCL Institute of Neurology, WC1N 3BG London, UK
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, 08005 Barcelona, Spain.,Hospital del Mar Medical Research Institute (IMIM), 08005 Barcelona, Spain.,Universitat Pompeu Fabra, 08002 Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBERBBN), 28089 Madrid, Spain
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12
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Grau-Rivera O, Operto G, Falcón C, Sánchez-Benavides G, Cacciaglia R, Brugulat-Serrat A, Gramunt N, Salvadó G, Suárez-Calvet M, Minguillon C, Iranzo Á, Gispert JD, Molinuevo JL. Association between insomnia and cognitive performance, gray matter volume, and white matter microstructure in cognitively unimpaired adults. Alzheimers Res Ther 2020; 12:4. [PMID: 31907066 PMCID: PMC6945611 DOI: 10.1186/s13195-019-0547-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [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: 07/30/2019] [Accepted: 10/17/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mounting evidence links poor sleep quality with a higher risk of late-life dementia. However, the structural and cognitive correlates of insomnia are still not well understood. The study aims were to characterize the cognitive performance and brain structural pattern of cognitively unimpaired adults at increased risk for Alzheimer's disease (AD) with insomnia. METHODS This cross-sectional study included 1683 cognitively unimpaired middle/late-middle-aged adults from the ALFA (ALzheimer and FAmilies) study who underwent neuropsychological assessment, T1-weighted structural imaging (n = 366), and diffusion-weighted imaging (n = 334). The World Health Organization's World Mental Health Survey Initiative version of the Composite International Diagnostic Interview was used to define the presence or absence of insomnia. Multivariable regression models were used to evaluate differences in cognitive performance between individuals with and without insomnia, as well as potential interactions between insomnia and the APOE genotype. Voxel-based morphometry and tract-based spatial statistics were used to assess between-group differences and potential interactions between insomnia and the APOE genotype in gray matter volume and white matter diffusion metrics. RESULTS Insomnia was reported by 615 out of 1683 participants (36.5%), including 137 out of 366 (37.4%) with T1-weighted structural imaging available and 119 out of 334 (35.6%) with diffusion-weighted imaging. Individuals with insomnia (n = 615) performed worse in executive function tests than non-insomniacs and displayed lower gray matter volume in left orbitofrontal and right middle temporal cortex, bilateral precuneus, posterior cingulate cortex and thalamus, higher gray matter volume in the left caudate nucleus, and widespread reduction of mean and axial diffusivity in right hemisphere white matter tracts. Insomnia interacted with the APOE genotype, with APOE-ε4 carriers displaying lower gray matter volumes when insomnia was present, but higher volumes when insomnia was not present, in several gray matter regions, including the left angular gyrus, the bilateral superior frontal gyri, the thalami, and the right hippocampus. CONCLUSIONS Insomnia in cognitively unimpaired adults at increased risk for AD is associated to poorer performance in some executive functions and volume changes in cortical and subcortical gray matter, including key areas involved in Alzheimer's disease, as well as decreased white matter diffusivity.
