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Poole VN, Ridwan AR, Arfanakis K, Dawe RJ, Seyfried NT, De Jager PL, Schneider JA, Leurgans SE, Yu L, Bennett DA. Associations of brain morphology with cortical proteins of cognitive resilience. Neurobiol Aging 2024; 137:1-7. [PMID: 38394722 PMCID: PMC10949968 DOI: 10.1016/j.neurobiolaging.2024.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 02/05/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024]
Abstract
In a recent proteome-wide study, we identified several candidate proteins for drug discovery whose cortical abundance was associated with cognitive resilience to late-life brain pathologies. This study examines the extent to which these proteins are associated with the brain structures of cognitive resilience in decedents from the Religious Orders Study and Memory and Aging Project. Six proteins were associated with brain morphometric characteristics related to higher resilience (i.e., larger anterior and medial temporal lobe volumes), and five were associated with morphometric characteristics related to lower resilience (i.e., enlarged ventricles). Two synaptic proteins, RPH3A and CPLX1, remained inversely associated with the lower resilience signature, after further controlling for 10 neuropathologic indices. These findings suggest preserved brain structure in periventricular regions as a potential mechanism by which RPH3A and CPLX1 are associated with cognitive resilience. Further work is needed to elucidate other mechanisms by which targeting these proteins can circumvent the effects of pathology on individuals at risk for cognitive decline.
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Affiliation(s)
- Victoria N Poole
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA.
| | - Abdur R Ridwan
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Robert J Dawe
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | | | - Philip L De Jager
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Center for Translational and Computational Neuroimmunology, Columbia University Medical Center, New York, NY, USA; Cell Circuits Program, Broad Institute, Cambridge, MA, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Kapasi A, Capuano AW, Lamar M, Leurgans SE, Evia AM, Bennett DA, Arfanakis K, Schneider JA. Atherosclerosis and Hippocampal Volumes in Older Adults: The Role of Age and Blood Pressure. J Am Heart Assoc 2024; 13:e031551. [PMID: 38240240 DOI: 10.1161/jaha.123.031551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/05/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Lower hippocampal volume is associated with late-life cognitive decline and is an important, but nonspecific marker for clinical Alzheimer's dementia. Cerebrovascular disease may also be associated with hippocampal volume. Here we study the role of intracranial large vessel disease (atherosclerosis) in association with hippocampal volume and the potential role of age, average late-life blood pressure across all visits, and other factors (sex, apolipoprotein ε4 [APOE ε4], and diabetes). METHODS AND RESULTS Data came from 765 community-based older people (91 years old on average at death; 72% women), from 2 ongoing clinical-pathologic cohort studies. Participants completed baseline assessment, annual standardized blood pressure measurements, vascular risk assessment for diabetes, and blood draws to determine APOE genotype, and at death, brains were removed and underwent ex vivo magnetic resonance imaging and neuropathologic evaluation for atherosclerosis pathology and other cerebrovascular and neurodegenerative pathologies. Linear regression models examined the association of atherosclerosis and hippocampal to hemisphere volume ratio and whether age at death, blood pressure, and other factors modified associations. In linear regression models adjusted for demographics and neurodegenerative and other cerebrovascular pathologies, atherosclerosis severity was associated with a lower hippocampal to hemisphere volume ratio. In separate models, we found the effect of atherosclerosis on the ratio of hippocampal to hemisphere volume was attenuated among advanced age at death or having higher systolic blood pressure (interaction terms P≤0.03). We did not find confounding or interactions with sex, diabetes, or APOE ε4. CONCLUSIONS Atherosclerosis severity is associated with lower hippocampal volume, independent of neurodegenerative and other cerebrovascular pathologies. Higher systolic blood pressures and advanced age attenuate associations.
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Affiliation(s)
- Alifiya Kapasi
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Pathology (Neuropathology) Rush University Medical Center Chicago IL
| | - Ana W Capuano
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Neurological Sciences Rush University Medical Center Chicago IL
| | - Melissa Lamar
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago IL
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Neurological Sciences Rush University Medical Center Chicago IL
| | - Arnold M Evia
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
| | - David A Bennett
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Neurological Sciences Rush University Medical Center Chicago IL
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Biomedical Engineering Illinois Institute of Technology Chicago IL
- Department of Diagnostic Radiology Rush University Medical Center Chicago IL
| | - Julie A Schneider
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL
- Department of Pathology (Neuropathology) Rush University Medical Center Chicago IL
- Department of Neurological Sciences Rush University Medical Center Chicago IL
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Lamar M, Arfanakis K, Evia A, Makkinejad N, Capuano AW, Kim N, Leurgans SE, Fleischman DA, Duke Han S, Poole V, Barnes LL. Changes in an in-vivo classifier of ARTerioloSclerosis (ARTS) with simultaneous change in cognition for older African Americans. Neurobiol Aging 2024; 134:21-27. [PMID: 37979249 PMCID: PMC10845033 DOI: 10.1016/j.neurobiolaging.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/30/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
At autopsy, African American decedents often have mixed Alzheimer's and cerebrovascular brain pathologies including arteriolosclerosis. We applied a novel in-vivo classifier of ARTerioloSclerosis (ARTS) in 167 older African Americans (∼75y of age) with > 2 biennial 3 T MRI scans and > 3 years of associated cognitive follow-up to determine if ARTS scores (higher score=higher likelihood of arteriolosclerosis) changed over time and if this change associated with changes in cognition in the same individuals. Mixed effects regression models tested whether ARTS scores increased over time, while simultaneous mixed effects regression models estimated the simultaneous rates of change in both ARTS and cognition and the correlation of these changes. ARTS scores increased over time (estimate=0.030, SE=0.002, p < 0.0001). Faster increases in ARTS were associated with faster rates of global cognitive decline (r = -0.447, p = 0.006) and domain-specific cognitive functions. Applying an in-vivo marker of arteriolosclerosis in an African American cohort revealed that the likelihood of arteriolosclerosis increases over time, and participants whose ARTS scores increased more rapidly tended to have faster than average rates of cognitive decline.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | | | - Nazanin Makkinejad
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Namhee Kim
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - S Duke Han
- Rush Alzheimer's Disease Center, USA; Department of Family Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - Victoria Poole
- Rush Alzheimer's Disease Center, USA; Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, USA; Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Zanon Zotin MC, Makkinejad N, Schneider JA, Arfanakis K, Charidimou A, Greenberg SM, van Veluw SJ. Sensitivity and Specificity of the Boston Criteria Version 2.0 for the Diagnosis of Cerebral Amyloid Angiopathy in a Community-Based Sample. Neurology 2024; 102:e207940. [PMID: 38165367 PMCID: PMC10834125 DOI: 10.1212/wnl.0000000000207940] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 09/27/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The Boston criteria are a set of clinical and neuroimaging features that enable accurate diagnosis of cerebral amyloid angiopathy (CAA) without invasive methods such as brain biopsies or autopsy. The last updates to the Boston criteria, named version 2.0, were recently released and incorporated new nonhemorrhagic MRI features. These criteria have been validated in symptomatic samples, with improved diagnostic yield. We set out to investigate the accuracy of the Boston criteria v2.0 for the diagnosis of CAA in a community-based sample. METHODS Participants were recruited from longitudinal clinical-pathologic studies of aging conducted at the Rush Alzheimer's Disease Center in Chicago: the Religious Orders Study and the Rush Memory and Aging Project. Deceased participants with in vivo 3T MRI and detailed pathologic data available were included in the analysis. We compared the diagnostic yield of the current and earlier versions of the Boston criteria in our sample. Among those classified as probable CAA according to the Boston criteria v2.0, we investigated the ability of each neuroimaging marker to distinguish between false-positive and true-positive cases. RESULTS In total, 134 individuals were included in the study (mean age = 82.4 ± 6.0 years; 69.4% F), and 49 of them were considered pathology-proven definite cases with CAA (mean age = 82.9 ± 6.0 years; 63.3% F). The Boston criteria versions 1.0 and 1.5 yielded similar sensitivity (26.5%, both), specificity (90.6% and 89.4%, respectively), and predictive values (negative: 68.1% and 67.9%; positive: 61.9% and 59.1%, respectively). The recently released Boston criteria v2.0 offered higher sensitivity (38.8%) and slightly lower specificity (83.5%). Among those classified as probable CAA (v2.0), pathology-proven true-positive cases had higher numbers of strictly cortical lobar microbleeds compared with false-positive cases (p = 0.004). DISCUSSION Similar to findings from symptomatic samples, the inclusion of nonhemorrhagic neuroimaging markers in the updated Boston criteria offered a 12.3% gain in sensitivity among community-dwelling individuals, at the expense of a 5.9% drop in specificity. In cases with probable CAA, the cortical location of microbleeds may represent a promising distinguishing feature between true-positive and false-positive cases. Despite its improved performance, the diagnostic sensitivity of the updated criteria in a community-based sample remains limited. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that the Boston criteria v2.0 accurately distinguishes people with CAA from those without CAA.
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Affiliation(s)
- Maria Clara Zanon Zotin
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Nazanin Makkinejad
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Julie A Schneider
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Konstantinos Arfanakis
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Andreas Charidimou
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Steven M Greenberg
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Susanne J van Veluw
- From the J. Philip Kistler Stroke Research Center (M.C.Z.Z., N.M., A.C., S.M.G., S.J.V.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Center for Imaging Sciences and Medical Physics (M.C.Z.Z.), Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo, Brazil; Rush Alzheimer's Disease Center (J.A.S., K.A.), Rush University Medical Center; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
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Lamar M, Arfanakis K, Yu L, Kapasi A, Duke Han S, Fleischman DA, Bennett DA, Boyle P. The Relationship of MRI-Derived Alzheimer's and Cerebrovascular-Related Signatures With Level of and Change in Health and Financial Literacy. Am J Geriatr Psychiatry 2023; 31:1129-1139. [PMID: 37541932 PMCID: PMC10800641 DOI: 10.1016/j.jagp.2023.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE The cortical thickness "signature" of Alzheimer's disease (AD-CT) and white matter hyperintensity (WMH) burden have each been associated with cognitive aging and incident AD and related dementias. Less is known about how these structural neuroimaging markers associate with other critical behaviors. We investigated associations of AD-CT and WMH volumes with a composite index of health and financial literacy given that the ability to access, understand, and utilize health and financial information significantly influences older adults' health outcomes. DESIGN, SETTING, PARTICIPANTS Participants were 303 adults without dementia (age∼80 years; 74% women) from the Rush Memory and Aging Project. MEASUREMENTS Baseline 3T MRI T1-weighted structural and T2-weighted FLAIR data were used to assess AD-CT and WMH volumes, respectively. Literacy was measured using questions designed to assess comprehension of health and financial information and concepts, yielding a total literacy score. Multivariable linear mixed effects regression models determined the relationship of each neuroimaging marker, first separately and then combined, with the level of and change in literacy. RESULTS Reduced AD-CT and higher WMH at baseline were each associated with lower levels of literacy; only AD-CT was associated with the rate of decline in literacy over time. The association of AD-CT with change in literacy persisted when both neuroimaging markers were included in the same model. CONCLUSIONS The cortical thickness signature of AD predicts changes in health and financial literacy in nondemented older adults suggesting that the multidimensional construct of health and financial literacy relies on specific brain networks implicated in AD.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL.
