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Nielsen RB, Parbo P, Ismail R, Dalby R, Tietze A, Brændgaard H, Gottrup H, Brooks DJ, Østergaard L, Eskildsen SF. Impaired perfusion and capillary dysfunction in prodromal Alzheimer's disease. Alzheimers Dement (Amst) 2020; 12:e12032. [PMID: 32490139 PMCID: PMC7241262 DOI: 10.1002/dad2.12032] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/21/2020] [Accepted: 02/24/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Cardiovascular disease increases the risk of developing Alzheimer's disease (AD), and growing evidence suggests an involvement of cerebrovascular pathology in AD. Capillary dysfunction, a condition in which capillary flow disturbances rather than arterial blood supply limit brain oxygen extraction, could represent an overlooked vascular contributor to neurodegeneration. We examined whether cortical capillary transit-time heterogeneity (CTH), an index of capillary dysfunction, is elevated in amyloid-positive patients with mild cognitive impairment (prodromal AD [pAD]). METHODS We performed structural and perfusion weighted MRI in 22 pAD patients and 21 healthy controls. RESULTS We found hypoperfusion, reduced blood volume, and elevated CTH in the parietal and frontal cortices of pAD-patients compared to controls, while only the precuneus showed focal cortical atrophy. DISCUSSION We propose that microvascular flow disturbances antedate cortical atrophy and may limit local tissue oxygenation in pAD. We speculate that capillary dysfunction contributes to the development of neurodegeneration in AD.
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Affiliation(s)
- Rune B. Nielsen
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
| | - Peter Parbo
- Department of Nuclear Medicine and PET CentreAarhus University HospitalAarhusDenmark
| | - Rola Ismail
- Department of Nuclear Medicine and PET CentreAarhus University HospitalAarhusDenmark
| | - Rikke Dalby
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
- Department of NeuroradiologyAarhus University HospitalAarhusDenmark
| | - Anna Tietze
- Charité, UniversitätsmedizinInstitute of NeuroradiologyBerlinGermany
| | - Hans Brændgaard
- Dementia ClinicDepartment of NeurologyAarhus University HospitalAarhusDenmark
| | - Hanne Gottrup
- Dementia ClinicDepartment of NeurologyAarhus University HospitalAarhusDenmark
| | - David J. Brooks
- Department of Nuclear Medicine and PET CentreAarhus University HospitalAarhusDenmark
- Division of NeuroscienceDepartment of MedicineImperial College LondonLondonUK
- Division of NeuroscienceNewcastle UniversityNewcastle upon TyneUK
| | - Leif Østergaard
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
- Department of Nuclear Medicine and PET CentreAarhus University HospitalAarhusDenmark
| | - Simon F. Eskildsen
- Center of Functionally Integrative NeuroscienceAarhus UniversityAarhusDenmark
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Ismail R, Hansen AK, Parbo P, Brændgaard H, Gottrup H, Brooks DJ, Borghammer P. The Effect of 40-Hz Light Therapy on Amyloid Load in Patients with Prodromal and Clinical Alzheimer's Disease. Int J Alzheimers Dis 2018; 2018:6852303. [PMID: 30155285 PMCID: PMC6091362 DOI: 10.1155/2018/6852303] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 05/01/2018] [Accepted: 06/25/2018] [Indexed: 11/18/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder. AD pathology is characterized by abnormal aggregation of the proteins amyloid-β (Aβ) and hyperphosphorylated tau. No effective disease modifying therapies are currently available. A short-duration intervention with 40 Hz light flicker has been shown to reduce brain Aβ load in transgenic mice. We aimed to test the effect of a similar short-duration 40 Hz light flicker regime in human AD patients. We utilized a Light Emitting Diode (LED) light bulb with a 40 Hz flicker. Six Aβ positive patients received 10 days of light therapy, had 2 hours of daily exposure, and underwent a postintervention PiB PET on day 11. After 10 days of light therapy, no significant decrease of PiB SUVR values was detected in any volumes of interest tested (primary visual cortex, visual association cortex, lateral parietal cortex, precuneus, and posterior cingulate) or in the total motor cortex, and longer treatments may be necessary to induce amyloid removal in humans.