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Affiliation(s)
- Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Álex Iranzo
- Neurology Service, Hospital Clínic de Barcelona and Institut D'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08003, Barcelona, Spain. .,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain. .,Universitat Pompeu Fabra, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
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13
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Brugulat-Serrat A, Salvadó G, Operto G, Cacciaglia R, Sudre CH, Grau-Rivera O, Suárez-Calvet M, Falcon C, Sánchez-Benavides G, Gramunt N, Minguillon C, Fauria K, Barkhof F, Molinuevo JL, Gispert JD. White matter hyperintensities mediate gray matter volume and processing speed relationship in cognitively unimpaired participants. Hum Brain Mapp 2019; 41:1309-1322. [PMID: 31778002 PMCID: PMC7267988 DOI: 10.1002/hbm.24877] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/25/2019] [Accepted: 11/14/2019] [Indexed: 12/17/2022] Open
Abstract
White matter hyperintensities (WMH) have been extensively associated with cognitive impairment and reductions in gray matter volume (GMv) independently. This study explored whether WMH lesion volume mediates the relationship between cerebral patterns of GMv and cognition in 521 (mean age 57.7 years) cognitively unimpaired middle‐aged individuals. Episodic memory (EM) was measured with the Memory Binding Test and executive functions (EF) using five WAIS‐IV subtests. WMH were automatically determined from T2 and FLAIR sequences and characterized using diffusion‐weighted imaging (DWI) parameters. WMH volume was entered as a mediator in a voxel‐wise mediation analysis relating GMv and cognitive performance (with both EM and EF composites and the individual tests independently). The mediation model was corrected by age, sex, education, number of Apolipoprotein E (APOE)‐ε4 alleles and total intracranial volume. We found that even at very low levels of WMH burden in the cohort (median volume of 3.2 mL), higher WMH lesion volume was significantly associated with a widespread pattern of lower GMv in temporal, frontal, and cerebellar areas. WMH mediated the relationship between GMv and EF, mainly driven by processing speed, but not EM. DWI parameters in these lesions were compatible with incipient demyelination and axonal loss. These findings lead to the reflection on the relevance of the control of cardiovascular risk factors in middle‐aged individuals as a valuable preventive strategy to reduce or delay cognitive decline.
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Affiliation(s)
- Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, UCL, London, UK.,Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Frederik Barkhof
- Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK.,Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.,Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherland
| | - José L Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Juan D Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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14
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Grau-Rivera O, Operto G, Falcon C, Cacciaglia R, Sánchez-Benavides G, Brugulat-Serrat A, Gramunt N, Salvadó G, Suárez-Calvet M, Minguillón C, Gispert JD, Molinuevo JL. O1‐06‐03: CHARACTERIZATION OF COGNITIVE PERFORMANCE, GRAY MATTER VOLUME AND WHITE MATTER MICROSTRUCTURE IN COGNITIVELY UNIMPAIRED ADULTS WITH INSOMNIA SYMPTOMS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN) Madrid Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Marc Suárez-Calvet
- BarcelonaBeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Carolina Minguillón
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
- BarcelonaBeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina (CIBER-BBN) Madrid Spain
- Universitat Pompeu Fabra Barcelona Spain
| | - Jose Luis Molinuevo
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES) Madrid Spain
- BarcelonaBeta Brain Research Center (BBRC) Pasqual Maragall Foundation Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
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15
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Cacciaglia R, Gispert JD, Operto G, Falcón C, Gramunt N, Sánchez-Benavides G, Brugulat-Serrat A, Suárez-Calvet M, Grau-Rivera O, Blennow K, Zetterberg H, Molinuevo JL. O3-02-01: APOE -
ε4 ALLELIC LOAD MODULATES THE ASSOCIATION BETWEEN CSF BETA-AMYLOID AND GRAY MATTER VOLUME IN COGNITIVELY UNIMPAIRED INDIVIDUALS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Universitat Pompeu Fabra; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería; Biomateriales y Nanomedicina (CIBER-BBN); Madrid Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería; Biomateriales y Nanomedicina (CIBER-BBN); Madrid Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | | | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Marc Suárez-Calvet
- BarcelonaBeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory; Sahlgrenska University Hospital; Mölndal Sweden
- Institute of Neuroscience and Physiology; Sahlgrenska Academy at the University of Gothenburg; Gothenburg Sweden
| | - Jose Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Universitat Pompeu Fabra; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
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16