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Diagnostic Radiology and Nuclear Medicine (KA, AK), Rush University Medical Center, Chicago, IL; Department of Biomedical Engineering (KA), Illinois Institute of Technology, Chicago, IL
| | - Lei Yu
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - Alifiya Kapasi
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Diagnostic Radiology and Nuclear Medicine (KA, AK), Rush University Medical Center, Chicago, IL
| | - S Duke Han
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Family Medicine (SDH), Keck School of Medicine of University of Southern California, Los Angeles, CA
| | - Debra A Fleischman
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Neurological Sciences (LY, DAF, DAB), Rush University Medical Center, Chicago, IL
| | - Patricia Boyle
- Rush Alzheimer's Disease Center (ML, KA, LY, AK, SDH, DAF, DAB, PB), Rush University Medical Center, Chicago, IL; Department of Psychiatry and Behavioral Sciences (ML, DAF, PB), Rush University Medical Center, Chicago, IL
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Wu Y, Ridwan AR, Niaz MR, Bennett DA, Arfanakis K. High resolution 0.5mm isotropic T 1-weighted and diffusion tensor templates of the brain of non-demented older adults in a common space for the MIITRA atlas. Neuroimage 2023; 282:120387. [PMID: 37783362 PMCID: PMC10625170 DOI: 10.1016/j.neuroimage.2023.120387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/22/2023] [Indexed: 10/04/2023] Open
Abstract
High quality, high resolution T1-weighted (T1w) and diffusion tensor imaging (DTI) brain templates located in a common space can enhance the sensitivity and precision of template-based neuroimaging studies. However, such multimodal templates have not been constructed for the older adult brain. The purpose of this work which is part of the MIITRA atlas project was twofold: (A) to develop 0.5 mm isotropic resolution T1w and DTI templates that are representative of the brain of non-demented older adults and are located in the same space, using advanced multimodal template construction techniques and principles of super resolution on data from a large, diverse, community cohort of 400 non-demented older adults, and (B) to systematically compare the new templates to other standardized templates. It was demonstrated that the new MIITRA-0.5mm T1w and DTI templates are well-matched in space, exhibit good definition of brain structures, including fine structures, exhibit higher image sharpness than other standardized templates, and are free of artifacts. The MIITRA-0.5mm T1w and DTI templates allowed higher intra-modality inter-subject spatial normalization precision as well as higher inter-modality intra-subject spatial matching of older adult T1w and DTI data compared to other available templates. Consequently, MIITRA-0.5mm templates allowed detection of smaller inter-group differences for older adult data compared to other templates. The MIITRA-0.5mm templates were also shown to be most representative of the brain of non-demented older adults compared to other templates with submillimeter resolution. The new templates constructed in this work constitute two of the final products of the MIITRA atlas project and are anticipated to have important implications for the sensitivity and precision of studies on older adults.
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Affiliation(s)
- Yingjuan Wu
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - Abdur Raquib Ridwan
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - Mohammad Rakeen Niaz
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.
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Wang Z, Wang J, Guo J, Dove A, Arfanakis K, Qi X, Bennett DA, Xu W. Association of Motor Function With Cognitive Trajectories and Structural Brain Differences: A Community-Based Cohort Study. Neurology 2023; 101:e1718-e1728. [PMID: 37657942 PMCID: PMC10624482 DOI: 10.1212/wnl.0000000000207745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/20/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The association of motor function with cognitive health remains controversial, and the mechanisms underlying this relationship are unclear. We aimed to examine the association between motor function and long-term cognitive trajectories and further explore the underlying mechanisms using brain MRI. METHODS In the Rush Memory and Aging Project, a prospective cohort study, a total of 2,192 volunteers were recruited from the communities in northeastern Illinois and followed up for up to 22 years (from 1997 to 2020). Individuals with dementia, disability, missing data on motor function at baseline, and missing follow-up data on cognitive function were excluded. At baseline, global motor function was evaluated using the averaged z scores of 10 motor tests covering dexterity, gait, and hand strength; the composite score was tertiled as low, moderate, or high. Global and domain-specific cognitive functions-including episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed-were measured annually through 19 cognitive tests. A subsample (n = 401) underwent brain MRI scans and regional brain volumes were measured. Data were analyzed using linear mixed-effects models and linear regression. RESULTS Among the 1,618 participants (mean age 79.45 ± 7.32 years) included in this study, baseline global motor function score ranged from 0.36 to 1.82 (mean 1.03 ± 0.22). Over the follow-up (median 6.03 years, interquartile range 3.00-10.01 years), low global motor function and its subcomponents were related to significantly faster declines in global cognitive function (β = -0.005, 95% CI -0.006 to -0.005) and each of the 5 cognitive domains. Of the 344 participants with available MRI data, low motor function was also associated with smaller total brain (β = -25.848, 95% CI -44.902 to -6.795), total white matter (β = -18.252, 95% CI -33.277 to -3.226), and cortical white matter (β = -17.503, 95% CI -32.215 to -2.792) volumes, but a larger volume of white matter hyperintensities (β = 0.257, 95% CI 0.118-0.397). DISCUSSION Low motor function is associated with an accelerated decline in global and domain-specific cognitive functions. Both neurodegenerative and cerebrovascular pathologies might contribute to this association.
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Affiliation(s)
- Zhangyu Wang
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Jiao Wang
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Jie Guo
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Abigail Dove
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Konstantinos Arfanakis
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Xiuying Qi
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - David A Bennett
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago
| | - Weili Xu
- From the Department of Epidemiology and Biostatistics (Z.W., J.W., X.Q., W.X.), School of Public Health, Tianjin Medical University, China; Aging Research Center, Department of Neurobiology (J.G., A.D., W.X.), Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Rush Alzheimer's Disease Center (K.A., D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Biomedical Engineering (K.A.), Illinois Institute of Technology, Chicago.
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8
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Poole VN, Oveisgharan S, Yu L, Dawe RJ, Leurgans SE, Zhang S, Arfanakis K, Buchman AS, Bennett DA. Volumetric brain correlates of gait associated with cognitive decline in community-dwelling older adults. Front Aging Neurosci 2023; 15:1194986. [PMID: 37860122 PMCID: PMC10582745 DOI: 10.3389/fnagi.2023.1194986] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 09/14/2023] [Indexed: 10/21/2023] Open
Abstract
Objective To determine the extent to which the regional brain volumes associated with slow gait speed can inform subsequent cognitive decline in older adults from the Rush Memory and Aging Project. Approach We utilized deformation-based morphometry (DBM) in a whole-brain exploratory approach to identify the regional brain volumes associated with gait speed assessed over a short distance during an in-home assessment. We created deformation scores to summarize the gait-associated regions and entered the scores into a series of longitudinal mixed effects models to determine the extent to which deformation predicted change in cognition over time, controlling for associations between gait and cognition. Results In 438 older adults (81 ± 7; 76% female), DBM revealed that slower gait speed was associated with smaller volumes across frontal white matter, temporal grey matter, and subcortical areas and larger volumes in the ventricles during the same testing cycle. When a subset was followed over multiple (5 ± 2) years, slower gait speed was also associated with annual declines in global cognition, executive functioning, and memory abilities. Several of the gait-related brain structures were associated with these declines in cognition; however, larger ventricles and smaller medial temporal lobe volumes proved most robust and attenuated the association between slow gait and cognitive decline. Conclusion Regional brain volumes in the ventricles and temporal lobe associated with both slow gait speed and faster cognitive decline have potential to improve risk stratification for cognitive decline in older adults.
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Affiliation(s)
- Victoria N. Poole
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Shahram Oveisgharan
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Robert J. Dawe
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Family and Preventive Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
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9
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Nikseresht G, Evia AM, Nag S, Leurgans SE, Capuano AW, Agam G, Barnes LL, Bennett DA, Schneider JA, Arfanakis K. Neuropathologic correlates of cerebral microbleeds in community-based older adults. Neurobiol Aging 2023; 129:89-98. [PMID: 37279617 PMCID: PMC10524842 DOI: 10.1016/j.neurobiolaging.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/14/2023] [Accepted: 05/04/2023] [Indexed: 06/08/2023]
Abstract
Cerebral microbleeds (CMBs) appearing as hypointense foci on T2*-weighted magnetic resonance images are small hemorrhages that have been linked to cognitive decline and increased mortality. However, the neuropathologic correlates of CMBs in community-based older adults are poorly understood. The present study investigated the association of age-related neuropathologies with CMBs in community-based older adults. Cerebral hemispheres from 289 participants of the Rush Memory and Aging Project, Religious Orders Study, Minority Aging Research Study, and Rush Alzheimer's Disease Clinical Core underwent ex vivo MRI and detailed neuropathologic examination. Following Bonferroni correction, CMBs in the cerebrum overall and in the frontal lobe were associated with cerebral amyloid angiopathy, CMBs in the frontal lobe were also associated with arteriolosclerosis, and CMBs in the basal ganglia showed a borderline significant association with microinfarcts. These findings suggest that CMBs can aid in the prediction of small vessel disease in community-based older adults. Finally, CMBs were not associated with dementia, suggesting that CMBs in community-based older adults may not be linked to substantial cognitive impairment.
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Affiliation(s)
- Grant Nikseresht
- Department of Computer Science, Illinois Institute of Technology, Chicago, IL, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Arnold M Evia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Sukriti Nag
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Ana W Capuano
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Gady Agam
- Department of Computer Science, Illinois Institute of Technology, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Diagnostic Radiology, Rush University Medical Center, Chicago, IL, USA.
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10
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Barnes LL, Dhana K, Liu X, Carey VJ, Ventrelle J, Johnson K, Hollings CS, Bishop L, Laranjo N, Stubbs BJ, Reilly X, Agarwal P, Zhang S, Grodstein F, Tangney CC, Holland TM, Aggarwal NT, Arfanakis K, Morris MC, Sacks FM. Trial of the MIND Diet for Prevention of Cognitive Decline in Older Persons. N Engl J Med 2023; 389:602-611. [PMID: 37466280 PMCID: PMC10513737 DOI: 10.1056/nejmoa2302368] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Findings from observational studies suggest that dietary patterns may offer protective benefits against cognitive decline, but data from clinical trials are limited. The Mediterranean-DASH Intervention for Neurodegenerative Delay, known as the MIND diet, is a hybrid of the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet, with modifications to include foods that have been putatively associated with a decreased risk of dementia. METHODS We performed a two-site, randomized, controlled trial involving older adults without cognitive impairment but with a family history of dementia, a body-mass index (the weight in kilograms divided by the square of the height in meters) greater than 25, and a suboptimal diet, as determined by means of a 14-item questionnaire, to test the cognitive effects of the MIND diet with mild caloric restriction as compared with a control diet with mild caloric restriction. We assigned the participants in a 1:1 ratio to follow the intervention or the control diet for 3 years. All the participants received counseling regarding adherence to their assigned diet plus support to promote weight loss. The primary end point was the change from baseline in a global cognition score and four cognitive domain scores, all of which were derived from a 12-test battery. The raw scores from each test were converted to z scores, which were averaged across all tests to create the global cognition score and across component tests to create the four domain scores; higher scores indicate better cognitive performance. The secondary outcome was the change from baseline in magnetic resonance imaging (MRI)-derived measures of brain characteristics in a nonrandom sample of participants. RESULTS A total of 1929 persons underwent screening, and 604 were enrolled; 301 were assigned to the MIND-diet group and 303 to the control-diet group. The trial was completed by 93.4% of the participants. From baseline to year 3, improvements in global cognition scores were observed in both groups, with increases of 0.205 standardized units in the MIND-diet group and 0.170 standardized units in the control-diet group (mean difference, 0.035 standardized units; 95% confidence interval, -0.022 to 0.092; P = 0.23). Changes in white-matter hyperintensities, hippocampal volumes, and total gray- and white-matter volumes on MRI were similar in the two groups. CONCLUSIONS Among cognitively unimpaired participants with a family history of dementia, changes in cognition and brain MRI outcomes from baseline to year 3 did not differ significantly between those who followed the MIND diet and those who followed the control diet with mild caloric restriction. (Funded by the National Institute on Aging; ClinicalTrials.gov number, NCT02817074.).
