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Kouri N, Frankenhauser I, Peng Z, Labuzan SA, Boon BDC, Moloney CM, Pottier C, Wickland DP, Caetano-Anolles K, Corriveau-Lecavalier N, Tranovich JF, Wood AC, Hinkle KM, Lincoln SJ, Spychalla AJ, Senjem ML, Przybelski SA, Engelberg-Cook E, Schwarz CG, Kwan RS, Lesser ER, Crook JE, Carter RE, Ross OA, Lachner C, Ertekin-Taner N, Ferman TJ, Fields JA, Machulda MM, Ramanan VK, Nguyen AT, Reichard RR, Jones DT, Graff-Radford J, Boeve BF, Knopman DS, Petersen RC, Jack CR, Kantarci K, Day GS, Duara R, Graff-Radford NR, Dickson DW, Lowe VJ, Vemuri P, Murray ME. Clinicopathologic Heterogeneity and Glial Activation Patterns in Alzheimer Disease. JAMA Neurol 2024:2817289. [PMID: 38619853 PMCID: PMC11019448 DOI: 10.1001/jamaneurol.2024.0784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/05/2024] [Indexed: 04/16/2024]
Abstract
Importance Factors associated with clinical heterogeneity in Alzheimer disease (AD) lay along a continuum hypothesized to associate with tangle distribution and are relevant for understanding glial activation considerations in therapeutic advancement. Objectives To examine clinicopathologic and neuroimaging characteristics of disease heterogeneity in AD along a quantitative continuum using the corticolimbic index (CLix) to account for individuality of spatially distributed tangles found at autopsy. Design, Setting, and Participants This cross-sectional study was a retrospective medical record review performed on the Florida Autopsied Multiethnic (FLAME) cohort accessioned from 1991 to 2020. Data were analyzed from December 2022 to December 2023. Structural magnetic resonance imaging (MRI) and tau positron emission tomography (PET) were evaluated in an independent neuroimaging group. The FLAME cohort includes 2809 autopsied individuals; included in this study were neuropathologically diagnosed AD cases (FLAME-AD). A digital pathology subgroup of FLAME-AD cases was derived for glial activation analyses. Main Outcomes and Measures Clinicopathologic factors of heterogeneity that inform patient history and neuropathologic evaluation of AD; CLix score (lower, relative cortical predominance/hippocampal sparing vs higher, relative cortical sparing/limbic predominant cases); neuroimaging measures (ie, structural MRI and tau-PET). Results Of the 2809 autopsied individuals in the FLAME cohort, 1361 neuropathologically diagnosed AD cases were evaluated. A digital pathology subgroup included 60 FLAME-AD cases. The independent neuroimaging group included 93 cases. Among the 1361 FLAME-AD cases, 633 were male (47%; median [range] age at death, 81 [54-96] years) and 728 were female (53%; median [range] age at death, 81 [53-102] years). A younger symptomatic onset (Spearman ρ = 0.39, P < .001) and faster decline on the Mini-Mental State Examination (Spearman ρ = 0.27; P < .001) correlated with a lower CLix score in FLAME-AD series. Cases with a nonamnestic syndrome had lower CLix scores (median [IQR], 13 [9-18]) vs not (median [IQR], 21 [15-27]; P < .001). Hippocampal MRI volume (Spearman ρ = -0.45; P < .001) and flortaucipir tau-PET uptake in posterior cingulate and precuneus cortex (Spearman ρ = -0.74; P < .001) inversely correlated with CLix score. Although AD cases with a CLix score less than 10 had higher cortical tangle count, we found lower percentage of CD68-activated microglia/macrophage burden (median [IQR], 0.46% [0.32%-0.75%]) compared with cases with a CLix score of 10 to 30 (median [IQR], 0.75% [0.51%-0.98%]) and on par with a CLix score of 30 or greater (median [IQR], 0.40% [0.32%-0.57%]; P = .02). Conclusions and Relevance Findings show that AD heterogeneity exists along a continuum of corticolimbic tangle distribution. Reduced CD68 burden may signify an underappreciated association between tau accumulation and microglia/macrophages activation that should be considered in personalized therapy for immune dysregulation.