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Brugulat-Serrat A, Salvadó G, Operto G, Cacciaglia R, Sudre CH, Grau-Rivera O, Suárez-Calvet M, Falcon C, Sánchez-Benavides G, Gramunt N, Minguillon C, Fauria K, Barkhof F, Molinuevo JL, Gispert JD. P3-323: WHITE MATTER HYPERINTENSITIES MEDIATE THE RELATIONSHIP BETWEEN GRAY MATTER VOLUME AND EXECUTIVE FUNCTION IN COGNITIVELY UNIMPAIRED MIDDLE-AGED INDIVIDUALS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Grégory Operto
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Carole H. Sudre
- School of Biomedical Engineering and Imaging Sciences; King's College London; London United Kingdom
- Dementia Research Centre; UCL Queen Square Institute of Neurology; London United Kingdom
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Marc Suárez-Calvet
- BarcelonaBeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería; Biomateriales y Nanomedicina (CIBERBBN); Madrid Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
| | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
- Brain Repair and Rehabilitation; UCL Institute of Neurology; London United Kingdom
- Centre for Medical Imaging Computing, Faculty of Engineering; University College London; London United Kingdom
| | - Jose Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
- Universitat Pompeu Fabra; Barcelona Spain
| | - Juan Domingo Gispert
- BarcelonaBeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Universitat Pompeu Fabra; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería; Biomateriales y Nanomedicina (CIBER-BBN); Madrid Spain
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Cacciaglia R, Molinuevo JL, Falcón C, Sánchez-Benavides G, Brugulat-Serrat A, Gramunt N, Gispert JD. P1-396: APOE
-ε4 RISK VARIANT FOR ALZHEIMER'S DISEASE IMPACTS ON BRAIN STRUCTURAL NETWORKS IN COGNITIVELY UNIMPAIRED MIDDLE-AGED INDIVIDUALS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.1001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Jose Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Universitat Pompeu Fabra; Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES); Madrid Spain
| | - Carles Falcón
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Madrid Spain
| | | | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC); Pasqual Maragall Foundation; Barcelona Spain
- Universitat Pompeu Fabra; Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN); Madrid Spain
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Salvadó G, Molinuevo JL, Brugulat-Serrat A, Falcon C, Grau-Rivera O, Suárez-Calvet M, Pavía J, Niñerola-Baizán A, Perissinotti A, Lomeña F, Minguillon C, Fauria K, Zetterberg H, Blennow K, Gispert JD. O1‐10‐04: CENTILOID CUT‐OFF VALUES FOR OPTIMAL AGREEMENT BETWEEN AMYLOID PET AND CSF CORE AD BIOMARKERS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Gemma Salvadó
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
| | - Jose Luis Molinuevo
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable Madrid Spain
- Universitat Pompeu Fabra Barcelona Spain
| | | | - Carles Falcon
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina Madrid Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
| | - Javier Pavía
- Nuclear Medicine Department Hospital Clinic Barcelona Spain
| | | | | | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable Madrid Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
- Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable Madrid Spain
| | - Henrik Zetterberg
- UK Dementia Research Institute at University College London London United Kingdom
- Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry The Sahlgrenska Academy at University of Gothenburg Mölndal Sweden
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Department of Neurodegenerative Disease University College London, Institute of Neurology London United Kingdom
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory Sahlgrenska University Hospital Mölndal Sweden
- Institute of Neuroscience and Physiology The Sahlgrenska Academy at the University of Gothenburg Gothenburg Sweden
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center Pasqual Maragall Foundation Barcelona Spain
- Universitat Pompeu Fabra Barcelona Spain
- Centro de Investigación Biomédica en Red de Bioingeniería Biomateriales y Nanomedicina Madrid Spain
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19
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Salvadó G, Molinuevo JL, Brugulat-Serrat A, Falcon C, Grau-Rivera O, Suárez-Calvet M, Pavia J, Niñerola-Baizán A, Perissinotti A, Lomeña F, Minguillon C, Fauria K, Zetterberg H, Blennow K, Gispert JD. Centiloid cut-off values for optimal agreement between PET and CSF core AD biomarkers. Alzheimers Res Ther 2019; 11:27. [PMID: 30902090 PMCID: PMC6429814 DOI: 10.1186/s13195-019-0478-z] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 02/27/2019] [Indexed: 01/22/2023]
Abstract
BACKGROUND The Centiloid scale has been developed to standardize measurements of amyloid PET imaging. Reference cut-off values of this continuous measurement enable the consistent operationalization of decision-making for multicentre research studies and clinical trials. In this study, we aimed at deriving reference Centiloid thresholds that maximize the agreement against core Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers in two large independent cohorts. METHODS A total of 516 participants of the ALFA+ Study (N = 205) and ADNI (N = 311) underwent amyloid PET imaging ([18F]flutemetamol and [18F]florbetapir, respectively) and core AD CSF biomarker determination using Elecsys® tests. Tracer uptake was quantified in Centiloid units (CL). Optimal Centiloid cut-offs were sought that maximize the agreement between PET and dichotomous determinations based on CSF levels of Aβ42, tTau, pTau, and their ratios, using pre-established reference cut-off values. To this end, a