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Bovenzi R, Schirinzi T, Conti M, Sancesario GM, Zenuni H, Simonetta C, Bissacco J, Mascioli D, Pieri M, Cerroni R, Stefani A, Mercuri NB, Pierantozzi M. A biological characterization of patients with postmenopausal Parkinson's disease. J Neurol 2024:10.1007/s00415-024-12258-8. [PMID: 38492015 DOI: 10.1007/s00415-024-12258-8] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/18/2024]
Abstract
Menopause increases the risk for Parkinson's disease (PD), although the underlying biological mechanisms have not been established in patients. Here, we aimed to understand the basis of menopause-related vulnerability to PD. Main motor and non-motor scores, blood levels of estradiol, testosterone, follicle-stimulating hormone, and luteinizing hormone, CSF levels of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181-tau were examined in 45 women with postmenopausal-onset PD and 40 age-matched controls. PD patients had higher testosterone and lower estradiol levels than controls, and the residual estradiol production was associated with milder motor disturbances and lower dopaminergic requirements. In PD but not in controls, follicle-stimulating hormone levels correlated with worse cognitive scores and CSF markers of amyloidopathy and neuronal loss. In conclusion, menopause-related hormonal changes might differentially contribute to clinical-pathological trajectories of PD, accounting for the peculiar vulnerability to the disease.
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Affiliation(s)
- Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Matteo Conti
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Henri Zenuni
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Jacopo Bissacco
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Davide Mascioli
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Clinical Biochemistry, Tor Vergata University Hospital, Rome, Italy
| | - Rocco Cerroni
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Mariangela Pierantozzi
- Unit of Neurology, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Zenuni H, Bovenzi R, Bissacco J, Grillo P, Simonetta C, Mascioli D, Pieri M, Bernardini S, Sancesario GM, Stefani A, Mercuri NB, Schirinzi T. Clinical and neurochemical correlates of the APOE genotype in early-stage Parkinson's disease. Neurobiol Aging 2023; 131:24-28. [PMID: 37572524 DOI: 10.1016/j.neurobiolaging.2023.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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] [Received: 05/23/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 08/14/2023]
Abstract
Emerging evidence indicates that apolipoprotein E (APOE) genotype may influence Parkinson's disease (PD) course, although clinical and neurochemical correlates have not been completely established. This study aimed to determine the associations of APOE genotypes (ε4 vs. non-ε4) with cerebrospinal fluid (CSF) neurodegeneration biomarkers and clinical parameters in early-stage PD patients. One hundred and seventy-five PD patients and 89 non-neurodegenerative controls grouped in APOE-ε4 carriers (28 PD; 12 controls) and non-APOE-ε4 carriers (147 PD; 78 controls) were enrolled. CSF levels of amyloid-β-42, amyloid-β-40, total and 181-phosphorylated tau, and clinical scores were compared among groups adjusting for main covariates. APOE genotypes prevalence was similar in PD and controls. PD APOE-ε4 carriers had lower amyloid-β-42 CSF levels than PD non-APOE-ε4 carriers and controls, independently from age. PD APOE-ε4 carriers also had higher total and "item 5" (attention and memory) non-motor symptoms scale scores than PD non-APOE-ε4 carriers, independently from confounding factors. APOE-ε4 genotype might thus account for a more vulnerable PD subtype characterized by prominent amyloidopathy and a greater burden of non-motor symptoms in the early disease stages. DATA AVAILABILITY: Data are available upon reasonable request.
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Affiliation(s)
- Henri Zenuni
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Jacopo Bissacco
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Piergiorgio Grillo
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Davide Mascioli
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Massimo Pieri
- Clinical Biochemistry Unit, Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Segio Bernardini
- Clinical Biochemistry Unit, Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
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Brunelli S, Giannella E, Bizzaglia M, De Angelis D, Sancesario GM. Secondary neurodegeneration following Stroke: what can blood biomarkers tell us? Front Neurol 2023; 14:1198216. [PMID: 37719764 PMCID: PMC10502514 DOI: 10.3389/fneur.2023.1198216] [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: 03/31/2023] [Accepted: 08/14/2023] [Indexed: 09/19/2023] Open
Abstract
Stroke is one of the leading causes of death and the primary source of disability in adults, resulting in neuronal necrosis of ischemic areas, and in possible secondary degeneration of regions surrounding or distant to the initial damaged area. Secondary neurodegeneration (SNDG) following stroke has been shown to have different pathogenetic origins including inflammation, neurovascular response and cytotoxicity, but can be associated also to regenerative processes. Aside from focal neuronal loss, ipsilateral and contralateral effects distal to the lesion site, disruptions of global functional connectivity and a transcallosal diaschisis have been reported in the chronic stages after stroke. Furthermore, SNDG can be observed in different areas not directly connected to the primary lesion, such as thalamus, hippocampus, amygdala, substantia nigra, corpus callosum, bilateral inferior fronto-occipital fasciculus and superior longitudinal fasciculus, which can be highlighted by neuroimaging techniques. Although the clinical relevance of SNDG following stroke has not been well understood, the identification of specific biomarkers that reflect the brain response to the damage, is of paramount importance to investigate in vivo the different phases of stroke. Actually, brain-derived markers, particularly neurofilament light chain, tau protein, S100b, in post-stroke patients have yielded promising results. This review focuses on cerebral morphological modifications occurring after a stroke, on associated cellular and molecular changes and on state-of-the-art of biomarkers in acute and chronic phase. Finally, we discuss new perspectives regarding the implementation of blood-based biomarkers in clinical practice to improve the rehabilitation approaches and post stroke recovery.
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Affiliation(s)
- Stefano Brunelli
- NeuroRehabilitation Unit 4, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Emilia Giannella
- Clinical Neurochemistry Unit and Biobank, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Mirko Bizzaglia
- Radiology and Diagnostic Imaging Unit, IRCCS Santa Lucia Foundation, Rome, Italy
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Toniolo S, Di Lorenzo F, Bernardini S, Mercuri NB, Sancesario GM. Blood-Brain Barrier Dysfunction and Aβ42/40 Ratio Dose-Dependent Modulation with the ApoE Genotype within the ATN Framework. Int J Mol Sci 2023; 24:12151. [PMID: 37569528 PMCID: PMC10418506 DOI: 10.3390/ijms241512151] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 08/13/2023] Open
Abstract
The definition of Alzheimer's disease (AD) now considers the presence of the markers of amyloid (A), tau deposition (T), and neurodegeneration (N) essential for diagnosis. AD patients have been reported to have increased blood-brain barrier (BBB) dysfunction, but that has not been tested within the ATN framework so far. As the field is moving towards the use of blood-based biomarkers, the relationship between BBB disruption and AD-specific biomarkers requires considerable attention. Moreover, other factors have been previously implicated in modulating BBB permeability, including age, gender, and ApoE status. A total of 172 cognitively impaired individuals underwent cerebrospinal fluid (CSF) analysis for AD biomarkers, and data on BBB dysfunction, demographics, and ApoE status were collected. Our data showed that there was no difference in BBB dysfunction across different ATN subtypes, and that BBB damage was not correlated with cognitive impairment. However, patients with BBB disruption, if measured with a high Qalb, had low Aβ40 levels. ApoE status did not affect BBB function but had a dose-dependent effect on the Aβ42/40 ratio. These results might highlight the importance of understanding dynamic changes across the BBB in future studies in patients with AD.