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Affiliation(s)
- Lisa L Barnes
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Klodian Dhana
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Xiaoran Liu
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Vincent J Carey
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Jennifer Ventrelle
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Kathleen Johnson
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Chiquia S Hollings
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Louise Bishop
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Nancy Laranjo
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Benjamin J Stubbs
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Xavier Reilly
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Puja Agarwal
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Shengwei Zhang
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Francine Grodstein
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Christy C Tangney
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Thomas M Holland
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Neelum T Aggarwal
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Konstantinos Arfanakis
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Martha Clare Morris
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
| | - Frank M Sacks
- From Rush Alzheimer's Disease Center (L.L.B., P.A., S.Z., F.G., N.T.A., K.A.), the Department of Neurology (L.L.B., N.T.A.), Rush Institute for Healthy Aging (K.D., X.L., C.S.H., T.M.H.), and the Departments of Internal Medicine (K.D., X.L., C.S.H., P.A., F.G., T.M.H., M.C.M.), Clinical Nutrition (J.V., P.A., C.C.T.), Preventive Medicine (J.V., C.C.T.), and Diagnostic Radiology and Nuclear Medicine (K.A.), Rush University Medical Center, and the Department of Biomedical Engineering, Illinois Institute of Technology (K.A.) - all in Chicago; and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital (V.J.C., N.L., B.J.S., X.R.), Harvard Medical School (V.J.C., N.L., B.J.S., X.R.), and the Department of Nutrition, Harvard T.H. Chan School of Public Health (K.J., L.B., F.M.S.) - all in Boston
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11
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Wuestefeld A, Pichet Binette A, Berron D, Spotorno N, van Westen D, Stomrud E, Mattsson-Carlgren N, Strandberg O, Smith R, Palmqvist S, Glenn T, Moes S, Honer M, Arfanakis K, Barnes LL, Bennett DA, Schneider JA, Wisse LEM, Hansson O. Age-related and amyloid-beta-independent tau deposition and its downstream effects. Brain 2023; 146:3192-3205. [PMID: 37082959 PMCID: PMC10393402 DOI: 10.1093/brain/awad135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/20/2023] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
Amyloid-β (Aβ) is hypothesized to facilitate the spread of tau pathology beyond the medial temporal lobe. However, there is evidence that, independently of Aβ, age-related tau pathology might be present outside of the medial temporal lobe. We therefore aimed to study age-related Aβ-independent tau deposition outside the medial temporal lobe in two large cohorts and to investigate potential downstream effects of this on cognition and structural measures. We included 545 cognitively unimpaired adults (40-92 years) from the BioFINDER-2 study (in vivo) and 639 (64-108 years) from the Rush Alzheimer's Disease Center cohorts (ex vivo). 18F-RO948- and 18F-flutemetamol-PET standardized uptake value ratios were calculated for regional tau and global/regional Aβ in vivo. Immunohistochemistry was used to estimate Aβ load and tangle density ex vivo. In vivo medial temporal lobe volumes (subiculum, cornu ammonis 1) and cortical thickness (entorhinal cortex, Brodmann area 35) were obtained using Automated Segmentation for Hippocampal Subfields packages. Thickness of early and late neocortical Alzheimer's disease regions was determined using FreeSurfer. Global cognition and episodic memory were estimated to quantify cognitive functioning. In vivo age-related tau deposition was observed in the medial temporal lobe and in frontal and parietal cortical regions, which was statistically significant when adjusting for Aβ. This was also observed in individuals with low Aβ load. Tau deposition was negatively associated with cortical volumes and thickness in temporal and parietal regions independently of Aβ. The associations between age and cortical volume or thickness were partially mediated via tau in regions with early Alzheimer's disease pathology, i.e. early tau and/or Aβ pathology (subiculum/Brodmann area 35/precuneus/posterior cingulate). Finally, the associations between age and cognition were partially mediated via tau in Brodmann area 35, even when including Aβ-PET as covariate. Results were validated in the ex vivo cohort showing age-related and Aβ-independent increases in tau aggregates in and outside the medial temporal lobe. Ex vivo age-cognition associations were mediated by medial and inferior temporal tau tangle density, while correcting for Aβ density. Taken together, our study provides support for primary age-related tauopathy even outside the medial temporal lobe in vivo and ex vivo, with downstream effects on structure and cognition. These results have implications for our understanding of the spreading of tau outside the medial temporal lobe, also in the context of Alzheimer's disease. Moreover, this study suggests the potential utility of tau-targeting treatments in primary age-related tauopathy, likely already in preclinical stages in individuals with low Aβ pathology.
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Affiliation(s)
- Anika Wuestefeld
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Alexa Pichet Binette
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany
| | - Nicola Spotorno
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Danielle van Westen
- Department of Diagnostic Radiology, Clinical Sciences, Lund University, SE-222 42 Lund, Sweden
- Image and Function, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Niklas Mattsson-Carlgren
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Department of Neurology, Skåne University Hospital, SE-205 02 Malmö, Sweden
- Wallenberg Center for Molecular Medicine, Lund University, 221 84 Lund, Sweden
| | - Olof Strandberg
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
| | - Ruben Smith
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Department of Neurology, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Sebastian Palmqvist
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
| | - Trevor Glenn
- Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Svenja Moes
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Michael Honer
- Roche Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, CH-4070 Basel, Switzerland
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL 60616, USA
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA
| | - Laura E M Wisse
- Department of Diagnostic Radiology, Clinical Sciences, Lund University, SE-222 42 Lund, Sweden
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, SE-222 42 Lund, Sweden
- Memory Clinic, Skåne University Hospital, SE-205 02 Malmö, Sweden
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12
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Liu X, Barisano G, Shao X, Jann K, Ringman JM, Lu H, Arfanakis K, Caprihan A, DeCarli C, Gold BT, Maillard P, Satizabal CL, Fadaee E, Habes M, Stables L, Singh H, Fischl B, Kouwe AVD, Schwab K, Helmer KG, Greenberg SM, Wang DJJ. Cross-Vendor Test-Retest Validation of Diffusion Tensor Image Analysis along the Perivascular Space (DTI-ALPS) for Evaluating Glymphatic System Function. Aging Dis 2023:AD.2023.0321-2. [PMID: 37307817 DOI: 10.14336/ad.2023.0321-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/21/2023] [Indexed: 06/14/2023] Open
Abstract
The diffusion tensor image analysis along the perivascular space (DTI-ALPS) method was proposed to evaluate glymphatic system (GS) function. However, few studies have validated its reliability and reproducibility. Fifty participants' DTI data from the MarkVCID consortium were included in this study. Two pipelines by using DSI studio and FSL software were developed for data processing and ALPS index calculation. The ALPS index was obtained by the average of bilateral ALPS index and was used for testing the cross-vendor, inter-rater and test-retest reliability by using R studio software. The ALPS index demonstrated favorable inter-scanner reproducibility (ICC=0.77 to 0.95, P < 0.001), inter-rater reliability (ICC=0.96 to 1, P< 0.001) and test-retest repeatability (ICC=0.89 to 0.95, P< 0.001), offering a potential biomarker for in vivo evaluation of GS function.
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Affiliation(s)
- Xiaodan Liu
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
- Zilkha Neurogenetic Institute, University of Southern California, Los Angeles, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | | | - Xingfeng Shao
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - John M Ringman
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hanzhang Lu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University, Chicago, IL, USA
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | | | - Charles DeCarli
- Department of Neurology, University of California, Davis, Davis, CA, USA
| | - Brian T Gold
- Department of Neuroscience, University of Kentucky, Lexington, KY, USA
| | - Pauline Maillard
- Department of Neurology, University of California, Davis, Davis, CA, USA
| | - Claudia L Satizabal
- Population Health Sciences and Glenn Biggs Institute for Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Elyas Fadaee
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mohamad Habes
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Lara Stables
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Herpreet Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Bruce Fischl
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
- Division of Health Sciences and Technology, Massachusetts Institute of Technology, Computer Science and AI Lab, Cambridge, Massachusetts, USA
| | - Andre van der Kouwe
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Kristin Schwab
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Karl G Helmer
- Department of Radiology, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, MA, USA
| | - Steven M Greenberg
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Danny J J Wang
- Laboratory of FMRI Technology (LOFT), Mark & Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
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13
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Fleischman DA, Arfanakis K, Leurgans SE, Zhang S, Lamar M, Han SD, Poole VN, Kim N, Bennett DA, Barnes LL. Late-life depressive symptoms and white matter structural integrity within older Black adults. Front Aging Neurosci 2023; 15:1138568. [PMID: 37205056 PMCID: PMC10186351 DOI: 10.3389/fnagi.2023.1138568] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/12/2023] [Indexed: 05/21/2023] Open
Abstract
Introduction Older Black adults experience a high burden of depressive symptoms and cerebrovascular disease but the specific neurobiological substrates underlying the association between late-life depressive symptoms and brain integrity are understudied, particularly in within-group designs. Methods Using the Center for Epidemiologic Studies Depression Scale and diffusion-tensor imaging, within-Black variation in the association between late-life depressive symptoms and white matter structural integrity was examined in 297 older Black participants without dementia that were enrolled across three epidemiological studies of aging and dementia. Linear regression models were used to test associations with DTI metrics (fractional anisotropy, trace of the diffusion tensor) as the outcomes and depressive symptoms as the predictor, while adjusting for age, sex, education, scanner, serotonin-reuptake inhibitor use, total volume of white-matter hyperintensities normalized by intracranial volume, and presence of white-matter hyperintensities at the voxel level. Results Higher level of self-reported late-life depressive symptoms was associated with greater diffusion-tensor trace (reduced white matter integrity) in connections between commissural pathways and contralateral prefrontal regions (superior and middle frontal/dorsolateral prefrontal cortex), association pathways connecting dorsolateral prefrontal cortex with insular, striatal and thalamic regions, and association pathways connecting the parietal, temporal and occipital lobes and the thalamus. Discussion This study demonstrated a discernable pattern of compromised white matter structural integrity underlying late-life depressive symptoms within older Black adults.
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Affiliation(s)
- Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, United States
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Preventive Medicine, Rush University Medical Center, Chicago IL, United States
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Family Medicine and Neurology, Keck School of Medicine, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
- School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Victoria N. Poole
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States
| | - Namhee Kim
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
| | | | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Chicago, IL, United States
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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14
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Glover CM, Arfanakis K, Aggarwal NT, Bennett DA, Marquez DX, Barnes LL. A Qualitative Examination of Knowledge, Experiences, and Considerations of PET Brain Scan Participation Among Older Black and Latino Adults. J Alzheimers Dis 2023; 91:961-976. [PMID: 36530086 DOI: 10.3233/jad-220861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Biological biomarkers yielded from positron emission tomography (PET) brain scans serve as a pathway to understanding Alzheimer's disease pathology. PET brain scan data remain limited for populations traditionally under-included in aging research. OBJECTIVE The purpose of this qualitative study was to examine participant-identified barriers to PET brain scan consent and characterize participant-informed elements of educational materials needed to facilitate PET brain scan participation among older Black and Latino adults. METHODS Participants (N = 31) were older adults (mean age = 71 years) who self-identified as either non-Latino Black (n = 15) or Latino (n = 16). Each participant took part in a one-time, in-depth individual interview. Researchers analyzed data guided by a Grounded Theory Approach with both Open Coding and Constant Comparative Coding. RESULTS Four overarching themes emerged across all participants: 1) knowledge limitations; 2) requirements for consent; 3) motivators for participation; and 4) social networks. Within the four themes, there were differences based on participant ethnoracial group. For example, for Theme Three, older Black adults indicated that they would expect compensation for PET brain scan participation. Conversely, older Latinos stated that they would appreciate, but not anticipate, a financial incentive. All participants stressed the importance of written educational materials with subsequent verbal discussions with studystaff. CONCLUSION Findings inform the development and implementation of scientifically-relevant and culturally-cognizant engagement approaches, educational materials, and recruitment strategies to increase PET brain scan participation by diverse older adults.