receiver operating characteristic analysis (ROC) was conducted, and Centiloid cut-offs were calculated as those that maximized the Youden's J Index or the overall percentage agreement recorded. RESULTS All Centiloid cut-offs fell within the range of 25-35, except for CSF Aβ42 that rendered an optimal cut-off value of 12 CL. As expected, the agreement of tau/Aβ42 ratios was higher than that of CSF Aβ42. Centiloid cut-off robustness was confirmed even when established in an independent cohort and against variations of CSF cut-offs. CONCLUSIONS A cut-off of 12 CL matches previously reported values derived against postmortem measures of AD neuropathology. Together with these previous findings, our results flag two relevant inflection points that would serve as boundary of different stages of amyloid pathology: one around 12 CL that marks the transition from the absence of pathology to subtle pathology and another one around 30 CL indicating the presence of established pathology. The derivation of robust and generalizable cut-offs for core AD biomarkers requires cohorts with adequate representation of intermediate levels. TRIAL REGISTRATION ALFA+ Study, NCT02485730 ALFA PET Sub-study, NCT02685969.
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Affiliation(s)
- Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- CIBER de Bioengeniería, Biomateriales y Nanomedicina, Madrid, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
| | - Javier Pavia
- CIBER de Bioengeniería, Biomateriales y Nanomedicina, Madrid, Spain
- Nuclear Medicine Department, Hospital Clínic, Barcelona, Spain
- Instititut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | | | | | | | - Carolina Minguillon
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Wellington 30, 08005 Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Bioengeniería, Biomateriales y Nanomedicina, Madrid, Spain
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20
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Salvadó G, Brugulat-Serrat A, Sudre CH, Grau-Rivera O, Suárez-Calvet M, Falcon C, Fauria K, Cardoso MJ, Barkhof F, Molinuevo JL, Gispert JD. Spatial patterns of white matter hyperintensities associated with Alzheimer's disease risk factors in a cognitively healthy middle-aged cohort. Alzheimers Res Ther 2019; 11:12. [PMID: 30678723 PMCID: PMC6346579 DOI: 10.1186/s13195-018-0460-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [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: 09/18/2018] [Accepted: 12/18/2018] [Indexed: 11/17/2022]
Abstract
Background White matter hyperintensities (WMH) of presumed vascular origin have been associated with an increased risk of Alzheimer’s disease (AD). This study aims to describe the patterns of WMH associated with dementia risk estimates and individual risk factors in a cohort of middle-aged/late middle-aged individuals (mean 58 (interquartile range 51–64) years old). Methods Magnetic resonance imaging and AD risk factors were collected from 575 cognitively unimpaired participants. WMH load was automatically calculated in each brain lobe and in four equidistant layers from the ventricular surface to the cortical interface. Global volumes and regional patterns of WMH load were analyzed as a function of the Cardiovascular Risk Factors, Aging and Incidence of Dementia (CAIDE) dementia risk score, as well as family history of AD and Apolipoprotein E (APOE) genotype. Additional analyses were performed after correcting for the effect of age and hypertension. Results The studied cohort showed very low WMH burden (median 1.94 cm3) and 20-year dementia risk estimates (median 1.47 %). Even so, higher CAIDE scores were significantly associated with increased global WMH load. The main drivers of this association were age and hypertension, with hypercholesterolemia and body mass index also displaying a minor, albeit significant, influence. Regionally, CAIDE scores were positively associated with WMH in anterior areas, mostly in the frontal lobe. Age and hypertension showed significant association with WMH in almost all regions analyzed. The APOE-ε2 allele showed a protective effect over global WMH with a pattern that comprised juxtacortical temporo-occipital and fronto-parietal deep white matter regions. Participants with maternal family history of AD had higher WMH load than those without, especially in temporal and occipital lobes. Conclusions WMH load is associated with AD risk factors even in cognitively unimpaired subjects with very low WMH burden and dementia risk estimates. Our results suggest that tight control of modifiable risk factors in middle-age/late middle-age could have a significant impact on late-life dementia. Electronic supplementary material The online version of this article (10.1186/s13195-018-0460-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gemma Salvadó
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Carole H Sudre
- Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, University College London, London, UK.,Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - M Jorge Cardoso
- Engineering and Imaging Sciences, King's College London, London, UK.,Dementia Research Centre, University College London, London, UK
| | - Frederik Barkhof
- Centre for Medical Imaging Computing, Faculty of Engineering, University College London, London, UK.,Brain Repair and Rehabilitation, University College London, London, UK.,Radiology & Nuclear Medicine, VU University Medical Centre, Amsterdam, Netherlands
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Wellington 30, 08005, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain. .,Universitat Pompeu Fabra, Barcelona, Spain.