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Affiliation(s)
- Sofia Toniolo
- Cognitive Neurology Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX1 3AZ, UK
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Francesco Di Lorenzo
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
- Non-Invasive Brain Simulation Unit, IRCSS Santa Lucia Foundation, 00179 Rome, Italy
| | - Sergio Bernardini
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
| | - Giulia Maria Sancesario
- Department of Systems Medicine, University of Rome ‘Tor Vergata’, 00133 Rome, Italy (G.M.S.)
- Biobank Unit, IRCSS Santa Lucia Foundation, 00179 Rome, Italy
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Grillo P, Sancesario GM, Bovenzi R, Zenuni H, Bissacco J, Mascioli D, Simonetta C, Forti P, Degoli GR, Pieri M, Chiurchiù V, Stefani A, Mercuri NB, Schirinzi T. Neutrophil-to-lymphocyte ratio and lymphocyte count reflect alterations in central neurodegeneration-associated proteins and clinical severity in Parkinson Disease patients. Parkinsonism Relat Disord 2023; 112:105480. [PMID: 37290213 DOI: 10.1016/j.parkreldis.2023.105480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/29/2023] [Accepted: 05/31/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Peripheral inflammation has been recently associated to Parkinson disease (PD). However, how the peripheral inflammatory immune response could affect the clinical-pathological features of the disease is not fully understood. In this study, we assessed the peripheral immune profile of a well-characterized PD cohort, examining several correlations with CSF biomarkers of neurodegeneration and the main clinical parameters, aimed at better elucidating the complex dynamics of the brain-periphery interactions in PD. METHODS The leukocyte populations counts (neutrophils, lymphocytes, monocytes, eosinophils, and basophils) and the neutrophil-to-lymphocyte ratio (NLR) were collected and compared in 61 PD patients and 60 sex/age matched controls (CTRLs). Immune parameters were correlated with CSF levels of total α-synuclein, amyloid-β-42, total and phosphorylated-tau and main motor and non-motor scores. RESULTS PD patients had lower lymphocyte and higher NLR counts compared to CTRLs. In PD patients, the lymphocyte count directly correlated with CSF α-synuclein levels, whereas NLR displayed an inverse correlation with the CSF amyloid-β42 levels. The lymphocyte count also negatively correlated with HY stage, while NLR positively with the disease duration. CONCLUSIONS This study provided in vivo evidence that, in PD, changes in leukocytes in the periphery, assessed as relative lymphopenia and NLR increase, reflect in central neurodegeneration-associated proteins modifications, especially in α-synuclein and amyloid-β pathways, and greater clinical burden.
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Affiliation(s)
- Piergiorgio Grillo
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | | | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Henri Zenuni
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Jacopo Bissacco
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Davide Mascioli
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Clara Simonetta
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Paolo Forti
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Rebecca Degoli
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Valerio Chiurchiù
- Institute of Translational Pharmacology, National Research Council, Rome, Italy; Laboratory of Resolution of Neuroinflammation, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Alessandro Stefani
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Experimental Neurology Unit, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
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6
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Bovenzi R, Sancesario GM, Conti M, Grillo P, Cerroni R, Bissacco J, Forti P, Giannella E, Pieri M, Minosse S, Ferrazzoli V, Pucci N, Laudazi M, Floris R, Garaci F, Pierantozzi M, Stefani A, Mercuri NB, Picchi E, Di Giuliano F, Schirinzi T. Sex hormones differentially contribute to Parkinson's disease in males: a multimodal biomarker study. Eur J Neurol 2023. [PMID: 36971787 DOI: 10.1111/ene.15801] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND AND PURPOSE Parkinson disease (PD) presents relevant sex-related differences in epidemiology, pathophysiology, and clinical features, with males being more vulnerable to the disease. Sex hormones might have a role, as the experimental models suggest; however, human-based evidence is scarce. Here, we integrated multimodal biomarkers to investigate the relationships between circulating sex hormones and clinical-pathological features in male PD patients. METHODS A cohort of 63 male PD patients underwent comprehensive clinical evaluation of motor and nonmotor disturbances; measurement of estradiol, testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) blood levels; and cerebrospinal fluid (CSF) assay of total α-synuclein, amyloid-β-42, amyloid-β-40, total tau, and phosphorylated-181 tau levels. A subgroup of 47 PD patients underwent brain volumetry by 3-T magnetic resonance imaging for further correlations. A control group of 56 age-matched individuals was enrolled for comparative analyses. RESULTS Male PD patients had higher estradiol and testosterone levels than controls. Estradiol had independent inverse associations with Movement Disorder Society-Unified Parkinson's Disease Rating Scale Part 3 score and disease duration; it was also lower in nonfluctuating patients. Testosterone had inverse independent correlations with CSF α-synuclein and right globus pallidus volume. FSH and LH had age-dependent correlations with cognitive impairment and CSF amyloid-β-42/amyloid-β-40 ratio. CONCLUSIONS The study suggested that sex hormones could differentially contribute to clinical-pathological features of PD in male patients. Whereas estradiol might have a protective role in motor impairment, testosterone might be involved in male vulnerability to PD neuropathology. Gonadotropins instead might mediate age-dependent phenomena of amyloidopathy and cognitive decline.