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Affiliation(s)
- Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Isabelle Frankenhauser
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Paracelsus Medical Private University, Salzburg, Austria
| | - Zhongwei Peng
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | | | | | | | - Cyril Pottier
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Daniel P. Wickland
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | | | - Nick Corriveau-Lecavalier
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Ashley C. Wood
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Kelly M. Hinkle
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | | | | | | | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | | | | - Rain S. Kwan
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Elizabeth R. Lesser
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Julia E. Crook
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Rickey E. Carter
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
| | - Christian Lachner
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | - Nilüfer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Tanis J. Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
| | | | - Aivi T. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - David T. Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Ranjan Duara
- Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, Florida
| | | | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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Habich A, Oltra J, Schwarz CG, Przybelski SA, Oppedal K, Inguanzo A, Blanc F, Lemstra AW, Hort J, Westman E, Segura B, Junque C, Lowe VJ, Boeve BF, Aarsland D, Dierks T, Kantarci K, Ferreira D. Grey matter networks in women and men with dementia with Lewy bodies. NPJ Parkinsons Dis 2024; 10:84. [PMID: 38615089 PMCID: PMC11016082 DOI: 10.1038/s41531-024-00702-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 04/02/2024] [Indexed: 04/15/2024] Open
Abstract
Sex differences permeate many aspects of dementia with Lewy bodies (DLB), yet sex differences in patterns of neurodegeneration in DLB remain largely unexplored. Here, we test whether grey matter networks differ between sexes in DLB and compare these findings to sex differences in healthy controls. In this cross-sectional study, we analysed clinical and neuroimaging data of patients with DLB and cognitively healthy controls matched for age and sex. Grey matter networks were constructed by pairwise correlations between 58 regional volumes after correction for age, intracranial volume, and centre. Network properties were compared between sexes and diagnostic groups. Additional analyses were conducted on w-scored data to identify DLB-specific sex differences. Data from 119 (68.7 ± 8.4 years) men and 45 women (69.9 ± 9.1 years) with DLB, and 164 healthy controls were included in this study. Networks of men had a lower nodal strength compared to women. In comparison to healthy women, the grey matter networks of healthy men showed a higher global efficiency, modularity, and fewer modules. None of the network measures showed significant sex differences in DLB. Comparing DLB patients with healthy controls revealed global differences in women and more local differences in men. Modular analyses showed a more distinct demarcation between cortical and subcortical regions in men compared with women. While topologies of grey matter networks differed between sexes in healthy controls, those sex differences were diluted in DLB patients. These findings suggest a disease-driven convergence of neurodegenerative patterns in women and men with DLB, which may inform precision medicine in DLB.
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Grants
- R01 AG041851 NIA NIH HHS
- C06 RR018898 NCRR NIH HHS
- P50 AG016574 NIA NIH HHS
- R01 AG040042 NIA NIH HHS
- R01 NS080820 NINDS NIH HHS
- R37 AG011378 NIA NIH HHS
- U01 NS100620 NINDS NIH HHS
- U01 AG006786 NIA NIH HHS
- ALF Medicine, Demensfonden, Center for Innovative Medicine (CIMED), Swedish Research Council (VR)
- Demensfonden, Foundation for Geriatric Diseases at Karolinska Institutet, Loo och Hans Osterman Stiftelse, Stiftelsen för Gamla Tjänarinnor, Stohnes Stiftelsen, KI Travel grants
- 2018 fellowship from the Spanish Ministry of Science, Innovation and Universities; and co-financed by the European Social Fund (PRE2018-086675)
- Stohnes Stiftelsen, Loo och Hans Osterman Stiftelse
- project nr. LX22NPO5107 (MEYS): Financed by EU – Next Generation EU
- Swedish Research Council (VR), Swedish Foundation for Strategic Research (SSF), Center for Innovative Medicine (CIMED), King Gustaf V:s and Queen Victorias Foundation, Hjärnfonden, Alzheimerfonden, Parkinsonfonden,
- Spanish Ministry of Economy and Competitiveness (MINECO PID2020-114640GB-I00/AEI/10.13039/501100011033) Generalitat de Catalunya (SGR 2021SGR00801) María de Maeztu Unit of Excellence (Institute of Neurosciences, University of Barcelona) CEX2021-001159-M, Ministry of Science and Innovation.
- National Institutes of Health (U01-NS100620; P50-AG016574)
- Western Norway Regional Health Authority
- National Institutes of Health (U01-NS100620; R01-AG040042)
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Affiliation(s)
- Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- University Hospital of Psychiatry and Psychotherapy Bern, University of Bern, Bern, Switzerland
| | - Javier Oltra
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | - Ketil Oppedal
- Department of Electrical Engineering and Computer Science, University of Stavanger, Stavanger, Norway
| | - Anna Inguanzo
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
| | - Frédéric Blanc
- Day Hospital of Geriatrics, Memory Resource and Research Centre (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
- ICube Laboratory and Federation de Medecine Translationnelle de Strasbourg (FMTS), University of Strasbourg and French National Centre for Scientific Research (CNRS), Team Imagerie Multimodale Integrative en Sante (IMIS)/ICONE, Strasbourg, France
| | - Afina W Lemstra
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| | - Jakub Hort
- Memory Clinic, Department of Neurology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Motol University Hospital, Prague, Czech Republic
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Barbara Segura
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
| | - Carme Junque
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Catalonia, Spain
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy Bern, University of Bern, Bern, Switzerland
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
- Facultad de Ciencias de la Salud, Universidad Fernando Pessoa Canarias, Las Palmas, Spain.