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21
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Cacciaglia R, Molinuevo JL, Sánchez-Benavides G, Falcón C, Gramunt N, Brugulat-Serrat A, Grau O, Gispert JD. Episodic memory and executive functions in cognitively healthy individuals display distinct neuroanatomical correlates which are differentially modulated by aging. Hum Brain Mapp 2018; 39:4565-4579. [PMID: 29972619 PMCID: PMC6220988 DOI: 10.1002/hbm.24306] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 11/21/2022] Open
Abstract
The neuroanatomical bases of episodic memory (EM) and executive functions (EFs) have been widely addressed in patients with brain damage and in individuals with neurologic disorders. These studies reported that larger brain structures support better outcomes in both cognitive domains, thereby supporting the “bigger is better” account. However, relatively few studies have explored the cerebral morphological properties underlying EM and EFs in cognitively healthy individuals and current findings indicate no unitary theoretical explanation for the structure–function relationship. Moreover, existing studies have typically restricted the analyses to a priori defined regions of interest. Here we conducted unbiased voxel‐wise analysis of the associations between regional gray as well as white matter volumes (GMv; WMv) and performance in both cognitive domains in a sample of 463 cognitively intact individuals. We found that efficiency in EM was predicted by lower GMv in brain areas belonging to the default‐mode network (DMN). By contrast, EFs performance was predicted by larger GMv in a distributed set of regions, which overlapped with the executive control network (ECN). Volume of white matter bundles supporting both cross‐cortical and interhemispheric connections was positively related to processing speed. Furthermore, aging modulated the relationship between regional volumes and cognitive performance in several areas including the hippocampus and frontal cortex. Our data extend the critical role of the DMN and ECN by showing that variability in their morphological properties, and not only their activation patterns, affects EM and EFs, respectively. Moreover, our finding that aging reverts these associations supports previously advanced theories of cognitive neurodevelopment.