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Affiliation(s)
- Crystal M Glover
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL, USA.,Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA.,Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
| | - David X Marquez
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Kinesiology and Nutrition, University of Illinois - Chicago, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Psychiatry and Behavioral Sciences, Rush Medical College, Chicago, IL, USA.,Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
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15
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Oveisgharan S, Kim N, Agrawal S, Yu L, Leurgans S, Kapasi A, Arfanakis K, Bennett DA, Schneider JA, Buchman AS. Brain and spinal cord arteriolosclerosis and its associations with cerebrovascular disease risk factors in community-dwelling older adults. Acta Neuropathol 2023; 145:219-233. [PMID: 36469116 PMCID: PMC10183107 DOI: 10.1007/s00401-022-02527-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/30/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
Arteriolosclerosis is common in older brains and related to cognitive and motor impairment. We compared the severity of arteriolosclerosis and its associations with cerebrovascular disease risk factors (CVD-RFs) in multiple locations in the brain and spinal cord. Participants (n = 390) were recruited in the context of a longitudinal community-based clinical-pathological study, the Rush Memory and Aging Project. CVD-RFs were assessed annually for an average of 8.7 (SD = 4.3) years before death. The annual assessments included systolic (SBP) and diastolic (DBP) blood pressure, diabetes mellitus (DM), low- and high-density lipoprotein cholesterol, triglyceride, body mass index, and smoking. Postmortem pathological assessments included assessment of arteriolosclerosis severity using the same rating scale in three brain locations (basal ganglia, frontal, and parietal white matter regions) and four spinal cord levels (cervical, thoracic, lumbar and sacral levels). A single measure was used to summarize the severity of spinal arteriolosclerosis assessments at the four levels due to their high correlations. Average age at death was 91.5 (SD = 6.2) years, and 73% were women. Half showed arteriolosclerosis in frontal white matter and spinal cord followed by parietal white matter (38%) and basal ganglia (27%). The severity of arteriolosclerosis in all three brain locations showed mild-to-moderate correlations. By contrast, spinal arteriolosclerosis was associated with brain arteriolosclerosis only in frontal white matter. Higher DBP was associated with more severe arteriolosclerosis in all three brain locations. DM was associated with more severe arteriolosclerosis only in frontal white matter. Controlling for DBP, higher SBP was inversely associated with arteriolosclerosis in parietal white matter. Blood cholesterol and triglyceride, high body mass index, or smoking were not related to the severity of arteriolosclerosis in any brain region. None of the CVD-RFs were associated with the severity of spinal arteriolosclerosis. These data indicate that severity of arteriolosclerosis and its associations with CVD-RFs may vary in different CNS locations.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
| | - Namhee Kim
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alifiya Kapasi
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison, Suite 1000, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Nelson PT, Lee EB, Cykowski MD, Alafuzoff I, Arfanakis K, Attems J, Brayne C, Corrada MM, Dugger BN, Flanagan ME, Ghetti B, Grinberg LT, Grossman M, Grothe MJ, Halliday GM, Hasegawa M, Hokkanen SRK, Hunter S, Jellinger K, Kawas CH, Keene CD, Kouri N, Kovacs GG, Leverenz JB, Latimer CS, Mackenzie IR, Mao Q, McAleese KE, Merrick R, Montine TJ, Murray ME, Myllykangas L, Nag S, Neltner JH, Newell KL, Rissman RA, Saito Y, Sajjadi SA, Schwetye KE, Teich AF, Thal DR, Tomé SO, Troncoso JC, Wang SHJ, White CL, Wisniewski T, Yang HS, Schneider JA, Dickson DW, Neumann M. LATE-NC staging in routine neuropathologic diagnosis: an update. Acta Neuropathol 2023; 145:159-173. [PMID: 36512061 PMCID: PMC9849315 DOI: 10.1007/s00401-022-02524-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/15/2022]
Abstract
An international consensus report in 2019 recommended a classification system for limbic-predominant age-related TDP-43 encephalopathy neuropathologic changes (LATE-NC). The suggested neuropathologic staging system and nomenclature have proven useful for autopsy practice and dementia research. However, some issues remain unresolved, such as cases with unusual features that do not fit with current diagnostic categories. The goal of this report is to update the neuropathologic criteria for the diagnosis and staging of LATE-NC, based primarily on published data. We provide practical suggestions about how to integrate available genetic information and comorbid pathologies [e.g., Alzheimer's disease neuropathologic changes (ADNC) and Lewy body disease]. We also describe recent research findings that have enabled more precise guidance on how to differentiate LATE-NC from other subtypes of TDP-43 pathology [e.g., frontotemporal lobar degeneration (FTLD) and amyotrophic lateral sclerosis (ALS)], and how to render diagnoses in unusual situations in which TDP-43 pathology does not follow the staging scheme proposed in 2019. Specific recommendations are also made on when not to apply this diagnostic term based on current knowledge. Neuroanatomical regions of interest in LATE-NC are described in detail and the implications for TDP-43 immunohistochemical results are specified more precisely. We also highlight questions that remain unresolved and areas needing additional study. In summary, the current work lays out a number of recommendations to improve the precision of LATE-NC staging based on published reports and diagnostic experience.
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Affiliation(s)
- Peter T Nelson
- University of Kentucky, Rm 575 Todd Building, Lexington, KY, USA.
| | - Edward B Lee
- University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Konstantinos Arfanakis
- Rush University Medical Center, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
| | | | | | | | | | | | | | | | | | - Michel J Grothe
- Unidad de Trastornos del Movimiento, Servicio de Neurología Y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | | | - Masato Hasegawa
- Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | | | | | | | | | | | | | - Gabor G Kovacs
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada
- Laboratory Medicine Program, University Health Network, Toronto, Canada
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Qinwen Mao
- University of Utah, Salt Lake City, UT, USA
| | | | | | | | | | - Liisa Myllykangas
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sukriti Nag
- Rush University Medical Center, Chicago, IL, USA
| | - Janna H Neltner
- University of Kentucky, Rm 575 Todd Building, Lexington, KY, USA
| | | | | | - Yuko Saito
- Tokyo Metropolitan Geriatric Hospital & Institute of Gerontology, Tokyo, Japan
| | | | | | | | - Dietmar R Thal
- Laboratory for Neuropathology, Department of Imaging and Pathoogy, and Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Department of Pathology, University Hospital Leuven, Leuven, Belgium
| | - Sandra O Tomé
- Laboratory for Neuropathology, Department of Imaging and Pathoogy, and Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | | | | | - Charles L White
- University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Hyun-Sik Yang
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, BostonBoston, MAMA, USA
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Lee AJ, Ma Y, Yu L, Dawe RJ, McCabe C, Arfanakis K, Mayeux R, Bennett DA, Klein HU, De Jager PL. Multi-region brain transcriptomes uncover two subtypes of aging individuals with differences in Alzheimer risk and the impact of APOEε4. bioRxiv 2023:2023.01.25.524961. [PMID: 36747803 PMCID: PMC9900823 DOI: 10.1101/2023.01.25.524961] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The heterogeneity of the older population suggests the existence of subsets of individuals which share certain brain molecular features and respond differently to risk factors for Alzheimer's disease, but this population structure remains poorly defined. Here, we performed an unsupervised clustering of individuals with multi-region brain transcriptomes to assess whether a broader approach, simultaneously considering data from multiple regions involved in cognition would uncover such subsets. We implemented a canonical correlation-based analysis in a Discovery cohort of 459 participants from two longitudinal studies of cognitive aging that have RNA sequence profiles in three brain regions. 690 additional participants that have data in only one or two of these regions were used in the Replication effort. These clustering analyses identified two meta-clusters, MC-1 and MC-2. The two sets of participants differ primarily in their trajectories of cognitive decline, with MC-2 having a delay of 3 years to the median age of incident dementia. This is due, in part, to a greater impact of tau pathology on neuronal chromatin architecture and to broader brain changes including greater loss of white matter integrity in MC-1. Further evidence of biological differences includes a significantly larger impact of APOEε4 risk on cognitive decline in MC-1. These findings suggest that our proposed population structure captures an aspect of the more distributed molecular state of the aging brain that either enhances the effect of risk factors in MC-1 or of protective effects in MC-2. These observations may inform the design of therapeutic development efforts and of trials as both become increasingly more targeted molecularly. One Sentence Summary: There are two types of aging brains, with one being more vulnerable to APOEε4 and subsequent neuronal dysfunction and cognitive loss.
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Fleischman DA, Arfanakis K, Zhang S, Leurgans SE, Barnes LL, Bennett DA, Marquez DX, Lamar M. Acculturation in Context and Brain Health in Older Latino Adults: A Diffusion Tensor Imaging Study. J Alzheimers Dis 2023; 95:1585-1595. [PMID: 37718813 PMCID: PMC10599486 DOI: 10.3233/jad-230491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023]
Abstract
BACKGROUND Latinos are at higher risk of developing mild cognitive impairment (MCI) and Alzheimer's disease than non-Latino Whites. Acculturation factors may influence this risk, yet there are few studies that have examined associations of acculturation, particularly in the context of socioenvironmental and familial factors, and brain health in older Latinos. OBJECTIVE To examine potential associations between acculturation in context and brain health in older Latinos. METHODS Using three previously established composites of acculturation-in-context, (acculturation-related: nativity status, language preference, acculturation scores; contextually-related socioenvironmental: perceived discrimination, loneliness/social isolation, social network size; and familism), and diffusion-tensor imaging (DTI), associations with white matter structural integrity were examined in 92 Latino adults without dementia participating in one of three epidemiological studies of aging. Linear regression models were used to test associations with DTI-derived metrics (fractional anisotropy, FA; trace) as separate outcomes and acculturation composite scores as individual predictors, while adjusting for age, sex, education, scanner, and white matter hyperintensities (voxelwise and total volumes normalized by intracranial volume). RESULTS Higher scores on the socioenvironmental composite were associated with lower FA in two clusters of left-hemisphere connections. Cluster 1 was dominated by both short association pathways connecting frontal regions and projection pathways connecting frontal regions with the thalamus. Cluster 2 was dominated by long association pathways connecting parietal, frontal, and temporal regions. CONCLUSIONS This study of older Latino adults demonstrated an association between reduced brain white matter integrity and contextually related socioenvironmental experiences known to increase risk of MCI and Alzheimer's disease.
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Affiliation(s)
- Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David X. Marquez
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Kinesiology and Nutrition, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Bahrani AA, Abner EL, DeCarli CS, Barber JM, Sutton AC, Maillard P, Sandoval F, Arfanakis K, Yang YC, Evia AM, Schneider JA, Habes M, Franklin CG, Seshadri S, Satizabal CL, Caprihan A, Thompson JF, Rosenberg GA, Wang DJJ, Jann K, Zhao C, Lu H, Rosenberg PB, Albert MS, Ali DG, Singh H, Schwab K, Greenberg SM, Helmer KG, Powel DK, Gold BT, Goldstein LB, Wilcock DM, Jicha GA. Multi-Site Cross-Site Inter-Rater and Test-Retest Reliability and Construct Validity of the MarkVCID White Matter Hyperintensity Growth and Regression Protocol. J Alzheimers Dis 2023; 96:683-693. [PMID: 37840499 PMCID: PMC11009792 DOI: 10.3233/jad-230629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND White matter hyperintensities (WMH) that occur in the setting of vascular cognitive impairment and dementia (VCID) may be dynamic increasing or decreasing volumes or stable over time. Quantifying such changes may prove useful as a biomarker for clinical trials designed to address vascular cognitive-impairment and dementia and Alzheimer's Disease. OBJECTIVE Conducting multi-site cross-site inter-rater and test-retest reliability of the MarkVCID white matter hyperintensity growth and regression protocol. METHODS The NINDS-supported MarkVCID Consortium evaluated a neuroimaging biomarker developed to track WMH change. Test-retest and cross-site inter-rater reliability of the protocol were assessed. Cognitive test scores were analyzed in relation to WMH changes to explore its construct validity. RESULTS ICC values for test-retest reliability of WMH growth and regression were 0.969 and 0.937 respectively, while for cross-site inter-rater ICC values for WMH growth and regression were 0.995 and 0.990 respectively. Word list long-delay free-recall was negatively associated with WMH growth (p < 0.028) but was not associated with WMH regression. CONCLUSIONS The present data demonstrate robust ICC validity of a WMH growth/regression protocol over a one-year period as measured by cross-site inter-rater and test-retest reliability. These data suggest that this approach may serve an important role in clinical trials of disease-modifying agents for VCID that may preferentially affect WMH growth, stability, or regression.
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Affiliation(s)
- Ahmed A Bahrani
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Erin L Abner
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Epidemiology & Environmental Health, University of Kentucky, College of Public Health, Lexington, KY, USA
| | | | - Justin M Barber
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Abigail C Sutton
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Pauline Maillard
- Department of Neurology, University of California, Davis, CA, USA
| | | | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Yung-Chuan Yang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Arnold M Evia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Mohamad Habes
- Research Imaging Institute, University of Texas Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Crystal G Franklin
- Research Imaging Institute, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | | | - Gary A Rosenberg
- Center for Memory and Aging, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA
| | - Danny J J Wang
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chenyang Zhao
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hanzhang Lu
- Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Paul B Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Doaa G Ali
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Herpreet Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kristin Schwab
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Steven M Greenberg
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Karl G Helmer
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David K Powel
- Department of Neuroscience, University of Kentucky, College of Medicine, Lexington, KY, USA
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
| | - Brian T Gold
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Neuroscience, University of Kentucky, College of Medicine, Lexington, KY, USA
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
| | - Larry B Goldstein
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Donna M Wilcock
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Physiology, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Gregory A Jicha
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
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20
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Agrawal S, Farfel JM, Arfanakis K, Al-Harthi L, Shull T, Teppen TL, Evia AM, Patel MB, Ely EW, Leurgans SE, Bennett DA, Mehta R, Schneider JA. Brain autopsies of critically ill COVID-19 patients demonstrate heterogeneous profile of acute vascular injury, inflammation and age-linked chronic brain diseases. Acta Neuropathol Commun 2022; 10:186. [PMID: 36528671 PMCID: PMC9758667 DOI: 10.1186/s40478-022-01493-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [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: 12/06/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND This study examined neuropathological findings of patients who died following hospitalization in an intensive care unit with SARS-CoV-2. METHODS Data originate from 20 decedents who underwent brain autopsy followed by ex-vivo imaging and dissection. Systematic neuropathologic examinations were performed to assess histopathologic changes including cerebrovascular disease and tissue injury, neurodegenerative diseases, and inflammatory response. Cerebrospinal fluid (CSF) and fixed tissues were evaluated for the presence of viral RNA and protein. RESULTS The mean age-at-death was 66.2 years (range: 26-97 years) and 14 were male. The patient's medical history included cardiovascular risk factors or diseases (n = 11, 55%) and dementia (n = 5, 25%). Brain examination revealed a range of acute and chronic pathologies. Acute vascular pathologic changes were common in 16 (80%) subjects and included infarctions (n = 11, 55%) followed by acute hypoxic/ischemic injury (n = 9, 45%) and hemorrhages (n = 7, 35%). These acute pathologic changes were identified in both younger and older groups and those with and without vascular risk factors or diseases. Moderate-to-severe microglial activation were noted in 16 (80%) brains, while moderate-to-severe T lymphocyte accumulation was present in 5 (25%) brains. Encephalitis-like changes included lymphocytic cuffing (n = 6, 30%) and neuronophagia or microglial nodule (most prominent in the brainstem, n = 6, 30%) were also observed. A single brain showed vasculitis-like changes and one other exhibited foci of necrosis with ball-ring hemorrhages reminiscent of acute hemorrhagic leukoencephalopathy changes. Chronic pathologies were identified in only older decedents: 7 brains exhibited neurodegenerative diseases and 8 brains showed vascular disease pathologies. CSF and brain samples did not show evidence of viral RNA or protein. CONCLUSIONS Acute tissue injuries and microglial activation were the most common abnormalities in COVID-19 brains. Focal evidence of encephalitis-like changes was noted despite the lack of detectable virus. The majority of older subjects showed age-related brain pathologies even in the absence of known neurologic disease. Findings of this study suggest that acute brain injury superimposed on common pre-existing brain disease may put older subjects at higher risk of post-COVID neurologic sequelae.