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Mak E, Reid RI, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Raghavan S, Vemuri P, Jack CR, Min HK, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff-Radford J, Jones DT, Botha H, St Louis EK, Knopman DS, Ramanan VK, Dickson DW, Graff-Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, O'Brien JT, Kantarci K. Influences of amyloid-β and tau on white matter neurite alterations in dementia with Lewy bodies. NPJ Parkinsons Dis 2024; 10:76. [PMID: 38570511 PMCID: PMC10991290 DOI: 10.1038/s41531-024-00684-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 03/13/2024] [Indexed: 04/05/2024] Open
Abstract
Dementia with Lewy bodies (DLB) is a neurodegenerative condition often co-occurring with Alzheimer's disease (AD) pathology. Characterizing white matter tissue microstructure using Neurite Orientation Dispersion and Density Imaging (NODDI) may help elucidate the biological underpinnings of white matter injury in individuals with DLB. In this study, diffusion tensor imaging (DTI) and NODDI metrics were compared in 45 patients within the dementia with Lewy bodies spectrum (mild cognitive impairment with Lewy bodies (n = 13) and probable dementia with Lewy bodies (n = 32)) against 45 matched controls using conditional logistic models. We evaluated the associations of tau and amyloid-β with DTI and NODDI parameters and examined the correlations of AD-related white matter injury with Clinical Dementia Rating (CDR). Structural equation models (SEM) explored relationships among age, APOE ε4, amyloid-β, tau, and white matter injury. The DLB spectrum group exhibited widespread white matter abnormalities, including reduced fractional anisotropy, increased mean diffusivity, and decreased neurite density index. Tau was significantly associated with limbic and temporal white matter injury, which was, in turn, associated with worse CDR. SEM revealed that amyloid-β exerted indirect effects on white matter injury through tau. We observed widespread disruptions in white matter tracts in DLB that were not attributed to AD pathologies, likely due to α-synuclein-related injury. However, a fraction of the white matter injury could be attributed to AD pathology. Our findings underscore the impact of AD pathology on white matter integrity in DLB and highlight the utility of NODDI in elucidating the biological basis of white matter injury in DLB.
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Affiliation(s)
- Elijah Mak
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Robert I Reid
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Hoon Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Manoj K Jain
- Department of Radiology, Mayo Clinic, Jacksonville, FL, USA
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - David T Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Erik K St Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Dennis W Dickson
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Tanis J Ferman
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ronald C Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - John T O'Brien
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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4
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Diaz‐Galvan P, Przybelski SA, Algeciras‐Schimnich A, Figdore DJ, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min PH, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff‐Radford J, Ramanan VK, Jones DT, Botha H, St Louis EK, Knopman DS, Graff‐Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. Plasma biomarkers of Alzheimer's disease in the continuum of dementia with Lewy bodies. Alzheimers Dement 2024; 20:2485-2496. [PMID: 38329197 PMCID: PMC11032523 DOI: 10.1002/alz.13653] [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: 10/05/2023] [Revised: 11/28/2023] [Accepted: 12/01/2023] [Indexed: 02/09/2024]
Abstract
INTRODUCTION Patients with dementia with Lewy bodies (DLB) may have Alzheimers disease (AD) pathology that can be detected by plasma biomarkers. Our objective was to evaluate plasma biomarkers of AD and their association with positron emission tomography (PET) biomarkers of amyloid and tau deposition in the continuum of DLB, starting from prodromal stages of the disease. METHODS The cohort included patients with isolated rapid eye movement (REM) sleep behavior disorder (iRBD), mild cognitive impairment with Lewy bodies (MCI-LB), or DLB, with a concurrent blood draw and PET scans. RESULTS Abnormal levels of plasma glial fibrillary acidic protein (GFAP) were found at the prodromal stage of MCI-LB in association with increased amyloid PET. Abnormal levels of plasma phosphorylated tau (p-tau)-181 and neurofilament light (NfL) were found at the DLB stage. Plasma p-tau-181 showed the highest accuracy in detecting abnormal amyloid and tau PET in patients with DLB. DISCUSSION The range of AD co-pathology can be detected with plasma biomarkers in the DLB continuum, particularly with plasma p-tau-181 and GFAP.