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Affiliation(s)
- Roberta Bovenzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Matteo Conti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Piergiorgio Grillo
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Rocco Cerroni
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Jacopo Bissacco
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Paolo Forti
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Emilia Giannella
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Rome "Tor Vergata", Rome, Italy
- Department of Clinical Biochemistry, Tor Vergata University Hospital, Rome, Italy
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Noemi Pucci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Mario Laudazi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Mariangela Pierantozzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Alessandro Stefani
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- Parkinson Centre Unit, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
- IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Grillo P, Sancesario GM, Mascioli D, Geusa L, Zenuni H, Giannella E, Della Morte D, Mercuri NB, Schirinzi T. Constipation distinguishes different clinical-biochemical patterns in de novo Parkinson's disease. Parkinsonism Relat Disord 2022; 102:64-67. [DOI: 10.1016/j.parkreldis.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022]
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Schirinzi T, Zenuni H, Grillo P, Bovenzi R, Guerrera G, Gargano F, Pieri M, Bernardini S, Biagio Mercuri N, Battistini L, Sancesario GM. Tau and Amyloid-β Peptides in Serum of Patients With Parkinson's Disease: Correlations With CSF Levels and Clinical Parameters. Front Neurol 2022; 13:748599. [PMID: 35280296 PMCID: PMC8914101 DOI: 10.3389/fneur.2022.748599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 07/28/2021] [Accepted: 01/18/2022] [Indexed: 12/13/2022] Open
Abstract
Relevance of blood-based biomarkers is increasing into the neurodegenerative diseases field, but data on Parkinson's disease (PD) remain still scarce. In this study, we used the SiMoA technique to measure serum content of total tau protein and amyloid-β peptides (Aβ-42, Aβ-40) in 22 PD patients and ten control subjects. Serum levels of each biomarker were correlated with the respective CSF levels in both the groups; in PD patients, also the correlations between serum biomarkers and main clinical parameters were tested (motor, non-motor, cognitive scores and levodopa equivalent daily dose). Serum biomarkers did not exhibit quantitative differences between patients and controls; however, only PD patients had inter-fluids (serum-CSF) associations in tau and amyloid-β-42 levels. Moreover, serum content of tau protein was inversely correlated with cognitive performances (MoCA score). These findings, albeit preliminary, indicate that brain-derived peptides may change in parallel in both peripheral blood and CSF of PD patients, eventually even in association with some clinical features. Further studies are now needed to validate the use of blood-based biomarkers in PD.
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Affiliation(s)
- Tommaso Schirinzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
- *Correspondence: Tommaso Schirinzi
| | - Henri Zenuni
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Piergiorgio Grillo
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Roberta Bovenzi
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Gisella Guerrera
- European Centre for Brain Research, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Francesca Gargano
- European Centre for Brain Research, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Massimo Pieri
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Unit of Neurology, Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
- European Centre for Brain Research, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Luca Battistini
- European Centre for Brain Research, IRCCS Fondazione Santa Lucia, Rome, Italy
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Zenuni H, Schirinzi T, Sancesario GM, Mercuri N, Bernardini S, Grillo P. Correlations between systemic comorbidity burden and CSF biomarkers of neurodegeneration in aging individuals. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.119001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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10
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Sancesario GM, Di Lazzaro G, Grillo P, Biticchi B, Giannella E, Alwardat M, Pieri M, Bernardini S, Mercuri NB, Pisani A, Schirinzi T. Biofluids profile of α-Klotho in patients with Parkinson's disease. Parkinsonism Relat Disord 2021; 90:62-64. [PMID: 34392132 DOI: 10.1016/j.parkreldis.2021.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/14/2021] [Accepted: 08/09/2021] [Indexed: 12/29/2022]
Abstract
We measured α-Klotho in CSF and serum of PD patients at early stage of the disease, finding two distinct pools, the first increased, the second reduced. CSF α-Klotho was inversely associated with CSF α-synuclein levels. Our preliminary results suggest α-Klotho as potential biomarker or therapeutic target in PD.
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Affiliation(s)
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Piergiorgio Grillo
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | | | - Mohammad Alwardat
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Allied Medical Science Department, Division of Physical Therapy, Aqaba University of Technology, Aqaba, Jordan
| | - Massimo Pieri
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy
| | - Antonio Pisani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
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Sancesario GM, Di Lazzaro G, Alwardat M, Biticchi B, Basile V, Salimei C, Colona VL, Sinibaldi Salimei P, Bernardini S, Mercuri NB, Pisani A, Schirinzi T. Amyloid-β42/Neurogranin Ratio as a Potential Index for Cognitive Impairment in Parkinson's Disease. J Alzheimers Dis 2021; 76:1171-1178. [PMID: 32597810 DOI: 10.3233/jad-200344] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Synaptopathy is critical in pathophysiology of Parkinson's disease (PD). Cerebrospinal fluid (CSF) levels of neurogranin (NG) and amyloid-β42 (Aβ42) are considered markers of synaptic dysfunction in neurodegenerative diseases. OBJECTIVE To evaluate the CSF synaptopathy-related biomarkers, especially the novel Aβ42/NG ratio, in PD, establishing possible associations with cognitive level and other clinical parameters. METHODS Levels of NG, Aβ42, amyloid-β40, total and phosphorylated tau, and Aβ42/NG ratio were measured in 30 PD patients and 30 controls and correlated with cognitive and motor parameters. The accuracy in distinguishing the cognitive status was determined. RESULTS NG and Aβ42 were significantly reduced in PD, with higher NG levels in patients with worse cognition. The Aβ42/NG ratio showed a direct correlation with Mini-Mental State Examination, independently from age and sex, and differentiated cognitively impaired patients with 92% sensitivity and 71.4% specificity, accuracy higher than NG alone. No correlations resulted with motor disturbances or therapy. CONCLUSIONS The novel Aβ42/NG ratio couples either presynaptic or postsynaptic markers of synaptic dysfunction, representing a potential global index of synaptopathy, useful to track cognitive functions in PD.