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Affiliation(s)
- Sonal Agrawal
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Pathology, Rush University Medical Center, Chicago, IL USA
| | - Jose M. Farfel
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - Konstantinos Arfanakis
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.62813.3e0000 0004 1936 7806Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA
| | - Lena Al-Harthi
- grid.240684.c0000 0001 0705 3621Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, IL USA
| | - Tanner Shull
- grid.240684.c0000 0001 0705 3621Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, IL USA
| | - Tara L. Teppen
- grid.240684.c0000 0001 0705 3621Department of Microbial Pathogens and Immunity, Rush University Medical Center, Chicago, IL USA
| | - Arnold M. Evia
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA
| | - Mayur B. Patel
- grid.412807.80000 0004 1936 9916Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Departments of Medicine, Vanderbilt University Medical Center, Nashville, TN USA ,grid.452900.a0000 0004 0420 4633The Geriatric Research Education Clinical Center (GRECC), Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System (TVHS), Nashville, TN USA
| | - E. Wesley Ely
- grid.412807.80000 0004 1936 9916Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Departments of Medicine, Vanderbilt University Medical Center, Nashville, TN USA ,grid.452900.a0000 0004 0420 4633The Geriatric Research Education Clinical Center (GRECC), Nashville Veterans Affairs Medical Center, Tennessee Valley Healthcare System (TVHS), Nashville, TN USA
| | - Sue. E. Leurgans
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - David A. Bennett
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
| | - Rupal Mehta
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Pathology, Rush University Medical Center, Chicago, IL USA
| | - Julie A. Schneider
- grid.240684.c0000 0001 0705 3621Rush Alzheimer’s Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago, IL 60612 USA ,grid.240684.c0000 0001 0705 3621Department of Pathology, Rush University Medical Center, Chicago, IL USA ,grid.240684.c0000 0001 0705 3621Department of Neurological Sciences, Rush University Medical Center, Chicago, IL USA
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Maillard P, Hillmer LJ, Lu H, Arfanakis K, Gold BT, Bauer CE, Kramer JH, Staffaroni AM, Stables L, Wang DJ, Seshadri S, Satizabal CL, Beiser A, Habes M, Fornage M, Mosley TH, Rosenberg GA, Singh B, Singh H, Schwab K, Helmer KG, Greenberg SM, DeCarli C, Caprihan A. MRI free water as a biomarker for cognitive performance: Validation in the MarkVCID consortium. Alzheimers Dement (Amst) 2022; 14:e12362. [PMID: 36523847 PMCID: PMC9745638 DOI: 10.1002/dad2.12362] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/11/2022] [Accepted: 08/29/2022] [Indexed: 12/15/2022]
Abstract
Introduction To evaluate the clinical validity of free water (FW), a diffusion tensor imaging-based biomarker kit proposed by the MarkVCID consortium, by investigating the association between mean FW (mFW) and executive function. Methods Baseline mFW was related to a baseline composite measure of executive function (EFC), adjusting for relevant covariates, in three MarkVCID sub-cohorts, and replicated in five, large, independent legacy cohorts. In addition, we tested whether baseline mFW predicted accelerated EFC score decline (mean follow-up time: 1.29 years). Results Higher mFW was found to be associated with lower EFC scores in MarkVCID legacy and sub-cohorts (p-values < 0.05). In addition, higher baseline mFW was associated significantly with accelerated decline in EFC scores (p = 0.0026). Discussion mFW is a sensitive biomarker of cognitive decline, providing a strong clinical rational for its use as a marker of white matter (WM) injury in multi-site observational studies and clinical trials of vascular cognitive impairment and dementia (VCID).
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Affiliation(s)
- Pauline Maillard
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Laura J. Hillmer
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Hanzhang Lu
- Department of RadiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Konstantinos Arfanakis
- Department of Biomedical EngineeringIllinois Institute of TechnologyChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterDepartment of Diagnostic Radiology and Nuclear MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Brian T. Gold
- Department of NeuroscienceUniversity of KentuckyLexingtonKentuckyUSA
| | | | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Adam M. Staffaroni
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Lara Stables
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Danny J.J. Wang
- Laboratory of FMRI Technology (LOFT)Stevens Neuroimaging and Informatics InstituteKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sudha Seshadri
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Claudia L. Satizabal
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
- Department of Population Health SciencesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Alexa Beiser
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular MedicineMcGovern Medical SchoolSchool of Public HealthThe University of Texas Health Science Center at HoustonHoustonTexasUSA
- Human Genetics CenterSchool of Public HealthThe University of Texas Health Science Center at HoustonHoustonTexasUSA
| | - Thomas H. Mosley
- MIND CenterUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | - Gary A. Rosenberg
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Baljeet Singh
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Herpreet Singh
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Kristin Schwab
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Karl G. Helmer
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
| | | | - Charles DeCarli
- Department of NeurologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Arvind Caprihan
- The Mind Research NetworkAlbuquerqueNew MexicoAlbuquerqueNew MexicoUSA
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Oveisgharan S, Dawe RJ, Yu L, Kapasi A, Arfanakis K, Hachinski V, Schneider JA, Bennett DA. Frequency and Underlying Pathology of Pure Vascular Cognitive Impairment. JAMA Neurol 2022; 79:1277-1286. [PMID: 36279115 PMCID: PMC9593318 DOI: 10.1001/jamaneurol.2022.3472] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/05/2022] [Indexed: 01/14/2023]
Abstract
Importance It is not clear how common pure vascular cognitive impairment (VCI) is in the absence of Alzheimer disease (AD) and/or other neurodegenerative pathologies. Objective To identify participants without AD and other neurodegenerative pathologies and determine the extent to which cerebrovascular disease pathologies were associated with cognitive impairment. Design, Setting, and Participants This clinical pathological study included participants from 2 ongoing community-based cohorts that began enrollment in 1994 and 1997. Prior to death, participants were observed for a mean (SD) of 8.4 (5.3) years with annual assessments. From 2096 participants who died, 1799 (85.8%) underwent autopsy and 1767 had complete postmortem pathological examination data at the time of data analyses. To identify participants without neurodegenerative pathologies, we categorized them in 3 subgroups. A vascular subgroup was composed of participants without significant levels of neurodegenerative brain pathologies. A neurodegenerative subgroup was composed of participants without significant levels of cerebrovascular disease pathologies. A mixed subgroup was composed of the rest of the participants. Data were analyzed from May 2021 to July 2022. Exposures Brain pathology indices obtained by postmortem pathological assessments. Main Outcomes and Measures The primary outcome was cognitive impairment defined by presence of mild cognitive impairment or dementia. The secondary outcome was cognition assessed by 19 neuropsychological tests. Results Of 1767 included participants, 1189 (67.3%) were women, and the mean (SD) age at death was 89.4 (6.6) years. In the vascular subgroup (n = 369), cognitive impairment was present in 156 participants (42.3%) and was associated with cerebrovascular disease pathologies (macroinfarcts: odds ratio [OR], 2.05; 95% CI, 1.49-2.82; P < .001; arteriolosclerosis in basal ganglia: OR, 1.35; 95% CI, 1.04-1.76; P = .03) but not AD or other neurodegenerative pathologies, an indication of pure VCI. In mixed-effects models including all the pathologies, only macroinfarcts were associated with a faster cognitive decline rate (estimate, -0.019; SE, 0.005; P < .001) in the vascular subgroup. Further analyses identified macroinfarcts in the frontal white matter to be associated with faster cognitive decline rate when macroinfarcts of cortical and subcortical brain regions were examined in a single model. Conclusions and Relevance In this study, pure VCI was not rare. Macroinfarcts, specifically in frontal white matter, were the main cerebrovascular disease pathologies associated with cognitive decline in pure VCI.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Robert J. Dawe
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Alifiya Kapasi
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago
| | | | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Ridwan AR, Niaz MR, Wu Y, Zhang S, Bennett DA, Arfanakis K. Development and systematic evaluation of high resolution PD‐weighted, T2‐weighted, and T2 map templates of the MIITRA atlas for use in studies on older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.066032] [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: 12/24/2022]
Affiliation(s)
- Abdur Raquib Ridwan
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | | | - Yingjuan Wu
- Illinois Institute of Technology Chicago IL USA
| | - Shengwei Zhang
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
- Illinois Institute of Technology Chicago IL USA
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Saifullah K, Tazwar M, Evia AM, Tamhane AA, Bennett DA, Schneider JA, Arfanakis K. Neurofibrillary Tangles Prediction Based On MRI. Alzheimers Dement 2022. [DOI: 10.1002/alz.066142] [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: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush University Medical Center Chicago IL USA
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Tazwar M, Evia AM, Tamhane AA, Ridwan AR, Bennett DA, Schneider JA, Arfanakis K. Limbic Predominant Age‐related TDP‐43 Encephalopathy Neuropathological Change (LATE‐NC) is Associated with Lower Diffusion Anisotropy in Medial Temporal Lobe White Matter. Alzheimers Dement 2022. [DOI: 10.1002/alz.058977] [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: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush University Medical Center Chicago IL USA
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Yasar MT, Tazwar M, Tamhane AA, Evia AM, Bennett DA, Schneider JA, Arfanakis K. Positive association of Cerebral Amyloid Angiopathy (CAA) with R2 Relaxation rate: A study of ex‐vivo MRI and pathology. Alzheimers Dement 2022. [DOI: 10.1002/alz.066154] [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: 12/24/2022]
Affiliation(s)
| | | | | | | | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush University Medical Center Chicago IL USA
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Han SD, Fleischman DA, Yu L, Poole V, Lamar M, Kim N, Leurgans SE, Bennett DA, Arfanakis K, Barnes LL. Cognitive decline and hippocampal functional connectivity within older Black adults. Hum Brain Mapp 2022; 43:5044-5052. [PMID: 36066181 PMCID: PMC9582363 DOI: 10.1002/hbm.26070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 06/26/2022] [Accepted: 08/22/2022] [Indexed: 11/09/2022] Open
Abstract
While there has been a proliferation of neuroimaging studies on cognitive decline in older non-Hispanic White adults, there is a dearth of knowledge regarding neuroimaging correlates of cognitive decline in Black adults. Resting-state functional neuroimaging approaches may be particularly sensitive to early cognitive decline, but there are no studies that we know of that apply this approach to examining associations of brain function to cognition in older Black adults. We investigated the association of cognitive decline with whole-brain voxel-wise functional connectivity to the hippocampus, a key brain region functionally implicated in early Alzheimer's dementia, in 132 older Black adults without dementia participating in the Minority Aging Research Study and Rush Memory and Aging Project, two longitudinal studies of aging that include harmonized annual cognitive assessments and magnetic resonance imaging brain imaging. In models adjusted for demographic factors (age, education, sex), global cognitive decline was associated with functional connectivity of the hippocampus to three clusters in the right and left frontal regions of the dorsolateral prefrontal cortex. In domain-specific analyses, decline in semantic memory was associated with functional connectivity of the hippocampus to bilateral clusters in the precentral gyrus, and decline in perceptual speed was inversely associated with connectivity of the hippocampus to the bilateral intracalcarine cortex and the right fusiform gyrus. These findings elucidate neurobiological mechanisms underlying cognitive decline in older Black adults and may point to specific targets of intervention for Alzheimer's disease.
