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Mehta NH, Wang X, Keil SA, Xi K, Zhou L, Lee K, Tan W, Spector E, Goldan A, Kelly J, Karakatsanis NA, Mozley PD, Nehmeh S, Chazen JL, Morin S, Babich J, Ivanidze J, Pahlajani S, Tanzi EB, Saint-Louis L, Butler T, Chen K, Rusinek H, Carare RO, Li Y, Chiang GC, de Leon MJ. [1- 11C]-Butanol Positron Emission Tomography reveals an impaired brain to nasal turbinates pathway in aging amyloid positive subjects. Fluids Barriers CNS 2024; 21:30. [PMID: 38566110 PMCID: PMC10985958 DOI: 10.1186/s12987-024-00530-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/11/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Reduced clearance of cerebrospinal fluid (CSF) has been suggested as a pathological feature of Alzheimer's disease (AD). With extensive documentation in non-human mammals and contradictory human neuroimaging data it remains unknown whether the nasal mucosa is a CSF drainage site in humans. Here, we used dynamic PET with [1-11C]-Butanol, a highly permeable radiotracer with no appreciable brain binding, to test the hypothesis that tracer drainage from the nasal pathway reflects CSF drainage from brain. As a test of the hypothesis, we examined whether brain and nasal fluid drainage times were correlated and affected by brain amyloid. METHODS 24 cognitively normal subjects (≥ 65 years) were dynamically PET imaged for 60 min. using [1-11C]-Butanol. Imaging with either [11C]-PiB or [18F]-FBB identified 8 amyloid PET positive (Aβ+) and 16 Aβ- subjects. MRI-determined regions of interest (ROI) included: the carotid artery, the lateral orbitofrontal (LOF) brain, the cribriform plate, and an All-turbinate region comprised of the superior, middle, and inferior turbinates. The bilateral temporalis muscle and jugular veins served as control regions. Regional time-activity were used to model tracer influx, egress, and AUC. RESULTS LOF and All-turbinate 60 min AUC were positively associated, thus suggesting a connection between the brain and the nose. Further, the Aβ+ subgroup demonstrated impaired tracer kinetics, marked by reduced tracer influx and slower egress. CONCLUSION The data show that tracer kinetics for brain and nasal turbinates are related to each other and both reflect the amyloid status of the brain. As such, these data add to evidence that the nasal pathway is a potential CSF drainage site in humans. These data warrant further investigation of brain and nasal contributions to protein clearance in neurodegenerative disease.
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Affiliation(s)
- Neel H Mehta
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Harvard Medical School, Boston, MA, USA
| | - Xiuyuan Wang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Samantha A Keil
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Ke Xi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Liangdong Zhou
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Kevin Lee
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Weill Cornell Medicine, School of Medicine New York, New York, NY, USA
| | - Wanbin Tan
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Edward Spector
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- University of Michigan, Ann Arbor, MI, USA
| | - Amirhossein Goldan
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - James Kelly
- Department of Radiology, Molecule Imaging Innovations Institute, Weill Cornell Medicine, New York, NY, USA
| | | | - P David Mozley
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Radiopharm Theranostics, New York, NY, USA
| | - Sadek Nehmeh
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - J Levi Chazen
- Department of Radiology, Hospital for Special Surgery, New York, NY, USA
| | - Simon Morin
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | | | - Jana Ivanidze
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Silky Pahlajani
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Emily B Tanzi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | | | - Tracy Butler
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Kewei Chen
- College of Health Solutions, Arizona State University, Downtown Phoenix Campus, Arizona, USA
| | - Henry Rusinek
- Department of Radiology, NYU Langone Health, New York, NY, USA
| | - Roxana O Carare
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Yi Li
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
| | - Gloria C Chiang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA
- Department of Radiology, Weill Cornell Medicine, New York, NY, USA
| | - Mony J de Leon
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 East 61 Street, 10065, New York, NY, USA.