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Affiliation(s)
- Giulia Maria Sancesario
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Mohammad Alwardat
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Benedetta Biticchi
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Valerio Basile
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Chiara Salimei
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Vito Luigi Colona
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Sergio Bernardini
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Antonio Pisani
- IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
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12
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Liguori C, Spanetta M, Izzi F, Franchini F, Nuccetelli M, Sancesario GM, Di Santo S, Bernardini S, Mercuri NB, Placidi F. Sleep-Wake Cycle in Alzheimer's Disease Is Associated with Tau Pathology and Orexin Dysregulation. J Alzheimers Dis 2021; 74:501-508. [PMID: 32065791 DOI: 10.3233/jad-191124] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common form of dementia. It is mainly characterized by a progressive deterioration of cognition, but sleep-wake cycle disturbances frequently occur. Irregular sleep-wake cycle, insomnia, and daytime napping usually occur in patients with AD in the course of the disease. OBJECTIVE The aim of the present study was to verify the sleep-wake cycle in mild to moderate AD patients compared to controls, and to evaluate the relationship between the sleep-wake cycle impairment and the neuropsychological testing, CSF AD biomarkers, and CSF orexin concentrations. METHODS Mild to moderate AD patients were enrolled and underwent 14-day actigraphic recording, sleep diary, neuropsychological testing, and CSF biomarkers analysis. All patients were compared to controls. RESULTS Eighteen AD patients were compared to ten controls. AD patients showed the alteration of the sleep-wake cycle, featured by sleep dysregulation and daytime wake fragmentation, with respect to controls. Considering the correlation analysis, we documented the correlation between tau proteins and orexin CSF levels and sleep-wake cycle dysregulation. CONCLUSION This study confirmed the dysregulation of sleep-wake cycle in AD patients, as reflected by the daytime wake fragmentation, irregular sleep-wake rhythm, and nocturnal sleep impairment. This sleep-wake cycle disorder correlates with AD neuropathological in vivo features and brain orexin activity. Hence, we suppose that a more marked AD pathology coupled with orexinergic system dysregulation may promote sleep-wake cycle impairment in AD patients.
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Affiliation(s)
- Claudio Liguori
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy.,Neurology Unit, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy
| | - Matteo Spanetta
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy
| | - Francesca Izzi
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy
| | | | - Marzia Nuccetelli
- Department of Clinical Biochemistry and Molecular Biology, University of Rome "Tor Vergata", Rome, Italy
| | | | | | - Sergio Bernardini
- Department of Clinical Biochemistry and Molecular Biology, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy.,Fondazione Santa Lucia IRCCS, Rome, Italy
| | - Fabio Placidi
- Sleep Medicine Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy
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13
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Zenuni H, Grillo P, Sancesario GM, Bernardini S, Mercuri NB, Schirinzi T. How Comorbidity Reflects on Cerebrospinal Fluid Biomarkers of Neurodegeneration in Aging. J Alzheimers Dis Rep 2021; 5:87-92. [PMID: 33681720 PMCID: PMC7902985 DOI: 10.3233/adr-200280] [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] [Accepted: 12/29/2020] [Indexed: 12/23/2022] Open
Abstract
Systemic comorbidity precipitates the risk for dementia. To comprehend the underlying mechanisms into a therapeutic perspective, we analyzed how comorbidity affects neurodegeneration-related cerebrospinal fluid (CSF) biomarkers of 55 cognitively intact subjects. The Charson Comorbidity Index (CCI) was correlated with CSF amyloid-β42 (Aβ42), amyloid-β40, total-tau, 181-phosphorylated-tau (p-tau), the Aβ42/p-tau ratio, neurogranin, and lactate. The age-related brain lesions at imaging were also considered. CCI had a raw association with Aβ42/p-tau and p-tau, and a stronger, age-independent correlation with lactate. These preliminary findings suggested that, in normal subjects, systemic comorbidity might increase CNS oxidative stress and, together with aging, contribute to develop an Alzheimer's disease-like biochemical profile.
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Affiliation(s)
- Henri Zenuni
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Piergiorgio Grillo
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Sergio Bernardini
- Department of Experimental Medicine, University of Roma Tor Vergata, Rome, Italy
- Department of Clinical Biochemistry, Tor Vergata University Hospital, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
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14
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Schirinzi T, Di Lazzaro G, Sancesario GM, Summa S, Petrucci S, Colona VL, Bernardini S, Pierantozzi M, Stefani A, Mercuri NB, Pisani A. Young-onset and late-onset Parkinson's disease exhibit a different profile of fluid biomarkers and clinical features. Neurobiol Aging 2020; 90:119-124. [PMID: 32169356 DOI: 10.1016/j.neurobiolaging.2020.02.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [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] [Received: 10/22/2019] [Revised: 02/10/2020] [Accepted: 02/12/2020] [Indexed: 12/11/2022]
Abstract
Young-onset Parkinson's disease (YOPD) is a relevant condition whose neurobiology is questioned if different from those of typical late-onset Parkinson's disease (LOPD). Here, we explored whether the clinical-biochemical profile of Parkinson's disease (PD) could be affected by the age-of-onset (AO), as a possible result of a distinct neurodegenerative process. A panel of fluid biomarkers (CSF lactate, 42-amyloid-β peptide, total and 181-phosphorylated tau; serum uric acid) and the standard scores for motor and nonmotor signs were assessed in 76 idiopathic PD patients (genetic cases excluded; YOPD, AO ≤ 50, n = 44; LOPD, AO > 50, n = 32) and 75 sex/age-matched controls, adjusting the models for the main confounding factors. In PD, AO directly correlated to either CSF lactate and tau proteins or the nonmotor symptoms scale score. Specifically, a younger AO was associated with lower levels of biomarkers and minor burden of nonmotor symptoms. Our findings indicate that clinical-biochemical features of idiopathic PD may vary depending on the AO, accounting for different profiles in YOPD and LOPD whose recognition is fundamental for further pathophysiological implications and clinical applications.
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Affiliation(s)
- Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Giulia Maria Sancesario
- Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | - Susanna Summa
- Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy
| | - Simona Petrucci
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy; Department of Clinical and Molecular Medicine, S. Andrea University Hospital, Rome, Italy; IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Vito Luigi Colona
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
| | | | - Alessandro Stefani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Antonio Pisani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy; Department of Experimental Neurosciences, IRCCS Santa Lucia Foundation, Rome, Italy
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15
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Festa G, Mallamace F, Sancesario GM, Corsaro C, Mallamace D, Fazio E, Arcidiacono L, Garcia Sakai V, Senesi R, Preziosi E, Sancesario G, Andreani C. Aggregation States of A β1-40, A β1-42 and A βp 3-42 Amyloid Beta Peptides: A SANS Study. Int J Mol Sci 2019; 20:ijms20174126. [PMID: 31450543 PMCID: PMC6747079 DOI: 10.3390/ijms20174126] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022] Open
Abstract
Aggregation states of amyloid beta peptides for amyloid beta A β 1 - 40 to A β 1 - 42 and A β p 3 - 42 are investigated through small angle neutron scattering (SANS). The knowledge of these small peptides and their aggregation state are of key importance for the comprehension of neurodegenerative diseases (e.g., Alzheimer's disease). The SANS technique allows to study the size and fractal nature of the monomers, oligomers and fibrils of the three different peptides. Results show that all the investigated peptides have monomers with a radius of gyration of the order of 10 Å, while the oligomers and fibrils display differences in size and aggregation ability, with A β p 3 - 42 showing larger oligomers. These properties are strictly related to the toxicity of the corresponding amyloid peptide and indeed to the development of the associated disease.