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Affiliation(s)
- Rola Ismail
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Allan K. Hansen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Peter Parbo
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Brændgaard
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - David J. Brooks
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
- Division of Neuroscience, Newcastle University, Newcastle, UK
| | - Per Borghammer
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
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Parbo P, Ismail R, Hansen KV, Amidi A, Mårup FH, Gottrup H, Brændgaard H, Eriksson BO, Eskildsen SF, Lund TE, Tietze A, Edison P, Pavese N, Stokholm MG, Borghammer P, Hinz R, Aanerud J, Brooks DJ. Brain inflammation accompanies amyloid in the majority of mild cognitive impairment cases due to Alzheimer's disease. Brain 2017; 140:2002-2011. [PMID: 28575151 DOI: 10.1093/brain/awx120] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 04/12/2017] [Indexed: 01/19/2023] Open
Abstract
See Kreisl (doi:10.1093/awx151) for a scientific commentary on this article.Subjects with mild cognitive impairment associated with cortical amyloid-β have a greatly increased risk of progressing to Alzheimer's disease. We hypothesized that neuroinflammation occurs early in Alzheimer's disease and would be present in most amyloid-positive mild cognitive impairment cases. 11C-Pittsburgh compound B and 11C-(R)-PK11195 positron emission tomography was used to determine the amyloid load and detect the extent of neuroinflammation (microglial activation) in 42 mild cognitive impairment cases. Twelve age-matched healthy control subjects had 11C-Pittsburgh compound B and 10 healthy control subjects had 11C-(R)-PK11195 positron emission tomography for comparison. Amyloid-positivity was defined as 11C-Pittsburgh compound B target-to-cerebellar ratio above 1.5 within a composite cortical volume of interest. Supervised cluster analysis was used to generate parametric maps of 11C-(R)-PK11195 binding potential. Levels of 11C-(R)-PK11195 binding potential were measured in a selection of cortical volumes of interest and at a voxel level. Twenty-six (62%) of 42 mild cognitive impairment cases showed a raised cortical amyloid load compared to healthy controls. Twenty-two (85%) of the 26 amyloid-positive mild cognitive impairment cases showed clusters of increased cortical microglial activation accompanying the amyloid. There was a positive correlation between levels of amyloid load and 11C-(R)-PK11195 binding potentials at a voxel level within subregions of frontal, parietal and temporal cortices. 11C-(R)-PK11195 positron emission tomography reveals increased inflammation in a majority of amyloid positive mild cognitive impairment cases, its cortical distribution overlapping that of amyloid deposition.