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Zhou L, Nguyen TD, Chiang GC, Wang XH, Xi K, Hu T, Tanzi EB, Butler TA, de Leon MJ, Li Y. Parenchymal CSF fraction is a measure of brain glymphatic clearance and positively associated with amyloid beta deposition on PET. Alzheimers Dement 2024; 20:2047-2057. [PMID: 38184796 PMCID: PMC10984424 DOI: 10.1002/alz.13659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION Mapping of microscopic changes in the perivascular space (PVS) of the cerebral cortex, beyond magnetic resonance-visible PVS in white matter, may enhance our ability to diagnose Alzheimer's disease (AD) early. METHODS We used the cerebrospinal fluid (CSF) water fraction (CSFF), a magnetic resonance imaging-based biomarker, to characterize brain parenchymal CSF water, reflecting microscopic PVS in parenchyma. We measured CSFF and amyloid beta (Aβ) using 11 C Pittsburgh compound B positron emission tomography to investigate their relationship at both the subject and voxel levels. RESULTS Our research has demonstrated a positive correlation between the parenchymal CSFF, a non-invasive imaging biomarker indicative of parenchymal glymphatic clearance, and Aβ deposition, observed at both individual and voxel-based assessments in the posterior cingulate cortex. DISCUSSION This study shows that an increased parenchymal CSFF is associated with Aβ deposition, suggesting that CSFF could serve as a biomarker for brain glymphatic clearance, which can be used to detect early fluid changes in PVS predisposing individuals to the development of AD. HIGHLIGHTS Cerebrospinal fluid fraction (CSFF) could be a biomarker of parenchymal perivascular space. CSFF is positively associated with amyloid beta (Aβ) deposition at subject level. CSFF in an Aβ+ region is higher than in an Aβ- region in the posterior cingulate cortex. Correspondence is found between Aβ deposition and glymphatic clearance deficits measured by CSFF.
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Affiliation(s)
- Liangdong Zhou
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Thanh D. Nguyen
- Department of RadiologyMRI Research Institute (MRIRI)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Gloria C. Chiang
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
- Department of RadiologyDivision of NeuroradiologyWeill Cornell MedicineNew York‐Presbyterian HospitalNew YorkNew YorkUSA
| | - Xiuyuan H. Wang
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Ke Xi
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Tsung‐Wei Hu
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Emily B. Tanzi
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Tracy A. Butler
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Mony J. de Leon
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
| | - Yi Li
- Department of RadiologyBrain Health Imaging Institute (BHII)Weill Cornell MedicineNew YorkNew YorkUSA
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3
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Zhou L, Butler TA, Wang XH, Xi K, Tanzi EB, Glodzik L, Chiang GC, de Leon MJ, Li Y. Multimodal assessment of brain fluid clearance is associated with amyloid-beta deposition in humans. J Neuroradiol 2023:S0150-9861(23)00261-4. [PMID: 37907155 PMCID: PMC11058119 DOI: 10.1016/j.neurad.2023.10.009] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/09/2023] [Accepted: 10/28/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE The present study investigates a multimodal imaging assessment of glymphatic function and its association with brain amyloid-beta deposition. METHODS Two brain CSF clearance measures (vCSF and DTI-ALPS) were derived from dynamic PET and MR diffusion tensor imaging (DTI) for 50 subjects, 24/50 were Aβ positive (Aβ+). T1W, T2W, DTI, T2FLAIR, and 11C-PiB and 18F-MK-6240 PET were acquired. Multivariate linear regression models were assessed with both vCSF and DTI-ALPS as independent variables and brain Aβ as the dependent variable. Three types of models were evaluated, including the vCSF-only model, the ALPS-only model and the vCSF+ALPS combined model. Models were applied to the whole group, and Aβ subgroups. All analyses were controlled for age, gender, and intracranial volume. RESULTS Sample demographics (N=50) include 20 males and 30 females with a mean age of 69.30 (sd=8.55). Our results show that the combination of vCSF and ALPS associates with Aβ deposition (p < 0.05, R2 = 0.575) better than either vCSF (p < 0.05, R2 = 0.431) or ALPS (p < 0.05, R2 = 0.372) alone in the Aβ+ group. We observed similar results in whole-group analyses (combined model: p < 0.05, R2 = 0.287; vCSF model: p <0.05, R2 = 0.175; ALPS model: p < 0.05, R2 = 0.196) with less significance. Our data also showed that vCSF has higher correlation (r = -0.548) in subjects with mild Aβ deposition and DTI-ALPS has higher correlation (r=-0.451) with severe Aβ deposition subjects. CONCLUSION The regression model with both vCSF and DTI-ALPS is better associated with brain Aβ deposition. These two independent brain clearance measures may better explain the variation in Aβ deposition than either term individually. Our results suggest that vCSF and DTI-ALPS reflect complementary aspects of brain clearance functions.
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Affiliation(s)
- Liangdong Zhou
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Tracy A Butler
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Xiuyuan H Wang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Ke Xi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Emily B Tanzi
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Lidia Glodzik
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Gloria C Chiang
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Mony J de Leon
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States
| | - Yi Li
- Department of Radiology, Brain Health Imaging Institute, Weill Cornell Medicine, 407 E 61st St, Feil 2, New York, NY 10065, United States.