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Affiliation(s)
- Giulia Festa
- CENTRO FERMI-Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", 00184 Rome, Italy
| | - Francesco Mallamace
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Giulia Maria Sancesario
- IRCCS Fondazione Santa Lucia, 00142 Rome, Italy
- Department of Experimental Medicine and Surgery, Università degli Studi di Roma "Tor Vergata", 00133 Rome, Italy
| | - Carmelo Corsaro
- Dipartimento di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, 98166 Messina, Italy.
| | - Domenico Mallamace
- Dipartimento di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, 98166 Messina, Italy.
| | - Enza Fazio
- Dipartimento di Scienze Matematiche e Informatiche, Scienze Fisiche e Scienze della Terra (MIFT), Università di Messina, 98166 Messina, Italy
| | - Laura Arcidiacono
- CENTRO FERMI-Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", 00184 Rome, Italy
- Science and Technology Facilities Council, ISIS Pulsed Neutron and Muon Source, Didcot OX11 0QX, UK
| | - Victoria Garcia Sakai
- Science and Technology Facilities Council, ISIS Pulsed Neutron and Muon Source, Didcot OX11 0QX, UK
| | - Roberto Senesi
- CENTRO FERMI-Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", 00184 Rome, Italy
- NAST Centre and Department of Physics, Università degli Studi di Roma "Tor Vergata", 00133 Rome, Italy
| | - Enrico Preziosi
- NAST Centre and Department of Physics, Università degli Studi di Roma "Tor Vergata", 00133 Rome, Italy
| | - Giuseppe Sancesario
- Department of Systems Medicine, Università degli Studi di Roma "Tor Vergata", 00133 Rome, Italy
| | - Carla Andreani
- CENTRO FERMI-Museo Storico della Fisica e Centro Studi e Ricerche "Enrico Fermi", 00184 Rome, Italy
- NAST Centre and Department of Physics, Università degli Studi di Roma "Tor Vergata", 00133 Rome, Italy
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16
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Cariulo C, Martufi P, Verani M, Azzollini L, Bruni G, Weiss A, Deguire SM, Lashuel HA, Scaricamazza E, Sancesario GM, Schirinzi T, Mercuri NB, Sancesario G, Caricasole A, Petricca L. Phospho-S129 Alpha-Synuclein Is Present in Human Plasma but Not in Cerebrospinal Fluid as Determined by an Ultrasensitive Immunoassay. Front Neurosci 2019; 13:889. [PMID: 31507364 PMCID: PMC6714598 DOI: 10.3389/fnins.2019.00889] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 07/03/2019] [Accepted: 08/07/2019] [Indexed: 01/05/2023] Open
Abstract
Accumulation and aggregation of misfolded alpha-synuclein is believed to be a cause of Parkinson’s disease (PD). Phosphorylation of alpha-synuclein at S129 is known to be associated with the pathological misfolding process, but efforts to investigate the relevance of this post-translational modification for pathology have been frustrated by difficulties in detecting and quantifying it in relevant samples. We report novel, ultrasensitive immunoassays based on single-molecule counting technology, useful for detecting alpha-synuclein and its S129 phosphorylated form in clinical samples in the low pg/ml range. Using human CSF and plasma samples, we find levels of alpha-synuclein comparable to those previously reported. However, while alpha-synuclein phosphorylated on S129 could easily be detected in human plasma, where its detection is extremely sensitive to protein phosphatases, its levels in CSF were undetectable, with a possible influence of a matrix effect. In plasma samples from a small test cohort comprising 5 PD individuals and five age-matched control individuals we find that pS129 alpha-synuclein levels are increased in PD plasma samples, in line with previous reports. We conclude that pS129 alpha-synuclein is not detectable in CSF and recommend the addition of phosphatase inhibitors to plasma samples at the time of collection. Moreover, the findings obtained on the small cohort of clinical plasma samples point to plasma pS129 alpha-synuclein levels as a candidate diagnostic biomarker in PD.
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Affiliation(s)
| | - Paola Martufi
- Department of Neuroscience, IRBM S.p.A., Rome, Italy
| | | | | | | | | | - Sean M Deguire
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, School of Life Sciences, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Hilal A Lashuel
- Laboratory of Molecular and Chemical Biology of Neurodegeneration, School of Life Sciences, Brain Mind Institute, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Eugenia Scaricamazza
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giuseppe Sancesario
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | | | - Lara Petricca
- Department of Neuroscience, IRBM S.p.A., Rome, Italy
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17
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Boccardi M, Nicolosi V, Festari C, Bianchetti A, Cappa SF, Chiasserini D, Falini A, Guerra UP, Nobili F, Padovani A, Sancesario GM, Morbelli S, Parnetti L, Tiraboschi P, Muscio C, Perani D, Pizzini FB, Beltramello A, Porro GS, Ciaccio M, Schillaci O, Trabucchi M, Tagliavini F, Frisoni GB. P1-238: ITALIAN CONSENSUS RECOMMENDATIONS FOR THE ETIOLOGICAL DIAGNOSIS IN MEMORY CLINICS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.793] [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]
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18
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Alwardat M, Schirinzi T, Di Lazzaro G, Sancesario GM, Franco D, Imbriani P, Sinibaldi Salimei P, Bernardini S, Mercuri NB, Pisani A. Association between physical activity and dementia's risk factors in patients with Parkinson's disease. J Neural Transm (Vienna) 2019; 126:319-325. [PMID: 30746564 DOI: 10.1007/s00702-019-01979-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 11/28/2018] [Accepted: 01/30/2019] [Indexed: 01/04/2023]
Abstract
Evidence suggests that physical activity (PA) exerts beneficial effects on neurodegenerative processes, either as symptomatic relief or disease-modifying strategy. Actually, it may represent a viable neuroprotective intervention in Parkinson's disease dementia (PDD), a severe, frequent, and untreatable complication of Parkinson's disease (PD). According to such hypothesis, this cross-sectional study tested, in PD patients, the association between levels of PA and well-known risk factors for PDD, such as mood disorders and amyloid-β42 CSF content. Amount of PA was measured by the International Physical Activity Questionnaires-Short Form (IPAQ-SF) in 128 cognitively intact PD patients and correlated with the Hamilton-Depression (HAM-D) and the Hamilton-Anxiety (HAM-A) scores; in a homogenous subgroup of 40 patients, it was further correlated with a panel of CSF biomarkers, including amyloid-β42, total α-synuclein, total, and phosphorylated tau. The statistical model was corrected for the main potential confounding factors (motor impairment, dopaminergic treatment, disease duration, age, and sex). Both the HAM-A and HAM-D scores, as well as the Aβ42 CSF content, improved in parallel with the increase of the total week amount of PA. Although with several limitations, we preliminarily demonstrated that a high level of PA is associated with a more favourable profile of PDD risk factors, in terms of both mood disturbances and CSF markers of neurodegeneration. However, confirmative studies are necessary to validate the efficacy of PA as protective intervention for PDD.