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Affiliation(s)
- Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | | | - Carles Falcón
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Oriol Grau
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
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22
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Operto G, Cacciaglia R, Grau-Rivera O, Falcon C, Brugulat-Serrat A, Ródenas P, Ramos R, Morán S, Esteller M, Bargalló N, Molinuevo JL, Gispert JD. White matter microstructure is altered in cognitively normal middle-aged APOE-ε4 homozygotes. Alzheimers Res Ther 2018; 10:48. [PMID: 29793545 PMCID: PMC5968505 DOI: 10.1186/s13195-018-0375-x] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [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: 01/16/2018] [Accepted: 04/24/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND The ε4 allele of the apolipoprotein E gene (APOE-ε4) is the strongest genetic factor for late-onset Alzheimer's disease. During middle age, cognitively healthy APOE-ε4 carriers already show several brain alterations that resemble those of Alzheimer's disease (AD), but to a subtler degree. These include microstructural white matter (WM) changes that have been proposed as one of the earliest structural events in the AD cascade. However, previous studies have focused mainly on comparison of APOE-ε4 carriers vs noncarriers. Therefore, the extent and magnitude of the brain alterations in healthy ε4 homozygotes, who are the individuals at highest risk, remain to be characterized in detail. METHODS We examined mean, axial, and radial water diffusivity (MD, AxD, and RD, respectively) and fractional anisotropy in the WM as measured by diffusion-weighted imaging in 532 cognitively healthy middle-aged participants from the ALFA study (ALzheimer and FAmilies) cohort, a single-site population-based study enriched for AD risk (68 APOE-ε4 homozygotes, 207 heterozygotes, and 257 noncarriers). We examined the impact of age and APOE genotype on these parameters using tract-based spatial statistics. RESULTS Healthy APOE-ε4 homozygotes display increased WM diffusivity in regions known to be affected by AD. The effects in AxD were much smaller than in RD, suggesting a disruption of the myelin sheath rather than pure axonal damage. CONCLUSIONS These findings could be interpreted as the result of the reduced capacity of the ε4 isoform of the APOE protein to keep cholesterol homeostasis in the brain. Because cerebral lipid metabolism is strongly related to the pathogenesis of AD, our results shed light on the possible mechanisms through which the APOE-ε4 genotype is associated with an increased risk of AD.
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Affiliation(s)
- Grégory Operto
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain
| | - Raffaele Cacciaglia
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain
| | - Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain
| | - Carles Falcon
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain
| | - Pablo Ródenas
- Barcelona Supercomputing Center, Barcelona, Catalonia, Spain
| | - Rubén Ramos
- Barcelona Supercomputing Center, Barcelona, Catalonia, Spain
| | - Sebastián Morán
- Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona, Catalonia, Spain
| | - Manel Esteller
- Cancer Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona, Catalonia, Spain.,Departament de Ciències Fisiològiques II, Escola de Medicina, Universitat de Barcelona, Barcelona, Catalonia, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Catalonia, Spain
| | - Nuria Bargalló
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,Centre Mèdic Diagnòstic Alomar, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.,CIBER Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, C/ Wellington, 30, 08005, Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain.
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23
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Rojas S, Brugulat-Serrat A, Bargalló N, Minguillón C, Tucholka A, Falcon C, Carvalho A, Morán S, Esteller M, Gramunt N, Fauria K, Camí J, Molinuevo JL, Gispert JD. Higher prevalence of cerebral white matter hyperintensities in homozygous APOE-ɛ4 allele carriers aged 45-75: Results from the ALFA study. J Cereb Blood Flow Metab 2018; 38:250-261. [PMID: 28492093 PMCID: PMC5951016 DOI: 10.1177/0271678x17707397] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Cerebral white matter hyperintensities are believed the consequence of small vessel disease and are associated with risk and progression of Alzheimer's disease. The ɛ4 allele of the APOE gene is the major factor accountable for Alzheimer's disease heritability. However, the relationship between white matter hyperintensities and APOE genotype in healthy subjects remains controversial. We investigated the association between APOE-ɛ4 and vascular risk factors with white matter hyperintensities, and explored their interactions, in a cohort of cognitively healthy adults (45-75 years). White matter hyperintensities were assessed with the Fazekas Scale from magnetic resonance images (575 participants: 74 APOE-ɛ4 homozygotes, 220 heterozygotes and 281 noncarriers) and classified into normal (Fazekas < 2) and pathological (≥2). Stepwise logistic regression was used to study the association between pathological Fazekas and APOE genotype after correcting for cardiovascular and sociodemographic factors. APOE-ɛ4 homozygotes, but not heterozygotes, bear a significantly higher risk (OR 3.432; 95% CI [1.297-9.082]; p = 0.013) of displaying pathological white matter hyperintensities. As expected, aging, hypertension and cardiovascular and dementia risk scales were also positively associated to pathological white matter hyperintensities, but these did not modulate the effect of APOE-ɛ4/ɛ4. In subjects at genetic risk of developing Alzheimer's disease, the control of modifiable risk factors of white matter hyperintensities is of particular relevance to reduce or delay dementia's onset.