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Li Y, Rusinek H, Butler T, Glodzik L, Pirraglia E, Babich J, Mozley PD, Nehmeh S, Pahlajani S, Wang X, Tanzi EB, Zhou L, Strauss S, Carare RO, Theise N, Okamura N, de Leon MJ. Decreased CSF clearance and increased brain amyloid in Alzheimer's disease. Fluids Barriers CNS 2022; 19:21. [PMID: 35287702 PMCID: PMC8919541 DOI: 10.1186/s12987-022-00318-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 02/21/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In sporadic Alzheimer's disease (AD), brain amyloid-beta (Aβ) deposition is believed to be a consequence of impaired Aβ clearance, but this relationship is not well established in living humans. CSF clearance, a major feature of brain glymphatic clearance (BGC), has been shown to be abnormal in AD murine models. MRI phase contrast and intrathecally delivered contrast studies have reported reduced CSF flow in AD. Using PET and tau tracer 18F-THK5117, we previously reported that the ventricular CSF clearance of the PET tracer was reduced in AD and associated with elevated brain Aβ levels. METHODS In the present study, we use two PET tracers, 18F-THK5351 and 11C-PiB to estimate CSF clearance calculated from early dynamic PET frames in 9 normal controls and 15 AD participants. RESULTS we observed that the ventricular CSF clearance measures were correlated (r = 0.66, p < 0.01), with reductions in AD of 18 and 27%, respectively. We also replicated a significant relationship between ventricular CSF clearance (18F-THK5351) and brain Aβ load (r = - 0.64, n = 24, p < 0.01). With a larger sample size, we extended our observations to show that reduced CSF clearance is associated with reductions in cortical thickness and cognitive performance. CONCLUSIONS Overall, the findings support the hypothesis that failed CSF clearance is a feature of AD that is related to Aβ deposition and to the pathology of AD. Longitudinal studies are needed to determine whether failed CSF clearance is a predictor of progressive amyloidosis or its consequence.
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Affiliation(s)
- Yi Li
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA.
| | - Henry Rusinek
- Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - Tracy Butler
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Lidia Glodzik
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Elizabeth Pirraglia
- Department of Psychiatry, New York University School of Medicine, New York, NY, USA
| | - John Babich
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - P David Mozley
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Sadek Nehmeh
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Silky Pahlajani
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Xiuyuan Wang
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Emily B Tanzi
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Liangdong Zhou
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Sara Strauss
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA
| | - Roxana O Carare
- Department of Clinical Neuroanatomy, University of Southampton, Southampton, UK
| | - Neil Theise
- Department of Pathology, New York University School of Medicine, New York, NY, USA
| | - Nobuyuki Okamura
- Division of Pharmacology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Mony J de Leon
- Department of Radiology, Weill Cornell Medicine, Cornell University, Brain Health Imaging Institute, 407 East 61 Street, New York, NY, 10021, USA.
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5
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Liu Y, Wang G, Cao C, Zhang G, Tanzi EB, Zhang Y, Zhou W, Li Y. Neuromodulation Effect of Very Low Intensity Transcranial Ultrasound Stimulation on Multiple Nuclei in Rat Brain. Front Aging Neurosci 2021; 13:656430. [PMID: 33935688 PMCID: PMC8081960 DOI: 10.3389/fnagi.2021.656430] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 01/20/2021] [Accepted: 03/02/2021] [Indexed: 11/13/2022] Open
Abstract
Objective Low-intensity transcranial ultrasound stimulation (TUS) is a non-invasive neuromodulation technique with high spatial resolution and feasible penetration depth. To date, the mechanisms of TUS modulated neural oscillations are not fully understood. This study designed a very low acoustic intensity (AI) TUS system that produces considerably reduced AI Ultrasound pulses (ISPTA < 0.5 W/cm2) when compared to previous methods used to measure regional neural oscillation patterns under different TUS parameters. Methods We recorded the local field potential (LFP) of five brain nuclei under TUS with three groups of simulating parameters. Spectrum estimation, time-frequency analysis (TFA), and relative power analysis methods have been applied to investigate neural oscillation patterns under different stimulation parameters. Results Under PRF, 500 Hz and 1 kHz TUS, high-amplitude LFP activity with the auto-rhythmic pattern appeared in selected nuclei when ISPTA exceeded 12 mW/cm2. With TFA, high-frequency energy (slow gamma and high gamma) was significantly increased during the auto-rhythmic patterns. We observed an initial plateau in nuclei response when ISPTA reached 16.4 mW/cm2 for RPF 500 Hz and 20.8 mW/cm2 for RPF 1 kHz. The number of responding nuclei started decreasing while ISPTA continued increasing. Under 1.5 kHz TUS, no auto-rhythmic patterns have been observed, but slow frequency power was increased during TUS. TUS inhibited most of the frequency band and generated obvious slow waves (theta and delta band) when stimulated at RPF = 1.5 kHz, ISPTA = 8.8 mW/cm2. Conclusion These results demonstrate that very low intensity Transcranial Ultrasound Stimulation (VLTUS) exerts significant neuromodulator effects under specific parameters in rat models and may be a valid tool to study neuronal physiology.