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Affiliation(s)
- Mohammad Alwardat
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy
| | - Tommaso Schirinzi
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy.
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy
| | - Giulia Maria Sancesario
- Department of Experimental Medicine and Surgery, University of Roma "Tor Vergata", Via Montpellier 1, Rome, 00135, Italy
| | - Donatella Franco
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy
| | - Paola Imbriani
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Paola Sinibaldi Salimei
- Department of Biomedicine and Prevention, University of Roma "Tor Vergata", Via Montpellier 1, Rome, 00135, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, University of Roma "Tor Vergata", Via Montpellier 1, Rome, 00135, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Antonio Pisani
- Department of Systems Medicine, University of Roma "Tor Vergata", Via Montpellier 1, 00135, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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19
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Liguori C, Paoletti FP, Placidi F, Ruffini R, Sancesario GM, Eusebi P, Mercuri NB, Parnetti L. CSF Biomarkers for Early Diagnosis of Synucleinopathies: Focus on Idiopathic RBD. Curr Neurol Neurosci Rep 2019; 19:3. [DOI: 10.1007/s11910-019-0918-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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20
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Schirinzi T, Di Lorenzo F, Sancesario GM, Di Lazzaro G, Ponzo V, Pisani A, Mercuri NB, Koch G, Martorana A. Amyloid-Mediated Cholinergic Dysfunction in Motor Impairment Related to Alzheimer’s Disease. J Alzheimers Dis 2018; 64:525-532. [DOI: 10.3233/jad-171166] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Tommaso Schirinzi
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Giulia Maria Sancesario
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giulia Di Lazzaro
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | | | - Antonio Pisani
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
- IRCCS Fondazione Santa Lucia, Rome, Italy
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21
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Schirinzi T, Sancesario GM, Di Lazzaro G, D'Elia A, Imbriani P, Scalise S, Pisani A. Cerebrospinal fluid biomarkers profile of idiopathic normal pressure hydrocephalus. J Neural Transm (Vienna) 2018; 125:673-679. [PMID: 29353355 DOI: 10.1007/s00702-018-1842-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 11/19/2017] [Accepted: 01/08/2018] [Indexed: 01/24/2023]
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a disabling neurological disorder whose potential treatability is significantly limited by diagnostic uncertainty. In fact, typical clinical presentation occurs at late phases of disease, when CSF shunting could be ineffective. In recent years, measurement of different CSF proteins, whose concentration directly reflects neuropathological changes of CNS, has significantly improved both diagnostic timing and accuracy of neurodegenerative disease. Unfortunately iNPH lacks neuropathological hallmarks allowing the identification of specific disease biomarkers. However, neuropathology of iNPH is so rich and heterogeneous that many processes can be tracked in CSF, including Alzheimer's disease core pathology, subcortical degeneration, neuroinflammation and vascular dysfunction. Indeed, a huge number of CSF biomarkers have been analyzed in iNPH patients, but a unifying profile has not been provided yet. In this brief survey, we thus attempted to summarize the main findings in the field of iNPH CSF biomarkers, aimed at outlining a synthetic model. Although defined cut-off values for biomarkers are not available, a better knowledge of CSF characteristics may definitely assist in diagnosing the disease.
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Affiliation(s)
- Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. .,Department of Neurosciences, IRCCS Bambino Gesù Children Hospital, Rome, Italy.
| | - Giulia Maria Sancesario
- Department of Experimental Medicine and Surgery, University of Roma Tor Vergata, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Giulia Di Lazzaro
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Alessio D'Elia
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Paola Imbriani
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Simona Scalise
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Antonio Pisani
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
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22
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Schirinzi T, Di Lazzaro G, Sancesario GM, Colona VL, Scaricamazza E, Mercuri NB, Martorana A, Sancesario G. Levels of amyloid-beta-42 and CSF pressure are directly related in patients with Alzheimer's disease. J Neural Transm (Vienna) 2017; 124:1621-1625. [PMID: 28866757 DOI: 10.1007/s00702-017-1786-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [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: 05/25/2017] [Accepted: 08/28/2017] [Indexed: 12/21/2022]
Abstract
Experimental data suggest that the cerebrospinal fluid (CSF) dynamic is involved in the clearance of beta-amyloid, a key event in the pathogenesis of Alzheimer's disease (AD). At this regard no evidence still exists in vivo. In this study we explored the relationships between CSF pressure and AD pathology, as measured with CSF core biomarkers. We enrolled 16 patients with probable AD and 21 controls, collecting demographics, clinical data, CSF opening pressure and CSF levels of beta-amyloid-42 fragment (Aβ42), total-tau (t-tau), phosphorylated-tau-181 (p-tau), albumin and albumin ratio. Differences between the groups were calculated with non-parametric tests, while correlations among all parameters were separately calculated with Spearman's test in each group. The groups significantly differed in biomarkers' concentration with lower Aβ42, and higher t-tau and p-tau in AD patients. Moreover, CSF pressure was significantly lower in AD group (11.0 ± 2.8 vs. 13.3 ± 3.0 mmHg, p < 0.05) and directly correlated with Aβ42 levels (R = 0.512; p < 0.05), but not with other biomarkers or parameters. No significant correlations emerged for biomarkers in control group. AD patients exhibit low CSF pressure whose values are directly and selectively related to CSF Aβ42 levels. This interesting correlation may confirm in vivo the association between CSF dynamic and beta-amyloid metabolism occurring in AD.