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Affiliation(s)
- S. Duke Han
- Department of Family MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of NeurologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Debra A. Fleischman
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Lei Yu
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Victoria Poole
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Orthopedic SurgeryRush University Medical CenterChicagoIllinoisUSA
| | - Melissa Lamar
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Namhee Kim
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Sue E. Leurgans
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - David A. Bennett
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Biomedical EngineeringIllinois Institute of TechnologyChicagoIllinoisUSA
- Department of Diagnostic Radiology and Nuclear MedicineRush University Medical CenterChicagoIllinoisUSA
| | - Lisa L. Barnes
- Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
- Department of Neurological SciencesRush University Medical CenterChicagoIllinoisUSA
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Wu Y, Ridwan AR, Niaz MR, Qi X, Zhang S, Alzheimer's Disease Neuroimaging Initiative, Bennett DA, Arfanakis K. Development of high quality T 1-weighted and diffusion tensor templates of the older adult brain in a common space. Neuroimage 2022; 260:119417. [PMID: 35793748 PMCID: PMC9437946 DOI: 10.1016/j.neuroimage.2022.119417] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 05/27/2022] [Accepted: 06/27/2022] [Indexed: 01/23/2023] Open
Abstract
High-quality T1-weighted (T1w) and diffusion tensor imaging (DTI) brain templates that are representative of the individuals under study enhance the accuracy of template-based neuroimaging investigations, and when they are also located in a common space they facilitate optimal integration of information on brain morphometry and diffusion characteristics. However, such multimodal templates have not been constructed for the brain of older adults. The purpose of this work was threefold: (A) to introduce an iterative method for construction of multimodal T1w and DTI templates that aims at maximizing the quality of each template separately as well as the spatial matching between templates, (B) to use this method to develop T1w and DTI templates of the older adult brain in a common space, and (C) to evaluate the performance of the method across iterations and compare it to the performance of state-of-the-art approaches based on multichannel registration. It was demonstrated that more iterations of the proposed method enhanced the characteristics and spatial matching of the resulting T1w and DTI templates. The templates of the older adult brain generated by the final iteration of the proposed method provided better delineation of brain structures, higher discriminability between tissues, and higher image sharpness near the cortex compared to templates generated with approaches employing multichannel registration. In addition, the spatial matching between the T1w and DTI templates constructed by the proposed method approximated the template alignment achieved with methods employing multichannel registration. Finally, when using the templates generated by the proposed method as references for spatial normalization of older adult T1w and DTI data, both the intra-modality inter-subject normalization precision and the inter-modality spatial matching were higher in most metrics than those achieved with templates constructed with other methods. Overall, the present work brought new insights into multimodal template construction, generated much-needed high quality T1w and DTI templates of the older adult brain in a common space, and conducted a thorough, quantitative evaluation of available multimodal template construction methods.
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Affiliation(s)
- Yingjuan Wu
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA
| | - Abdur Raquib Ridwan
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA
| | - Mohammad Rakeen Niaz
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA
| | - Xiaoxiao Qi
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA
| | - Shengwei Zhang
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois USA
| | - Alzheimer's Disease Neuroimaging Initiative
- A portion of the data used in preparation of this article were obtained from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois USA
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois USA.
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Tazwar M, Evia AM, Tamhane AA, Ridwan AR, Leurgans SE, Bennett DA, Schneider JA, Arfanakis K. Limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) is associated with lower R 2 relaxation rate: an ex-vivo MRI and pathology investigation. Neurobiol Aging 2022; 117:128-138. [PMID: 35728463 PMCID: PMC9667705 DOI: 10.1016/j.neurobiolaging.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/04/2022] [Accepted: 05/23/2022] [Indexed: 11/16/2022]
Abstract
Limbic predominant age-related transactive response DNA binding protein 43 (TDP-43) encephalopathy neuropathological change (LATE-NC) is common in persons older than 80 years of age and is associated with cognitive decline and increased likelihood of dementia. The MRI signature of LATE-NC has not been fully determined. In this study, the association of LATE-NC with the transverse relaxation rate, R2, was investigated in a large number of community-based older adults. Cerebral hemispheres from 738 participants of the Rush Memory and Aging Project, Religious Orders Study, and Minority Aging Research Study, were imaged ex-vivo with multi-echo spin-echo MRI and underwent detailed neuropathologic examination. Voxel-wise analysis revealed a novel spatial pattern of lower R2 for higher LATE-NC stage, controlling for other neuropathologies and demographics. This pattern was consistent with the distribution of LATE-NC in gray matter, and also involved white matter providing temporo-temporal, fronto-temporal, and temporo-basal ganglia connectivity. Furthermore, analysis at different LATE-NC stages showed that R2 imaging may capture the general progression of LATE-NC, but only when TDP-43 inclusions extend beyond the amygdala.
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Affiliation(s)
- Mahir Tazwar
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Arnold M Evia
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Ashish A Tamhane
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Abdur Raquib Ridwan
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA; Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Diagnostic Radiology, Rush University Medical Center, Chicago, IL, USA.
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Heywood A, Stocks J, Schneider JA, Arfanakis K, Bennett DA, Beg MF, Wang L. The unique effect of TDP-43 on hippocampal subfield morphometry and cognition. Neuroimage Clin 2022; 35:103125. [PMID: 36002965 PMCID: PMC9421500 DOI: 10.1016/j.nicl.2022.103125] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 01/18/2023]
Abstract
•We explored postmortem TDP-43 burden and antemortem hippocampal surface deformation. •TDP-43 was uniquely associated with inward deformation in the hippocampus. •Deformation patterns account for co-existing disease showing TDP-43′s unique effect. •Deformation was significantly correlated with cognition scores.
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Affiliation(s)
- Ashley Heywood
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Jane Stocks
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA; Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | | | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Lamar M, Fleischman DA, Leurgans SE, Aggarwal N, Yu L, Kim N, Poole V, Han SD, Arfanakis K, Barnes LL. Relationship of Blood Pressure and White Matter Hyperintensity Burden With Level of and Change in Cognition in Older Black Adults. Psychosom Med 2022; 84:437-445. [PMID: 35100182 PMCID: PMC9064910 DOI: 10.1097/psy.0000000000001059] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Elevations in blood pressure (BP) and associated white matter hyperintensities (WMHs) are chronic comorbid conditions among older Black adults. We investigated whether WMHs modify the association between late-life BP and cognition within older Black adults. METHODS A total of 167 Black adults (age, ~75 years; without dementia at baseline) participating in neuroimaging studies at the Rush Alzheimer's Disease Center were evaluated for BP markers of cardiovascular health, including systolic BP, diastolic BP, pulse pressure, mean arterial pressure (MAP), and hypertension, and were assessed for global and domain-specific cognition at baseline and annually for up to 8 years. WMHs adjusted for intracranial volume were quantified at baseline. RESULTS Models adjusted for relevant confounders and the interaction of these variables with time revealed differential associations between BP markers and baseline cognition; however, only elevated diastolic BP predicted faster cognitive, that is, episodic memory, decline (estimate = -0.002, standard error = 0.0009, p = .002). Although WMH burden did not modify the association between diastolic BP and episodic memory decline, it did interact with diastolic BP to lower episodic memory at baseline (estimate = -0.051, standard error = 0.012, p = .0001); that is, greater WMHs combined with higher diastolic BP resulted in the lowest baseline episodic memory scores. A similar profile was noted for WMHs, MAP, and baseline episodic memory. Hypertension was neither associated with cognition nor modified by WMH burden after multiple comparisons correction. CONCLUSION Late-life diastolic BP was associated with faster rates of episodic memory decline in older Black adults; together with higher WMH burden, it (and MAP) lowered the point at which individuals begin their course of decline toward pathological aging.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Neelum Aggarwal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Namhee Kim
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Victoria Poole
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Departments of Family Medicine and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
- School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Maillard P, Lu H, Arfanakis K, Gold BT, Bauer CE, Zachariou V, Stables L, Wang DJ, Jann K, Seshadri S, Duering M, Hillmer LJ, Rosenberg GA, Snoussi H, Sepehrband F, Habes M, Singh B, Kramer JH, Corriveau RA, Singh H, Schwab K, Helmer KG, Greenberg SM, Caprihan A, DeCarli C, Satizabal CL. Instrumental validation of free water, peak-width of skeletonized mean diffusivity, and white matter hyperintensities: MarkVCID neuroimaging kits. Alzheimers Dement (Amst) 2022; 14:e12261. [PMID: 35382232 PMCID: PMC8959640 DOI: 10.1002/dad2.12261] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Indexed: 11/11/2022]
Abstract
Introduction To describe the protocol and findings of the instrumental validation of three imaging-based biomarker kits selected by the MarkVCID consortium: free water (FW) and peak width of skeletonized mean diffusivity (PSMD), both derived from diffusion tensor imaging (DTI), and white matter hyperintensity (WMH) volume derived from fluid attenuation inversion recovery and T1-weighted imaging. Methods The instrumental validation of imaging-based biomarker kits included inter-rater reliability among participating sites, test-retest repeatability, and inter-scanner reproducibility across three types of magnetic resonance imaging (MRI) scanners using intra-class correlation coefficients (ICC). Results The three biomarkers demonstrated excellent inter-rater reliability (ICC >0.94, P-values < .001), very high agreement between test and retest sessions (ICC >0.98, P-values < .001), and were extremely consistent across the three scanners (ICC >0.98, P-values < .001). Discussion The three biomarker kits demonstrated very high inter-rater reliability, test-retest repeatability, and inter-scanner reproducibility, offering robust biomarkers suitable for future multi-site observational studies and clinical trials in the context of vascular cognitive impairment and dementia (VCID).
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Affiliation(s)
- Pauline Maillard
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Hanzhang Lu
- Department of RadiologyJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Konstantinos Arfanakis
- Department of Biomedical EngineeringIllinois Institute of TechnologyChicagoIllinoisUSA
- Department of Diagnostic Radiology and Nuclear Medicine, Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Brian T. Gold
- Department of NeuroscienceUniversity of KentuckyLexingtonKentuckyUSA
| | | | | | - Lara Stables
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Danny J.J. Wang
- Laboratory of FMRI Technology (LOFT)Stevens Neuroimaging and Informatics InstituteKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Kay Jann
- Laboratory of FMRI Technology (LOFT)Stevens Neuroimaging and Informatics InstituteKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sudha Seshadri
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Marco Duering
- Department of Biomedical EngineeringMedical Image Analysis Center (MIAC AG)University of BaselBaselSwitzerland
| | - Laura J. Hillmer
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Gary A. Rosenberg
- Department of NeurologyUniversity of New MexicoAlbuquerqueNew MexicoUSA
| | - Haykel Snoussi
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Farshid Sepehrband
- Laboratory of FMRI Technology (LOFT)Stevens Neuroimaging and Informatics InstituteKeck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
| | - Baljeet Singh
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | | | - Herpreet Singh
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Kristin Schwab
- Department of NeurologyMassachusetts General HospitalBostonMassachusettsUSA
| | - Karl G. Helmer
- Department of RadiologyMassachusetts General HospitalBostonMassachusettsUSA
- Department of RadiologyHarvard Medical SchoolBostonMassachusettsUSA
| | | | | | - Charles DeCarli
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Claudia L. Satizabal
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health San AntonioSan AntonioTexasUSA
- Department of Population Health SciencesUniversity of Texas Health San AntonioSan AntonioTexasUSA
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Niaz MR, Ridwan AR, Wu Y, Bennett DA, Arfanakis K. Development and evaluation of a high resolution 0.5mm isotropic T1-weighted template of the older adult brain. Neuroimage 2022; 248:118869. [PMID: 34986396 PMCID: PMC8855670 DOI: 10.1016/j.neuroimage.2021.118869] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/23/2021] [Revised: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 10/28/2022] Open
Abstract
Investigating the structure of the older adult brain at high spatial resolution is of high significance, and a dedicated older adult structural brain template with sub-millimeter resolution is currently lacking. Therefore, the purpose of this work was twofold: (A) to develop a 0.5mm isotropic resolution standardized T1-weighted template of the older adult brain by applying principles of super resolution to high quality MRI data from 222 older adults (65-95 years of age), and (B) to systematically compare the new template to other standardized and study-specific templates in terms of image quality and performance when used as a reference for alignment of older adult data. The new template exhibited higher spatial resolution and improved visualization of fine structural details of the older adult brain compared to a template constructed using a conventional template building approach and the same data. In addition, the new template exhibited higher image sharpness and did not contain image artifacts observed in some of the other templates considered in this work. Due to the above enhancements, the new template provided higher inter-subject spatial normalization precision for older adult data compared to the other templates, and consequently enabled detection of smaller inter-group morphometric differences in older adult data. Finally, the new template was among those that were most representative of older adult brain data. Overall, the new template constructed here is an important resource for studies of aging, and the findings of the present work have important implications in template selection for investigations on older adults.