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Affiliation(s)
- Peter Parbo
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Rola Ismail
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Kim V Hansen
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Ali Amidi
- Department of Psychology and Behavioural Sciences and Department of Oncology Aarhus University and Aarhus University Hospital, Denmark
| | - Frederik H Mårup
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Gottrup
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Brændgaard
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Simon F Eskildsen
- Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
| | - Torben E Lund
- Center of Functionally Integrative Neuroscience (CFIN), Aarhus University, Aarhus, Denmark
| | - Anna Tietze
- Institute of Neuroradiology, Charité, Universitätsmedizin, Berlin, Germany
| | - Paul Edison
- Division of Neuroscience, Department of Medicine, Imperial College London, London, UK
| | - Nicola Pavese
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.,Division of Neuroscience, Newcastle University, Newcastle, UK
| | - Morten G Stokholm
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Per Borghammer
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Rainer Hinz
- Wolfson Molecular Imaging Centre, University of Manchester, Manchester, UK
| | - Joel Aanerud
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark
| | - David J Brooks
- Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.,Division of Neuroscience, Department of Medicine, Imperial College London, London, UK.,Division of Neuroscience, Newcastle University, Newcastle, UK
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Nielsen RB, Egefjord L, Angleys H, Mouridsen K, Gejl M, Møller A, Brock B, Brændgaard H, Gottrup H, Rungby J, Eskildsen SF, Østergaard L. Capillary dysfunction is associated with symptom severity and neurodegeneration in Alzheimer's disease. Alzheimers Dement 2017; 13:1143-1153. [PMID: 28343848 DOI: 10.1016/j.jalz.2017.02.007] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [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: 11/03/2016] [Revised: 01/13/2017] [Accepted: 02/13/2017] [Indexed: 01/18/2023]
Abstract
INTRODUCTION We examined whether cortical microvascular blood volume and hemodynamics in Alzheimer's disease (AD) are consistent with tissue hypoxia and whether they correlate with cognitive performance and the degree of cortical thinning. METHODS Thirty-two AD patients underwent cognitive testing, structural magnetic resonance imaging (MRI), and perfusion MRI at baseline and after 6 months. We measured cortical thickness, microvascular cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and capillary transit time heterogeneity (CTH) and estimated tissue oxygen tension (PtO2). RESULTS At baseline, poor cognitive performance and regional cortical thinning correlated with lower CBF and CBV, with higher MTT and CTH and with low PtO2 across the cortex. Cognitive decline over time was associated with increasing whole brain relative transit time heterogeneity (RTH = CTH/MTT). DISCUSSION Our results confirm the importance of microvascular pathology in AD. Deteriorating microvascular hemodynamics may cause hypoxia, which is known to precipitate amyloid retention.
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Affiliation(s)
- Rune B Nielsen
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark.
| | - Lærke Egefjord
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Hugo Angleys
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark
| | - Kim Mouridsen
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark
| | - Michael Gejl
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Arne Møller
- PET-Center, Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Birgitte Brock
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark
| | - Hans Brændgaard
- Dementia Clinic, Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Hanne Gottrup
- Dementia Clinic, Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Jørgen Rungby
- Department of Endocrinology, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Simon F Eskildsen
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark
| | - Leif Østergaard
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark; Department of Neuroradiology, Aarhus University Hospital, Aarhus, Denmark
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Gejl M, Gjedde A, Egefjord L, Møller A, Hansen SB, Vang K, Rodell A, Brændgaard H, Gottrup H, Schacht A, Møller N, Brock B, Rungby J. In Alzheimer's Disease, 6-Month Treatment with GLP-1 Analog Prevents Decline of Brain Glucose Metabolism: Randomized, Placebo-Controlled, Double-Blind Clinical Trial. Front Aging Neurosci 2016; 8:108. [PMID: 27252647 PMCID: PMC4877513 DOI: 10.3389/fnagi.2016.00108] [Citation(s) in RCA: 251] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 04/26/2016] [Indexed: 12/11/2022] Open
Abstract
In animal models, the incretin hormone GLP-1 affects Alzheimer’s disease (AD). We hypothesized that treatment with GLP-1 or an analog of GLP-1 would prevent accumulation of Aβ and raise, or prevent decline of, glucose metabolism (CMRglc) in AD. In this 26-week trial, we randomized 38 patients with AD to treatment with the GLP-1 analog liraglutide (n = 18), or placebo (n = 20). We measured Aβ load in brain with tracer [11C]PIB (PIB), CMRglc with [18F]FDG (FDG), and cognition with the WMS-IV scale (ClinicalTrials.gov NCT01469351). The PIB binding increased significantly in temporal lobe in placebo and treatment patients (both P = 0.04), and in occipital lobe in treatment patients (P = 0.04). Regional and global increases of PIB retention did not differ between the groups (P ≥ 0.38). In placebo treated patients CMRglc declined in all regions, significantly so by the following means in precuneus (P = 0.009, 3.2 μmol/hg/min, 95% CI: 5.45; 0.92), and in parietal (P = 0.04, 2.1 μmol/hg/min, 95% CI: 4.21; 0.081), temporal (P = 0.046, 1.54 μmol/hg/min, 95% CI: 3.05; 0.030), and occipital (P = 0.009, 2.10 μmol/hg/min, 95% CI: 3.61; 0.59) lobes, and in cerebellum (P = 0.04, 1.54 μmol/hg/min, 95% CI: 3.01; 0.064). In contrast, the GLP-1 analog treatment caused a numerical but insignificant increase of CMRglc after 6 months. Cognitive scores did not change. We conclude that the GLP-1 analog treatment prevented the decline of CMRglc that signifies cognitive impairment, synaptic dysfunction, and disease evolution. We draw no firm conclusions from the Aβ load or cognition measures, for which the study was underpowered.