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Affiliation(s)
- Santiago Rojas
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,2 Faculty of Medicine, Department of Morphological Sciences, Unit of Human Anatomy and Embryology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Anna Brugulat-Serrat
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Nuria Bargalló
- 3 Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,4 Centre Mèdic Diagnòstic Alomar, Barcelona, Spain
| | - Carolina Minguillón
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Alan Tucholka
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Carles Falcon
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,5 Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
| | - Andreia Carvalho
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,6 MRC Center for Developmental Neurobiology, King's College London, London, UK
| | - Sebastian Morán
- 7 Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Manel Esteller
- 7 Epigenetics and Biology Program (PEBC), Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain.,8 Department of Physiological Sciences II, School of Medicine, University of Barcelona (UB), Barcelona, Spain.,9 Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Nina Gramunt
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Karine Fauria
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Jordi Camí
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,10 Universitat Pompeu Fabra, Barcelona, Spain
| | - José L Molinuevo
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,11 Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Juan D Gispert
- 1 Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain.,5 Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain.,10 Universitat Pompeu Fabra, Barcelona, Spain
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Brugulat-Serrat A, Rojas S, Bargalló N, Conesa G, Minguillón C, Fauria K, Gramunt N, Molinuevo JL, Gispert JD. Incidental findings on brain MRI of cognitively normal first-degree descendants of patients with Alzheimer's disease: a cross-sectional analysis from the ALFA (Alzheimer and Families) project. BMJ Open 2017; 7:e013215. [PMID: 28341686 PMCID: PMC5372150 DOI: 10.1136/bmjopen-2016-013215] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES To describe the prevalence of brain MRI incidental findings (IF) in a cohort of cognitively normal first-degree descendants of patients with Alzheimer's disease (AD). DESIGN Cross-sectional observational study. SETTING All scans were obtained with a 3.0 T scanner. Scans were evaluated by a single neuroradiologist and IF recorded and categorised. The presence of white matter hyperintensities (WMH) was determined with the Fazekas scale and reported as relevant if ≥2. PARTICIPANTS 575 participants (45-75 years) underwent high-resolution structural brain MRI. Participants were cognitively normal and scored over the respective cut-off values in all the following neuropsychological tests: Mini-Mental State Examination (≥26), Memory Impairment Screen (≥6), Time Orientation Subtest of the Barcelona Test II (≥68), verbal semantic fluency (naming animals ≥12). Clinical Dementia Rating (CDR) had to be 0. RESULTS 155 participants (27.0%) presented with at least one IF. Relevant WMH were present in 7.8% of the participants, and vascular abnormalities, cyst and brain volume loss in 10.7%, 3.1% and 6.9% of the study volunteers, respectively. Neoplastic brain findings were found in 2.4% of participants and within these, meningiomas were the most common (1.7%) and more frequently found in women. A positive correlation between increasing age and the presence of IF was found. Additionally, brain atrophy greater than that expected by age was significantly more prevalent in participants without a parental history of AD. CONCLUSIONS Brain MRIs of healthy middle-aged participants show a relatively high prevalence of IF even when study participants have been screened for subtle cognitive alterations. Most of our participants are first-degree descendants of patients with AD, and therefore these results are of special relevance for novel imaging studies in the context of AD prevention in cognitively healthy middle-aged participants. TRIAL REGISTRATION NUMBER NCT02198586.
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Affiliation(s)
- Anna Brugulat-Serrat
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Santiago Rojas
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Unit of Human Anatomy and Embryology, Faculty of Medicine, Department of Morphological Sciences, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Nuria Bargalló
- Magnetic Resonance Imaging Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centre Mèdic Diagnòstic Alomar, Barcelona, Spain
| | - Gerardo Conesa
- Servicio de Neurocirugía, Hospital del Mar, Barcelona, Spain
| | - Carolina Minguillón
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Karine Fauria
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Nina Gramunt
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza, Spain
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