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Affiliation(s)
- Tommaso Schirinzi
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy. .,Department of Neurosciences, IRCCS Bambino Gesù Children Hospital, Rome, Italy.
| | - Giulia Di Lazzaro
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | | | - Vito Luigi Colona
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Eugenia Scaricamazza
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessandro Martorana
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Giuseppe Sancesario
- Neurology Unit, Department of Systems Medicine, University of Roma Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
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Schirinzi T, Di Lazzaro G, Colona VL, Imbriani P, Alwardat M, Sancesario GM, Martorana A, Pisani A. Assessment of serum uric acid as risk factor for tauopathies. J Neural Transm (Vienna) 2017. [DOI: 10.1007/s00702-017-1743-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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24
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Liguori C, Chiaravalloti A, Sancesario G, Stefani A, Sancesario GM, Mercuri NB, Schillaci O, Pierantozzi M. Cerebrospinal fluid lactate levels and brain [18F]FDG PET hypometabolism within the default mode network in Alzheimer's disease. Eur J Nucl Med Mol Imaging 2016; 43:2040-9. [PMID: 27221635 DOI: 10.1007/s00259-016-3417-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [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: 12/23/2015] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE It has been suggested that neuronal energy metabolism may be involved in Alzheimer's disease (AD). In this view, the finding of increased cerebrospinal fluid (CSF) lactate levels in AD patients has been considered the result of energetic metabolism dysfunction. Here, we investigated the relationship between neuronal energy metabolism, as measured via CSF lactate levels, and cerebral glucose metabolism, as stated at the 2-deoxy-2-(18F)fluoro-D-glucose positron emission tomography ([18F]FDG PET) in AD patients. METHODS AD patients underwent lumbar puncture to measure CSF lactate levels and [18F]FDG PET to assess brain glucose metabolism. CSF and PET data were compared to controls. Since patients were studied at rest, we specifically investigated brain areas active in rest-condition owing to the Default Mode Network (DMN). We correlated the CSF lactate concentrations with the [18F]FDG PET data in brain areas owing to the DMN, using sex, age, disease duration, Mini Mental State Examination, and CSF levels of tau proteins and beta-amyloid as covariates. RESULTS AD patients (n = 32) showed a significant increase of CSF lactate levels compared to Control 1 group (n = 28). They also showed brain glucose hypometabolism in the DMN areas compared to Control 2 group (n = 30). Within the AD group we found the significant correlation between increased CSF lactate levels and glucose hypometabolism in Broadman areas (BA) owing to left medial prefrontal cortex (BA10, mPFC), left orbitofrontal cortex (BA11, OFC), and left parahippocampal gyrus (BA 35, PHG). CONCLUSION We found high CSF levels of lactate and glucose hypometabolism within the DMN in AD patients. Moreover, we found a relationship linking the increased CSF lactate and the reduced glucose consumption in the left mPFC, OFC and PHG, owing to the anterior hub of DMN. These findings could suggest that neural glucose hypometabolism may affect the DMN efficiency in AD, also proposing the possible role of damaged brain energetic machine in impairing DMN.
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Affiliation(s)
- Claudio Liguori
- Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy. .,Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.
| | - Agostino Chiaravalloti
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy.,IRCSS Neuromed, Pozzilli, Italy
| | - Giuseppe Sancesario
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Alessandro Stefani
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Nicola Biagio Mercuri
- Neurophysiopathology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy.,Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Orazio Schillaci
- Department of Biomedicine and Prevention, University of Rome 'Tor Vergata', Rome, Italy.,IRCSS Neuromed, Pozzilli, Italy
| | - Mariangela Pierantozzi
- Neurology Unit, Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Martorana A, Di Lorenzo F, Belli L, Sancesario G, Toniolo S, Sallustio F, Sancesario GM, Koch G. Cerebrospinal Fluid Aβ42 Levels: When Physiological Become Pathological State. CNS Neurosci Ther 2015; 21:921-5. [PMID: 26555572 DOI: 10.1111/cns.12476] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [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: 08/10/2015] [Revised: 10/07/2015] [Accepted: 10/08/2015] [Indexed: 12/31/2022] Open
Abstract
Impaired amyloid beta (Aβ) metabolism is currently considered central to understand the pathophysiology of Alzheimer's disease (AD). Measurements of cerebrospinal fluid Aβ levels remain the most useful marker for diagnostic purposes and to individuate people at risk for AD. Despite recent advances criticized the direct role in neurodegeneration of cortical neurons, Aβ is considered responsible for synaptopathy and impairment of neurotransmission and therefore remains the major trigger of AD and future pharmacological treatment remain Aβ oriented. However, experimental and clinical findings showed that Aβ peptides could have a wider range of action responsible for cell dysfunction and for appearance of clinico-pathological entities different from AD. Such findings may induce misunderstanding of the real role played by Aβ in AD and therefore strengthen criticism on its centrality and need for CSF measurements. Aim of this review is to discuss the role of CSF Aβ levels in light of experimental, clinical pathologic, and electrophysiological results in AD and other pathological entities to put in a correct frame the value of Aβ changes.
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Affiliation(s)
- Alessandro Martorana
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Di Lorenzo
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy.,Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
| | - Lorena Belli
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe Sancesario
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Sofia Toniolo
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | - Fabrizio Sallustio
- Clinica Neurologica, Sytem Medicine Department, University of Rome "Tor Vergata", Rome, Italy
| | | | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Santa Lucia Foundation IRCCS, Rome, Italy
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Liguori C, Stefani A, Sancesario G, Sancesario GM, Marciani MG, Pierantozzi M. CSF lactate levels, τ proteins, cognitive decline: a dynamic relationship in Alzheimer's disease. J Neurol Neurosurg Psychiatry 2015; 86:655-9. [PMID: 25121572 DOI: 10.1136/jnnp-2014-308577] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [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] [Received: 05/15/2014] [Accepted: 07/25/2014] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate, in patients with Alzheimer's Disease (AD), the possible interplay linking alteration of neuronal energy metabolism, as measured via cerebrospinal fluid (CSF) lactate concentration, to severity of AD neurodegenerative processes and impairment of cognitive abilities. METHODS In this study we measured and correlated CSF lactate concentrations, AD biomarker levels (τ-proteins and β-amyloid) and Mini-Mental State Examination (MMSE) score in a population of drug-naïve patients with AD ranging from mild (MMSE≥21/30) to moderate-severe (MMSE<21/30) cognitive decline. They were compared to healthy controls and patients with vascular dementia (VaD). RESULTS Patients with AD (n=145) showed a significant increase of CSF lactate concentration compared to controls (n=80) and patients with VaD (n=44), which was higher in mild (n=67) than in patients with moderate-severe AD (n=78). Moreover, we found, in either the whole AD population or both subgroups, a CSF profile in which higher CSF levels of t-τ and p-τ proteins corresponded to lower concentrations of lactate. CONCLUSIONS We verified the occurrence of high CSF lactate levels in patients with AD, which may be ascribed to mitochondria impairment. Hypothesising that τ proteins may exert a detrimental effect on the entire cellular energy metabolism, the negative correlation found between lactate and τ-protein levels may allow speculation that τ toxicity, already demonstrated to have affected mitochondria, could also impair glycolytic metabolism with a less evident increase of lactate levels in more severe AD. Thus, we suggest a dynamic relationship between neuronal energy metabolism, τ proteins and cognitive decline in AD and propose the clinical potential of assessing CSF lactate levels in patients with AD to better define the neuronal brain metabolism damage.