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Affiliation(s)
- Yingjian Liu
- School of Microelectronics, Shandong University, Jinan, China
| | - Gang Wang
- School of Microelectronics, Shandong University, Jinan, China
| | - Chao Cao
- School of Microelectronics, Shandong University, Jinan, China
| | - Gaorui Zhang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China.,School of Medical Imaging, Weifang Medical University, Weifang, China
| | | | - Yang Zhang
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Weidong Zhou
- School of Microelectronics, Shandong University, Jinan, China
| | - Yi Li
- Weill Cornell Medicine, New York, NY, United States
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6
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Varga AW, Wohlleber ME, Giménez S, Romero S, Alonso JF, Ducca EL, Kam K, Lewis C, Tanzi EB, Tweardy S, Kishi A, Parekh A, Fischer E, Gumb T, Alcolea D, Fortea J, Lleó A, Blennow K, Zetterberg H, Mosconi L, Glodzik L, Pirraglia E, Burschtin OE, de Leon MJ, Rapoport DM, Lu SE, Ayappa I, Osorio RS. Reduced Slow-Wave Sleep Is Associated with High Cerebrospinal Fluid Aβ42 Levels in Cognitively Normal Elderly. Sleep 2016; 39:2041-2048. [PMID: 27568802 DOI: 10.5665/sleep.6240] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [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: 03/16/2016] [Accepted: 07/05/2016] [Indexed: 12/13/2022] Open
Abstract
STUDY OBJECTIVES Emerging evidence suggests a role for sleep in contributing to the progression of Alzheimer disease (AD). Slow wave sleep (SWS) is the stage during which synaptic activity is minimal and clearance of neuronal metabolites is high, making it an ideal state to regulate levels of amyloid beta (Aβ). We thus aimed to examine relationships between concentrations of Aβ42 in the cerebrospinal fluid (CSF) and measures of SWS in cognitively normal elderly subjects. METHODS Thirty-six subjects underwent a clinical and cognitive assessment, a structural MRI, a morning to early afternoon lumbar puncture, and nocturnal polysomnography. Correlations and linear regression analyses were used to assess for associations between CSF Aβ42 levels and measures of SWS controlling for potential confounders. Resulting models were compared to each other using ordinary least squared linear regression analysis. Additionally, the participant sample was dichotomized into "high" and "low" Aβ42 groups to compare SWS bout length using survival analyses. RESULTS A significant inverse correlation was found between CSF Aβ42 levels, SWS duration and other SWS characteristics. Collectively, total SWA in the frontal lead was the best predictor of reduced CSF Aβ42 levels when controlling for age and ApoE status. Total sleep time, time spent in NREM1, NREM2, or REM sleep were not correlated with CSF Aβ42. CONCLUSIONS In cognitively normal elderly, reduced and fragmented SWS is associated with increases in CSF Aβ42, suggesting that disturbed sleep might drive an increase in soluble brain Aβ levels prior to amyloid deposition.