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Affiliation(s)
- Mohammad Rakeen Niaz
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | - Abdur Raquib Ridwan
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | - Yingjuan Wu
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States
| | | | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, 3440 S Dearborn St, M-100, Chicago, IL 60616, United States; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States; Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, United States.
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Kapasi A, Yu L, Petyuk V, Arfanakis K, Bennett DA, Schneider JA. Association of small vessel disease with tau pathology. Acta Neuropathol 2022; 143:349-362. [PMID: 35044500 PMCID: PMC8858293 DOI: 10.1007/s00401-021-02397-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 12/14/2022]
Abstract
Emerging evidence suggests that small vessel disease (SVD) is a risk factor for clinical dementia and may contribute to AD neuropathological changes. Watershed brain regions are located at the most distal areas between arterial territories, making them vulnerable to SVD-related changes. We examined the association of pathologic markers of SVD, specifically arteriolosclerosis in watershed brain regions, with AD pathologic changes. Participants (N = 982; mean age-at-death = 90; 69% women) were enrolled as part of one of two cohort studies of aging and dementia. At autopsy, neuropathological evaluation included semi-quantitative grading of arteriolosclerosis pathology from 2 cortical watershed regions: the anterior watershed (AWS) and posterior watershed (PWS), densities for cortical β-amyloid and tau-tangle pathology, and other common age-related pathologies. Linear regression models examined the association of watershed arteriolosclerosis pathology with β-amyloid and tau-tangle burden. In follow-up analyses, available ex-vivo MRI and proteomics data in a subset of decedents were leveraged to examine the association of whole brain measure of WMH, as a presumed MRI marker of SVD, with β-amyloid and tau-tangle burden, as well as to examine the association of watershed arteriolosclerosis with proteomic tau. Watershed arteriolosclerosis was common, with 45% of older persons having moderate-to-severe arteriolosclerosis pathology in the AWS region, and 35% in the PWS. In fully adjusted models that controlled for demographics and common age-related pathologies, an increase in severity of PWS arteriolosclerosis was associated with a higher burden of tau-tangle burden, specifically neocortical tau burden, but not with β-amyloid. AWS arteriolosclerosis was not associated with β-amyloid or tau pathology. Ex-vivo WMH was associated with greater tau-tangle pathology burden but not β-amyloid. Furthermore, PWS arteriolosclerosis was associated with higher abundance of tau phosphopeptides, that promote formation of tau aggregates. These data provide compelling evidence that SVD, specifically posterior watershed arteriolosclerosis pathology, is linked with tau pathological changes in the aging brain.
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Affiliation(s)
- Alifiya Kapasi
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Chicago, IL, 60612, USA.
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA.
| | - L Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - V Petyuk
- Biological Sciences Division, Pacific Northwest National Laboratory, Richland, WA, USA
| | - K Arfanakis
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Chicago, IL, 60612, USA
- Department of Diagnostic Radiology and Nuclear Medicine, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - D A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Chicago, IL, 60612, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - J A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Chicago, IL, 60612, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Fleischman DA, Arfanakis K, Leurgans SE, Zhang S, Poole VN, Han SD, Yu L, Lamar M, Kim N, Bennett DA, Barnes LL. Associations of deformation-based brain morphometry with cognitive level and decline within older Blacks without dementia. Neurobiol Aging 2022; 111:35-43. [PMID: 34963062 PMCID: PMC9070546 DOI: 10.1016/j.neurobiolaging.2021.11.003] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 11/04/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
Blacks are at higher risk of developing cognitive impairment with age than non-Hispanic Whites, yet most brain morphometry and cognition research is performed with White samples or with mixed samples that control for race or compare across racial groups. A deeper understanding of the within-group variability in associations between brain structure and cognitive decline in Blacks is critically important for designing appropriate outcomes for clinical trials, predicting adverse outcomes, and developing interventions to preserve cognitive function, but no studies have examined these associations longitudinally within Blacks. We performed deformation-based morphometry in 376 older Black participants without dementia and examined associations of deformation-based morphometry with cognitive level and decline for global cognition and five cognitive domains. After correcting for widespread age-associated effects, there remained regions with less tissue and more cerebrospinal fluid associated with level and rate of decline in global cognition, memory, and perceptual speed. Further study is needed to examine the moderators of these associations, identify adverse outcomes predicted by brain morphometry, and deepen knowledge of underlying biological mechanisms.
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Affiliation(s)
- Debra A. Fleischman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Biomedical Engineering, Illinois Institute of Technology, 10 W. 35th St., Chicago, IL 60616
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Preventive Medicine, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Shengwei Zhang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Victoria N. Poole
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Orthopedic Surgery, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - S. Duke Han
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Departments of Family Medicine and Neurology, Keck School of Medicine, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA 90007,Department of Psychology, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA 90007,School of Gerontology, University of Southern California, 3551 Trousdale Parkway, Los Angeles, CA 90007
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Namhee Kim
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Neurological Sciences, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1725 W. Harrison, Chicago IL 60612
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Anad A, Barker MK, Katanga JA, Arfanakis K, Bridges LR, Esiri MM, Isaacs JD, Prpar Mihevc S, Pereira AC, Schneider JA, Hainsworth AH. Vasculocentric Axonal NfH in Small Vessel Disease. J Neuropathol Exp Neurol 2022; 81:182-192. [PMID: 35086142 PMCID: PMC8922195 DOI: 10.1093/jnen/nlab134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Cerebral small vessel disease (SVD) causes lacunar stroke and vascular cognitive impairment in older people. The pathogenic pathways from vessel pathology to parenchymal damage in SVD are unknown. Neurofilaments are axonal structural proteins. Neurofilament-light (NfL) is an emerging biomarker for neurological disease. Here, we examined the high molecular weight form neurofilament-heavy (NfH) and quantified a characteristic pattern of peri-arterial (vasculocentric) NfH labeling. Subcortical frontal and parietal white matter from young adult controls, aged controls, and older people with SVD or severe Alzheimer disease (n = 52) was immunohistochemically labeled for hyperphosphorylated NfH (pNfH). The extent of pNfH immunolabeling and the degree of vasculocentric axonal pNfH were quantified. Axonal pNfH immunolabeling was sparse in young adults but a common finding in older persons (controls, SVD, or AD). Axonal pNfH was often markedly concentrated around small penetrating arteries. This vasculocentric feature was more common in older people with SVD than in those with severe AD (p = 0.004). We conclude that axonal pNfH is a feature of subcortical white matter in aged brains. Vasculocentric axonal pNfH is a novel parenchymal lesion that is co-located with SVD arteriopathy and could be a consequence of vessel pathology.
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Affiliation(s)
- Adam Anad
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
| | - Miriam K Barker
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA (KA, JAS)
| | - Jessica A Katanga
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA (KA, JAS)
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, Illinois, USA (KA)
| | - Leslie R Bridges
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
- Department of Cellular Pathology, St George’s University Hospitals NHS Foundation Trust, London, UK (LRB)
| | - Margaret M Esiri
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, UK (MME)
| | - Jeremy D Isaacs
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
- Department of Neurology, St George’s University Hospitals NHS Foundation Trust, London, UK (JDI, ACP, AHH)
| | - Sonja Prpar Mihevc
- Institute for Preclinical Sciences, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia (SPM)
| | - Anthony C Pereira
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
- Department of Neurology, St George’s University Hospitals NHS Foundation Trust, London, UK (JDI, ACP, AHH)
| | - Julie A Schneider
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
| | - Atticus H Hainsworth
- From the Molecular and Clinical Sciences Research Institute, St George’s University of London, London, UK (AA, MKB, JAK, LRB, JDI, ACP, AHH)
- Department of Neurology, St George’s University Hospitals NHS Foundation Trust, London, UK (JDI, ACP, AHH)
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van Veluw SJ, Arfanakis K, Schneider JA. Neuropathology of Vascular Brain Health: Insights From Ex Vivo Magnetic Resonance Imaging-Histopathology Studies in Cerebral Small Vessel Disease. Stroke 2022; 53:404-415. [PMID: 35000425 PMCID: PMC8830602 DOI: 10.1161/strokeaha.121.032608] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [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: 02/03/2023]
Abstract
Sporadic cerebral small vessel disease (SVD) is a major contributor to vascular cognitive impairment and dementia in the aging human brain. On neuropathology, sporadic SVD is characterized by abnormalities to the small vessels of the brain predominantly in the form of cerebral amyloid angiopathy and arteriolosclerosis. These pathologies frequently coexist with Alzheimer disease changes, such as plaques and tangles, in a single brain. Conversely, during life, magnetic resonance imaging (MRI) only captures the larger manifestations of SVD in the form of parenchymal brain abnormalities. There appears to be a major knowledge gap regarding the underlying neuropathology of individual MRI-detectable SVD abnormalities. Ex vivo MRI in postmortem human brain tissue is a powerful tool to bridge this gap. This review summarizes current insights into the histopathologic correlations of MRI manifestations of SVD, their underlying cause, presumed pathophysiology, and associated secondary tissue injury. Moreover, we discuss the advantages and limitations of ex vivo MRI-guided histopathologic investigations and make recommendations for future studies.
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Affiliation(s)
- Susanne J. van Veluw
- J. Philip Kistler Stroke Research Center, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,MassGeneral Institute for Neurodegenerative Disease, Massachusetts General Hospital, Charlestown, MA, USA,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA,Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA,Departments of Pathology and Neurological Sciences, Rush University Medical Center, Chicago IL, USA
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Lamar M, Leurgans S, Kapasi A, Barnes LL, Boyle PA, Bennett DA, Arfanakis K, Schneider JA. Complex Profiles of Cerebrovascular Disease Pathologies in the Aging Brain and Their Relationship With Cognitive Decline. Stroke 2022; 53:218-227. [PMID: 34601898 PMCID: PMC8712368 DOI: 10.1161/strokeaha.121.034814] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND PURPOSE Cerebrovascular disease (CVD) pathologies including vessel disease (atherosclerosis, arteriolosclerosis, and cerebral amyloid angiopathy) and tissue injury (macroinfarcts and microinfarcts) each contribute to Alzheimer and other forms of dementia. CVD is often a complex mix of neuropathologies, with little known about the frequencies of differing combinations or their associations with cognition. METHODS We investigated 32 possible CVD combinations (3 types of vessel disease and 2 types of tissue injury) using autopsy data from 1474 decedents (≈88 years at death; 65% female) of Rush Alzheimer's Disease Center studies. We determined frequencies of all 32 CVD combinations and their relationships with global and domain-specific cognitive decline using mixed-effect models adjusted for demographics, neuropathologies, time before death, and interactions of these variables with time. RESULTS Of the 1184 decedents with CVD neuropathology (80% of the total sample), 37% had a single CVD (67-148 decedents/group) while 63% had mixed CVD profiles (11-54 decedents/group). When considered as 2 distinct groups, the mixed CVD profile group (but not the single CVD profile group) showed a faster cognitive decline across all domains assessed compared with decedents without CVD neuropathology. Most mixed CVD profiles, especially those involving both atherosclerosis and arteriolosclerosis, showed faster cognitive decline than any single CVD profile considered alone; specific mixed CVD profiles differentially associated with individual cognitive domains. CONCLUSIONS Mixed CVD, more common than single CVD, is associated with cognitive decline, and distinct mixed CVD profiles show domain-specific associations with cognitive decline. CVD is not monolithic but consists of heterogenous person-specific combinations with distinct contributions to cognitive decline.