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Affiliation(s)
- Michael Gejl
- Institute of Biomedicine, Aarhus UniversityAarhus, Denmark; Department of Nuclear Medicine and PET Center, Aarhus University HospitalAarhus, Denmark
| | - Albert Gjedde
- Department of Nuclear Medicine and PET Center, Aarhus University HospitalAarhus, Denmark; Department of Neuroscience and Pharmacology, University of CopenhagenCopenhagen, Denmark
| | - Lærke Egefjord
- Institute of Biomedicine, Aarhus UniversityAarhus, Denmark; Department of Nuclear Medicine and PET Center, Aarhus University HospitalAarhus, Denmark
| | - Arne Møller
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital Aarhus, Denmark
| | - Søren B Hansen
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital Aarhus, Denmark
| | - Kim Vang
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital Aarhus, Denmark
| | - Anders Rodell
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital Aarhus, Denmark
| | - Hans Brændgaard
- Dementia Clinic, Department of Neurology, Aarhus University Hospital Aarhus, Denmark
| | - Hanne Gottrup
- Dementia Clinic, Department of Neurology, Aarhus University Hospital Aarhus, Denmark
| | - Anna Schacht
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital Aarhus, Denmark
| | - Niels Møller
- Department of Endocrinology, Aarhus University Hospital Aarhus, Denmark
| | - Birgitte Brock
- Institute of Biomedicine, Aarhus UniversityAarhus, Denmark; Department of Clinical Biochemistry, Aarhus University HospitalAarhus, Denmark
| | - Jørgen Rungby
- Institute of Biomedicine, Aarhus UniversityAarhus, Denmark; Center for Diabetes Research and Department of Clinical Pharmacology, Copenhagen University Hospital Gentofte and RigshospitaletCopenhagen, Denmark
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Hoffmann K, Sobol NA, Frederiksen KS, Beyer N, Vogel A, Vestergaard K, Brændgaard H, Gottrup H, Lolk A, Wermuth L, Jacobsen S, Laugesen LP, Gergelyffy RG, Høgh P, Bjerregaard E, Andersen BB, Siersma V, Johannsen P, Cotman CW, Waldemar G, Hasselbalch SG. Moderate-to-High Intensity Physical Exercise in Patients with Alzheimer’s Disease: A Randomized Controlled Trial. J Alzheimers Dis 2015; 50:443-53. [DOI: 10.3233/jad-150817] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [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)
- Kristine Hoffmann
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nanna A. Sobol
- Musculoskeletal Rehabilitation Research Unit, University of Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Kristian S. Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nina Beyer
- Musculoskeletal Rehabilitation Research Unit, University of Copenhagen, Denmark
- Institute of Sports Medicine Copenhagen, Bispebjerg Hospital, University of Copenhagen, Denmark
| | - Asmus Vogel
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | | | | | - Hanne Gottrup
- Dementia Clinic, Aarhus University Hospital, Denmark
| | - Annette Lolk
- Dementia Clinic, Odense University Hospital, Denmark
| | - Lene Wermuth
- Dementia Clinic, Odense University Hospital, Denmark
| | - Søren Jacobsen
- Department of Geriatrics, Odense University Hospital, Svendborg Hospital, Denmark
| | | | | | - Peter Høgh
- Regional Dementia Research Center, Region Zealand, Roskilde Hospital, University of Copenhagen, Denmark
| | - Eva Bjerregaard
- Memory Clinic, Glostrup Hospital, University of Copenhagen, Denmark
| | - Birgitte B. Andersen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Volkert Siersma
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Denmark
| | - Peter Johannsen
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Carl W. Cotman
- Institute for Memory Impairments and Neurological Disorders, University of California-Irvine, CA, USA