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Affiliation(s)
- Andrew W Varga
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY
| | - Margaret E Wohlleber
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Sandra Giménez
- Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Spain
| | - Sergio Romero
- Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Spain.,Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politecnica de Catalunya (UPC), Barcelona, Spain
| | - Joan F Alonso
- Departament d'Enginyeria de Sistemes, Automàtica i Informàtica Industrial, Universitat Politecnica de Catalunya (UPC), Barcelona, Spain.,Escola Universitària d'Enginyeria Tècnica Industrial de Barcelona, UPC, Barcelona, Spain.,CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Emma L Ducca
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY
| | - Korey Kam
- The Nathan Kline Institute for Psychiatric Research, Orangeburg, NY
| | - Clifton Lewis
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY.,Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Emily B Tanzi
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Samuel Tweardy
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Akifumi Kishi
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Ankit Parekh
- NYU Polytechnic School of Engineering, Brooklyn, NY
| | - Esther Fischer
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Tyler Gumb
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY.,Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Daniel Alcolea
- Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Spain
| | - Juan Fortea
- Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED
| | - Alberto Lleó
- Department of Neurology, Hospital de la Santa Creu i Sant Pau-Biomedical Research Institute Sant Pau- Universitat Autònoma de Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas, CIBERNED
| | - Kaj Blennow
- Institute of Neuroscience and Psychiatry, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Institute of Neuroscience and Psychiatry, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Lisa Mosconi
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Lidia Glodzik
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Elizabeth Pirraglia
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - Omar E Burschtin
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY
| | - Mony J de Leon
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
| | - David M Rapoport
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY
| | - Shou-En Lu
- Department of Biostatistics, Rutgers School of Public Health, Piscataway, NJ
| | - Indu Ayappa
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU Langone Medical Center, New York, NY
| | - Ricardo S Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY
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7
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Osorio RS, Ducca EL, Wohlleber ME, Tanzi EB, Gumb T, Twumasi A, Tweardy S, Lewis C, Fischer E, Koushyk V, Cuartero-Toledo M, Sheikh MO, Pirraglia E, Zetterberg H, Blennow K, Lu SE, Mosconi L, Glodzik L, Schuetz S, Varga AW, Ayappa I, Rapoport DM, de Leon MJ. Orexin-A is Associated with Increases in Cerebrospinal Fluid Phosphorylated-Tau in Cognitively Normal Elderly Subjects. Sleep 2016; 39:1253-60. [PMID: 26951396 DOI: 10.5665/sleep.5846] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [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: 08/27/2015] [Accepted: 02/07/2016] [Indexed: 11/03/2022] Open
Abstract
STUDY OBJECTIVES To evaluate the role of orexin-A with respect to cerebrospinal fluid (CSF) Alzheimer disease (AD) biomarkers, and explore its relationship to cognition and sleep characteristics in a group of cognitively normal elderly individuals. METHODS Subjects were recruited from multiple community sources for National Institutes of Health supported studies on normal aging, sleep and CSF biomarkers. Sixty-three participants underwent home monitoring for sleep-disordered breathing, clinical, sleep and cognitive evaluations, as well as a lumbar puncture to obtain CSF. Individuals with medical history or with magnetic resonance imaging evidence of disorders that may affect brain structure or function were excluded. Correlation and linear regression analyses were used to assess the relationship between orexin-A and CSF AD-biomarkers controlling for potential sociodemographic and sleep confounders. RESULTS Levels of orexin-A, amyloid beta 42 (Aβ42), phosphorylated-tau (P-Tau), total-tau (T-Tau), Apolipoprotein E4 status, age, years of education, reported total sleep time, number of awakenings, apnea-hypopnea indices (AHI), excessive daytime sleepiness, and a cognitive battery were analyzed. Subjects were 69.59 ± 8.55 years of age, 57.1% were female, and 30.2% were apolipoprotein E4+. Orexin-A was positively correlated with Aβ42, P-Tau, and T-Tau. The associations between orexin-A and the AD-biomarkers were driven mainly by the relationship between orexin-A and P-Tau and were not influenced by other clinical or sleep characteristics that were available. CONCLUSIONS Orexin-A is associated with increased P-Tau in normal elderly individuals. Increases in orexin-A and P-Tau might be a consequence of the reduction in the proportion of the deeper, more restorative slow wave sleep and rapid eye movement sleep reported with aging. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov registration number NCT01962779.
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Affiliation(s)
| | - Emma L Ducca
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine, New York, NY
| | | | - Emily B Tanzi
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Tyler Gumb
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Akosua Twumasi
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Samuel Tweardy
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Clifton Lewis
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Esther Fischer
- Department of Neuroscience, JFK Medical Center, Edison, NJ
| | | | | | | | | | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,UCL Institute of Neurology, Queen Square, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Shou-En Lu
- Department of Biostatistics, Rutgers School of Public Health, Piscataway, NJ
| | - Lisa Mosconi
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Lidia Glodzik
- Center for Brain Health, NYU School of Medicine, New York, NY
| | - Sonja Schuetz
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine, New York, NY
| | - Andrew W Varga
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine, New York, NY
| | - Indu Ayappa
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine, New York, NY
| | - David M Rapoport
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine, New York, NY
| | - Mony J de Leon
- Center for Brain Health, NYU School of Medicine, New York, NY
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