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Affiliation(s)
- Melissa Lamar
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sue Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Alifiya Kapasi
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA;,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Biomedical Engineering, Chicago, IL, USA;,Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA;,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
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Abdelhak A, Solomon I, Montes SC, Saias A, Cordano C, Asken B, Fonseca C, Oertel FC, Arfanakis K, Staffaroni AM, Kramer JH, Geschwind M, Miller BL, Elahi FM, Green AJ. Retinal arteriolar parameters as a surrogate marker of intracranial vascular pathology. Alz & Dem Diag Ass & Dis Mo 2022; 14:e12338. [PMID: 35814617 PMCID: PMC9257197 DOI: 10.1002/dad2.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022]
Abstract
Introduction Development of novel diagnostic tools is a top research priority in vascular dementia. A major obstacle is the lack of a simple, non-invasive method to visualize cerebral arteriolar walls in vivo. Retinal arterioles offer a window into the cerebral circulation. Methods Intensity-based retinal arteriolar visualization in optical coherence tomography (I-bRAVO) was applied to evaluate mean wall thickness (MWT) and wall-to-lumen ratio (WLR) in 250 subjects with sporadic and genetic cerebral small vessel disease (CSVD), non-vascular neurodegenerative diseases (NVND), and healthy controls (HC) in association with imaging and cognitive markers. Results MWT and WLR were higher in CSVD, associated with severity of vascular white matter lesions, and correlated with magnetic resonance imaging-based intracranial arteriolosclerosis score. WLR correlated with gray and white matter volume and differentiated asymptomatic sporadic CSVD from HC (area under the curve = 0.82). Discussion I-bRAVO is a rapid, non-invasive tool. MWT and WLR were associated with imaging markers of CSVD and could contribute to early identification of sporadic CSVD.
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Affiliation(s)
- Ahmed Abdelhak
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Isaac Solomon
- San Diego School of Medicine University of California, San Diego La Jolla California USA
| | - Shivany Condor Montes
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Alexandra Saias
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Christian Cordano
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Breton Asken
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Corrina Fonseca
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Frederike Cosima Oertel
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Konstantinos Arfanakis
- Department of Biomedical Engineering Illinois Institute of Technology Chicago Illinois USA
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA
| | - Adam M. Staffaroni
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Joel H. Kramer
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Michael Geschwind
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Bruce L. Miller
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
| | - Fanny M. Elahi
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
- San Francisco Veterans Affairs Health Care System
| | - Ari J. Green
- Weill Institute for Neurosciences Department of Neurology University of California at San Francisco (UCSF) San Francisco California USA
- Department of Ophthalmology University of California at San Francisco (UCSF) San Francisco California USA
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Poole V, Dawe R, Luergans S, Bennett D, Buchman A, Arfanakis K. Brain Magnetic Susceptibility is Associated With Slower Gait in Community-Dwelling Older Adults. Innov Aging 2021. [PMCID: PMC8681799 DOI: 10.1093/geroni/igab046.3177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Age-related slowing of gait is exceedingly common and a robust predictor of various adverse health outcomes in older age. Prior neuroimaging studies have documented diverse non-specific structural brain abnormalities which are related to slow gait; however, the extent to which quantitative susceptibility mapping (QSM), which measures regional magnetic susceptibility in the brain, associates with gait speed remains unexplored. In the current study, 415 non-demented community-dwelling older adults (91 males; 81+/- 7 years) underwent an MRI (Siemens 3T TIM Trio) and in-home motor assessment. Gait speed was measured and averaged across 2 timed 8-ft walks. MR-acquired QSM data were pre-processed, registered to ICBM template, and spatially smoothed with a 5mm FWHM Gaussian kernel. When these maps entered group-level GLMs, voxel-wise associations with gait speed were of interest, after adjusting for demographics. We observed very strong negative associations between gait speed and magnetic susceptibility, such that those with slower gait had higher susceptibility in bilateral inferior frontal, superior temporal, and angular gyri (corrected p<.0005). Robust associations were also observed in the middle frontal, precentral, and postcentral gyri of the right hemisphere. These novel findings suggest that reduced myelination or increased iron accumulation in these brain regions may contribute to impaired gait. Future work will need to determine to what extent these cross-sectional QSM metrics are independent predictors of incident adverse health outcomes when controlling for other common brain imaging abnormalities observed in older adults.
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Affiliation(s)
| | - Robert Dawe
- Rush University, Chicago, Illinois, United States
| | - Sue Luergans
- Rush University, Chicago, Illinois, United States
| | | | - Aron Buchman
- Rush University, Chicago, Illinois, United States
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Makkinejad N, Tamhane AA, Bennett DA, Schneider JA, Gutman BA, Arfanakis K. Neuropathologic correlates of shape of subcortical brain structures. Alzheimers Dement 2021. [DOI: 10.1002/alz.051502] [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: 11/10/2022]
Affiliation(s)
| | | | | | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush University Medical Center Chicago IL USA
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Heywood A, Schneider JA, Bennett DA, Arfanakis K, Beg MF, Wang L. Sparse canonical correlation analysis reveals relationships between TDP‐43 within the entorhinal cortex and fractional anisotropy across widespread white matter tracts. Alzheimers Dement 2021. [DOI: 10.1002/alz.052413] [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: 11/09/2022]
Affiliation(s)
| | - Julie A. Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center Chicago IL USA
| | | | | | | | - Lei Wang
- Northwestern University Chicago IL USA
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Tazwar M, Evia AM, Tamhane AA, Bennett DA, Schneider JA, Arfanakis K. Spatial pattern of R
2
relaxation rate is associated with limbic‐predominant, age‐related, TDP‐43 encephalopathy neuropathological change (LATE‐NC). Alzheimers Dement 2021. [DOI: 10.1002/alz.051488] [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: 11/12/2022]
Affiliation(s)
| | | | | | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush University Medical Center Chicago IL USA
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Ridwan AR, Wu Y, Niaz MR, Qi X, Bennett DA, Arfanakis K. Development and evaluation of an unbiased, high‐resolution and detail‐preserving structural T1‐weighted template for use in studies on older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.053132] [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: 11/09/2022]
Affiliation(s)
| | - Yingjuan Wu
- Illinois Institute of Technology Chicago IL USA
| | | | - Xiaoxiao Qi
- Illinois Institute of Technology Chicago IL USA
| | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush Alzheimer's Disease Center Rush University Chicago IL USA
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Krueger KR, Dhana K, Aggarwal NT, Arfanakis K, Carey V, Sacks F, Barnes LL. Properties of the cognitive function battery for the MIND diet intervention to prevent Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.052299] [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: 11/09/2022]
Affiliation(s)
| | | | | | | | - Vincent Carey
- Brigham and Women’s Hospital, Harvard University Boston MA USA
| | - Frank Sacks
- Harvard School of Public Health, Harvard University Boston MA USA
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Abdelhak A, Solomon I, Saias A, Montes SC, Cordano C, Asken B, Fonseca C, Oertel FC, Arfanakis K, Staffaroni AM, Geschwind M, Elahi FM, Green AJ. Changes in wall thickness of retinal arterioles as a surrogate marker of intracranial vascular pathology. Alzheimers Dement 2021. [DOI: 10.1002/alz.055826] [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: 11/07/2022]
Affiliation(s)
- Ahmed Abdelhak
- University of California San Francisco (UCSF) San Francisco CA USA
| | - Isaac Solomon
- University of California San Diego (UCSD) San Diego CA USA
| | - Alexandra Saias
- University of California San Francisco (UCSF) San Francisco CA USA
| | | | | | - Breton Asken
- University of California San Francisco (UCSF) San Francisco CA USA
| | - Corrina Fonseca
- University of California San Francisco (UCSF) San Francisco CA USA
| | | | | | | | | | - Fanny M. Elahi
- University of California San Francisco (UCSF) San Francisco CA USA
| | - Ari J. Green
- University of California San Francisco (UCSF) San Francisco CA USA
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Nikseresht G, Tamhane AA, Makkinejad N, Javierre‐Petit C, Agam G, Bennett DA, Schneider JA, Arfanakis K. Neuropathologic and clinical correlates of cerebral microbleeds in community‐based older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.051449] [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: 11/07/2022]
Affiliation(s)
| | | | | | | | - Gady Agam
- Illinois Institute of Technology Chicago IL USA
| | | | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush Alzheimer's Disease Center Chicago IL USA
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Lee AJ, Ma Y, Yu L, Dawe RJ, Arfanakis K, Mayeux R, Bennett DA, Klein H, De Jager PL. Multi‐region brain transcriptomes uncover two subtypes of aging individuals with differences in the impact of
APOEe4. Alzheimers Dement 2021. [DOI: 10.1002/alz.057240] [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: 11/07/2022]
Affiliation(s)
- Annie J Lee
- Columbia University Irving Medical Center New York NY USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain New York NY USA
| | - Yiyi Ma
- Columbia University Irving Medical Center New York NY USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain New York NY USA
- Center for Translational and Computational Neuroimmunology New York NY USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Chicago IL USA
| | - Robert J Dawe
- Rush Alzheimer's Disease Center, Rush University Chicago IL USA
| | | | - Richard Mayeux
- Columbia University Irving Medical Center New York NY USA
- The Taub Institute for Research on Alzheimer’s Disease and The Aging Brain Columbia University New York NY USA
| | | | - Hans‐Ulrich Klein
- Columbia University Irving Medical Center New York NY USA
- Center for Translational and Computational Neuroimmunology New York NY USA
- Broad Institute Cambridge MA USA
| | - Philip L De Jager
- Columbia University Irving Medical Center New York NY USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain New York NY USA
- Center for Translational and Computational Neuroimmunology New York NY USA
- Broad Institute Cambridge MA USA
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Oveisgharan S, Yu L, Poole VN, Evia AM, Barnes LL, Schneider JA, Arfanakis K, Bennett DA, Buchman AS. Association of White Matter Hyperintensities With Pathology and Progression of Parkinsonism in Aging. JAMA Neurol 2021; 78:1494-1502. [PMID: 34724033 PMCID: PMC8561430 DOI: 10.1001/jamaneurol.2021.3996] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 09/13/2021] [Indexed: 12/26/2022]
Abstract
Importance Progressive parkinsonism is common in older adults without a diagnosis of Parkinson disease and is associated with adverse health outcomes, but its pathologic basis is controversial. Objective To examine if the burden of cerebral white matter hyperintensity (WMH), a common manifestation of cerebrovascular disease pathologies, is associated with the rate of progressive parkinsonism. Design, Setting, and Participants This community-based cohort study included participants recruited in 3 ongoing cohorts that began enrollment in 1994, 1997, and 2004. Prior to death, participants were observed for a mean of 7.5 years, with annual clinical assessments. From 4427 participants enrolled in the 3 cohorts, 2134 died. Postmortem autopsy was performed in 1725 decedents, and 598 also had ex vivo brain magnetic resonance imaging. Participants were excluded if they were missing any of the 9 postmortem pathology indices (n = 22) or repeated parkinsonism assessment (n = 41) or had received a clinical diagnosis of Parkinson disease at any point before or during the study (n = 19). Data were analyzed from April 2020 to August 2021. Exposures WMH burden was assessed using a modified Fazekas rating scale. Main Outcomes and Measures Parkinsonism was assessed annually using 26 items of a modified motor portion of the Unified Parkinson's Disease Rating Scale. A summary score was developed from the item scores, with higher scores indicating more severe parkinsonism. Results Of 516 included decedents, 364 (70.5%) were female, and the mean (SD) age at death was 90.2 (6.4) years. Higher WMH was associated with faster progressive parkinsonism (estimate, 0.024; SE, 0.008; P = .002). The attenuation of this association was greater when controlling for indices of cerebrovascular disease pathologies than when controlling for neurodegenerative pathologies (cerebrovascular disease: estimate, 0.019; SE, 0.008; P = .02; neurodegenerative: estimate, 0.022; SE, 0.008; P = .003), but both remained significant. Conclusions and Relevance In this cohort study, higher levels of both WMH and indices of cerebrovascular disease pathologies in aging brains were associated with more rapid progressive parkinsonism. Further studies are needed to determine if in vivo brain imaging of older adults for evidence of WMH and aggressive medical treatment of vascular risk factors and diseases can reduce the occurrence or severity of late-life parkinsonism.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Victoria N. Poole
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
| | - Arnold M. Evia
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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Niaz MR, Wu Y, Ridwan AR, Qi X, Bennett DA, Arfanakis K. Development and evaluation of high‐resolution gray matter labels for the MIITRA atlas. Alzheimers Dement 2021. [DOI: 10.1002/alz.052575] [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: 11/08/2022]
Affiliation(s)
| | - Yingjuan Wu
- Illinois Institute of Technology Chicago IL USA
| | | | - Xiaoxiao Qi
- Illinois Institute of Technology Chicago IL USA
| | | | - Konstantinos Arfanakis
- Illinois Institute of Technology Chicago IL USA
- Rush Alzheimer's Disease Center Rush University Chicago IL USA
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