| | - Gunhild Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Steen G. Hasselbalch
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Eskildsen SF, Gyldensted L, Nagenthiraja K, Hansen MB, Dalby RB, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. IC‐04‐01: Cortical capillary dysfunction in patients suspected of Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Eskildsen SF, Gyldensted L, Nagenthiraja K, Hansen MB, Dalby RB, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. P4‐062: Cortical capillary dysfunction in patients suspected of Alzheimer's disease. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.1767] [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: 11/28/2022]
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Eskildsen SF, Gyldensted L, Nagenthiraja K, Hansen M, Dalby R, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. IC‐P‐154: CAPILLARY TRANSIT TIME HETEROGENEITY IN THE CEREBRUM CORRELATE WITH COGNITIVE DECLINE IN AD. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.161] [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: 11/29/2022]
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Eskildsen SF, Gyldensted L, Nagenthiraja K, Hansen M, Dalby R, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. P1‐239: CAPILLARY TRANSIT TIME HETEROGENEITY IN THE CEREBRUM CORRELATE WITH COGNITIVE DECLINE IN AD. Alzheimers Dement 2014. [DOI: 10.1016/j.jalz.2014.05.478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Eskildsen S, Gyldensted L, Nagenthiraja K, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. P1–318: Increased oxygen extraction capacity in the basal ganglia and thalamus of patients with Alzheimer's disease. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Eskildsen S, Gyldensted L, Nagenthiraja K, Frandsen J, Rodell A, Gyldensted C, Jespersen SN, Mouridsen K, Brændgaard H, Østergaard L. IC‐P‐176: Increased oxygen extraction capacity in the basal ganglia and thalamus of people with Alzheimer's disease. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Østergaard L, Aamand R, Gutiérrez-Jiménez E, Ho YCL, Blicher JU, Madsen SM, Nagenthiraja K, Dalby RB, Drasbek KR, Møller A, Brændgaard H, Mouridsen K, Jespersen SN, Jensen MS, West MJ. The capillary dysfunction hypothesis of Alzheimer's disease. Neurobiol Aging 2012; 34:1018-31. [PMID: 23084084 DOI: 10.1016/j.neurobiolaging.2012.09.011] [Citation(s) in RCA: 136] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 08/17/2012] [Accepted: 09/07/2012] [Indexed: 12/21/2022]
Abstract
It is widely accepted that hypoperfusion and changes in capillary morphology are involved in the etiopathogenesis of Alzheimer's disease (AD). This is difficult to reconcile with the hyperperfusion observed in young high-risk subjects. Differences in the way cerebral blood flow (CBF) is coupled with the local metabolic needs during different phases of the disease can explain this apparent paradox. This review describes this coupling in terms of a model of cerebral oxygen availability that takes into consideration the heterogeneity of capillary blood flow patterns. The model predicts that moderate increases in heterogeneity requires elevated CBF in order to maintain adequate oxygenation. However, with progressive increases in heterogeneity, the resulting low tissue oxygen tension will require a suppression of CBF in order to maintain tissue metabolism. The observed biphasic nature of CBF responses in preclinical AD and AD is therefore consistent with progressive disturbances of capillary flow patterns. Salient features of the model are discussed in the context of AD pathology along with potential sources of increased capillary flow heterogeneity.