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Affiliation(s)
- C Liguori
- Department of Systems Medicine, Neurophysiopathology Unit, University of Rome "Tor Vergata", Rome, Italy Department of Systems Medicine, Neurology Unit, University of Rome "Tor Vergata", Rome, Italy
| | - A Stefani
- Department of Systems Medicine, Neurology Unit, University of Rome "Tor Vergata", Rome, Italy Fondazione Santa Lucia IRCCS, Rome, Italy
| | - G Sancesario
- Department of Systems Medicine, Neurology Unit, University of Rome "Tor Vergata", Rome, Italy Fondazione Santa Lucia IRCCS, Rome, Italy
| | - G M Sancesario
- Department of Clinical Biochemistry and Molecular Biology, University of Rome "Tor Vergata", Rome, Italy
| | - M G Marciani
- Department of Systems Medicine, Neurology Unit, University of Rome "Tor Vergata", Rome, Italy Fondazione Santa Lucia IRCCS, Rome, Italy
| | - M Pierantozzi
- Department of Systems Medicine, Neurology Unit, University of Rome "Tor Vergata", Rome, Italy
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27
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Schirinzi T, Sancesario GM, Ialongo C, Imbriani P, Madeo G, Toniolo S, Martorana A, Pisani A. A clinical and biochemical analysis in the differential diagnosis of idiopathic normal pressure hydrocephalus. Front Neurol 2015; 6:86. [PMID: 25954245 PMCID: PMC4407581 DOI: 10.3389/fneur.2015.00086] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 01/19/2015] [Accepted: 04/07/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Idiopathic normal pressure hydrocephalus (iNPH) can be misdiagnosed with other neurodegenerative diseases, especially in the early disease stages. Considering the opportunity of the shunt surgery, iNPH should be diagnosed with accuracy. Here, we evaluate the utility of CSF biomarkers and their relationship with clinical features in the diagnosis of iNPH. METHODS We performed a multivariate analysis of the CSF levels of Aβ42, t-tau, and p-tau collected from four groups of patients: 14 iNPH, 14 progressive supranuclear palsy (PSP), 14 Alzheimer's disease (AD), 14 controls (CTL). Diagnostic accuracy of biomarkers was determined by the receiver operating characteristic curve analysis. Statistical correlation was calculated between each CSF biomarker and single clinical items of iNPH. RESULTS Aβ42 levels in iNPH were lower than controls, although not as low as in AD. Likewise, CSF t-tau and p-tau were lower in iNPH than in controls. Of interest, t-tau and p-tau were higher in AD than in controls and hence both t-tau and p-tau were significantly lower in iNPH than in AD. No differences were found between iNPH and PSP. CSF biomarkers levels did not correlate to clinical features of iNPH, whereas two significant correlations emerged within clinical parameters: cognitive impairment was related to gait difficulties, while ventricular enlargement correlated with continence disturbances. CONCLUSION Measurement of CSF biomarker levels may be helpful in the differential diagnosis between iNPH and AD but not between iNPH and PSP. Both Aβ42 and tau levels appear unrelated to main clinical features of iNPH.
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Affiliation(s)
- Tommaso Schirinzi
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome , Italy
| | | | - Cristiano Ialongo
- Department of Experimental Medicine and Surgery, University of Rome "Tor Vergata" , Rome , Italy
| | - Paola Imbriani
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome , Italy
| | - Graziella Madeo
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome , Italy
| | - Sofia Toniolo
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome , Italy
| | | | - Antonio Pisani
- Department of Systems Medicine, University of Rome "Tor Vergata" , Rome , Italy ; IRCCS Santa Lucia Foundation , Rome , Italy
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Amadoro G, Corsetti V, Sancesario GM, Lubrano A, Melchiorri G, Bernardini S, Calissano P, Sancesario G. Cerebrospinal Fluid Levels of a 20–22 kDa NH2 Fragment of Human Tau Provide a Novel Neuronal Injury Biomarker in Alzheimer's Disease and Other Dementias. ACTA ACUST UNITED AC 2014; 42:211-26. [DOI: 10.3233/jad-140267] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Giuseppina Amadoro
- Institute of Translational Pharmacology (IFT)–CNR, Rome, Italy
- European Brain Research Institute (EBRI), Rome, Italy
| | | | - Giulia Maria Sancesario
- Department of Experimental Medicine and Surgery, Tor Vergata General Hospital, The University of Rome Tor Vergata, Rome, Italy
| | - Adele Lubrano
- Department of Systems Medicine, Tor Vergata General Hospital, The University of Rome Tor Vergata, Rome, Italy
| | - Gaia Melchiorri
- Department of Systems Medicine, Tor Vergata General Hospital, The University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Department of Experimental Medicine and Surgery, Tor Vergata General Hospital, The University of Rome Tor Vergata, Rome, Italy
| | | | - Giuseppe Sancesario
- Department of Systems Medicine, Tor Vergata General Hospital, The University of Rome Tor Vergata, Rome, Italy
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Martorana A, Esposito Z, Di Lorenzo F, Giacobbe V, Sancesario GM, Bucchi G, Bonnì S, Bernardini S, Sorge R, Sancesario G, Bernardi G, Caltagirone C, Koch G. Cerebrospinal fluid levels of Aβ42 relationship with cholinergic cortical activity in Alzheimer’s disease patients. J Neural Transm (Vienna) 2012; 119:771-8. [DOI: 10.1007/s00702-012-0780-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 02/22/2012] [Indexed: 11/28/2022]
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Nucci C, Martucci A, Martorana A, Sancesario GM, Cerulli L. Glaucoma progression associated with altered cerebral spinal fluid levels of amyloid beta and tau proteins. Clin Exp Ophthalmol 2011; 39:279-81. [PMID: 20973903 DOI: 10.1111/j.1442-9071.2010.02452.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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