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Affiliation(s)
- Leif Østergaard
- Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus, Denmark.
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Egefjord L, Gejl M, Møller A, Brændgaard H, Gottrup H, Antropova O, Møller N, Poulsen HE, Gjedde A, Brock B, Rungby J. Effects of liraglutide on neurodegeneration, blood flow and cognition in Alzheimer´s disease - protocol for a controlled, randomized double-blinded trial. Dan Med J 2012; 59:A4519. [PMID: 23158895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Type 2 diabetes (DM-2) increases the risk of developing Alzheimer´s disease (AD), and patients with AD are more likely to develop DM-2. DM-2 and AD share some pathophysiological features. In AD, amyloid-β (Aβ) is accumulated as extracellular plaques in the gray matter of the brain, while in DM-2 islet amyloid polypeptide (IAPP) is accumulated in the pancreas. Premature cellular degeneration is seen in both diseases. Glucagon-like peptide-1 (GLP-1) reduces the amount of Aβ and improves cognition in animal studies. The present study tests the hypothesis that treatment with the long-acting GLP-1 receptor agonist liraglutide affects the accumulation of Aβ in patients with AD. MATERIAL AND METHODS This is a randomized, controlled, double-blinded intervention study with AD patients treated for six months with liraglutide (n = 20) or placebo (n = 20). The primary outcome is change in deposition of Aβ in the central nervous system (CNS) by Pittsburgh compound B positron emission tomography (PET). The secondary outcome is evaluation of cognition using a neuro-psychological test battery, and examination of changes in glucose uptake in the CNS by 18F-fluoro-deoxy-glucose PET. Finally, a perfusion-weighted magnetic resonance imaging with contrast will be performed to evaluate blood flow. CONCLUSION No registered drug affects the deposition of Aβ in the brain of AD patients. Our goal is to find a new therapeutic agent that alters the pathophysiology in AD patients by decreasing the formation of Aβ plaques and thereby presumably improves the cognitive function. FUNDING The trial is investigator-initiated and investigator-driven and is supported by Novo Nordisk Scandinavia. TRIAL REGISTRATION ClinicalTrials.gov: NCT01469351.
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Affiliation(s)
- Lærke Egefjord
- Institute of Biomedicine, Aarhus University, 8000 Aarhus C, Denmark.
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Lindquist SG, Brændgaard H, Nørremølle A, Svenstrup K, Hasholt L, Nielsen JE. P4–114: Autosomal dominant frontotemporal dementia linked to chromosome 3, FTD3:
Recent clinical and molecular findings. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Suzanne G. Lindquist
- Memory Disorders Research Group, Department of NeurologyCopenhagen University Hospital, RigshospitaletCopenhagen ØDenmark
- Department of Medical Biochemistry and Genetics, Section of NeurogeneticsThe Panum Institute, University of CopenhagenCopenhagenDenmark
| | - Hans Brændgaard
- Department of NeurologyÅrhus University HospitalÅrhusDenmark
| | - Anne Nørremølle
- Department of Medical Biochemistry and Genetics, Section of NeurogeneticsThe Panum Institute, University of CopenhagenCopenhagenDenmark
| | - Kirsten Svenstrup
- Department of Medical Biochemistry and Genetics, Section of NeurogeneticsThe Panum Institute, University of CopenhagenCopenhagenDenmark
| | - Lis Hasholt
- Department of Medical Biochemistry and Genetics, Section of NeurogeneticsThe Panum Institute, University of CopenhagenCopenhagenDenmark
| | - Jørgen E. Nielsen
- Memory Disorders Research Group, Department of NeurologyCopenhagen University Hospital, RigshospitaletCopenhagen ØDenmark
- Department of Medical Biochemistry and Genetics, Section of NeurogeneticsThe Panum Institute, University of CopenhagenCopenhagenDenmark
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