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Affiliation(s)
| | | | | | - Dan J. Figdore
- Department of Laboratory Medicine and PathologyMayo ClinicRochesterMinnesotaUSA
| | - Timothy G. Lesnick
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Paul H Min
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Manoj K. Jain
- Department of RadiologyMayo ClinicJacksonvilleFloridaUSA
| | - Toji Miyagawa
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Hugo Botha
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Erik K. St Louis
- Mayo Center for Sleep MedicineMayo ClinicRochesterMinnesotaUSA
- Departments of Neurology and Clinical and Translational ResearchMayo Clinic Southwest WisconsinLa CrosseWisconsinUSA
| | | | | | - Tanis J. Ferman
- Department of Psychiatry & PsychologyMayo ClinicJacksonvilleFloridaUSA
| | - Ronald C. Petersen
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
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Pradeep A, Raghavan S, Przybelski SA, Preboske G, Schwarz CG, Lowe VJ, Knopman DS, Petersen RC, Jack CR, Graff-Radford J, Cogswell PM, Vemuri P. Can white matter hyperintensities based Fazekas visual assessment scales inform about Alzheimer's disease pathology in the population? Res Sq 2024:rs.3.rs-4017874. [PMID: 38558965 PMCID: PMC10980106 DOI: 10.21203/rs.3.rs-4017874/v1] [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] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background White matter hyperintensities (WMH) are considered hallmark features of cerebral small vessel disease and have recently been linked to Alzheimer's disease pathology. Their distinct spatial distributions, namely periventricular versus deep WMH, may differ by underlying age-related and pathobiological processes contributing to cognitive decline. We aimed to identify the spatial patterns of WMH using the 4-scale Fazekas visual assessment and explore their differential association with age, vascular health, Alzheimer's imaging markers, namely amyloid and tau burden, and cognition. Because our study consisted of scans from GE and Siemens scanners with different resolutions, we also investigated inter-scanner reproducibility and combinability of WMH measurements on imaging. Methods We identified 1144 participants from the Mayo Clinic Study of Aging consisting of older adults from Olmsted County, Minnesota with available structural magnetic resonance imaging (MRI), amyloid, and tau positron emission tomography (PET). WMH distribution patterns were assessed on FLAIR-MRI, both 2D axial and 3D, using Fazekas ratings of periventricular and deep WMH severity. We compared the association of periventricular and deep WMH scales with vascular risk factors, amyloid-PET and tau-PET standardized uptake value ratio, WMH volume, and cognition using Pearson partial correlation after adjusting for age. We also evaluated vendor compatibility and reproducibility of the Fazekas scales using intraclass correlations (ICC). Results Periventricular and deep WMH measurements showed similar correlations with age, cardiometabolic conditions score (vascular risk), and cognition, (p < 0.001). Both periventricular WMH and deep WMH showed weak associations with amyloidosis (R = 0.07, p = < 0.001), and none with tau burden. We found substantial agreement between data from the two scanners for Fazekas measurements (ICC = 0.78). The automated WMH volume had high discriminating power for identifying participants with Fazekas ≥ 2 (area under curve = 0.97). Conclusion Our study investigates risk factors underlying WMH spatial patterns and their impact on global cognition, with no discernible differences between periventricular and deep WMH. We observed minimal impact of amyloidosis on WMH severity. These findings, coupled with enhanced inter-scanner reproducibility of WMH data, suggest the combinability of inter-scanner data assessed by harmonized protocols in the context of vascular contributions to cognitive impairment and dementia biomarker research.
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6
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Robinson CG, Lee J, Min PH, Przybelski SA, Josephs KA, Jones DT, Graff‐Radford J, Boeve BF, Knopman DS, Jack CR, Petersen RC, Machulda MM, Fields JA, Lowe VJ. Significance of a positive tau PET scan with a negative amyloid PET scan. Alzheimers Dement 2024; 20:1923-1932. [PMID: 38159060 PMCID: PMC10947949 DOI: 10.1002/alz.13608] [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: 07/10/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION The implications of positive tau positron emission tomography (T) with negative beta amyloid positron emission tomography (A) are not well understood. We investigated cognitive performance in participants who were T+ but A-. METHODS We evaluated 98 participants from the Mayo Clinic who were T+ and A-. Participants were matched 2:1 to A- and T- cognitively unimpaired (CU) controls. Cognitive test scores were compared between different groups. RESULTS The A-T+ group demonstrated lower performance than the A-T- group on the Mini-Mental Status Exam (MMSE) (p < 0.001), Wechsler Memory Scale-Revised Logical Memory I (p < 0.001) and Logical Memory II (p < 0.001), Auditory Verbal Learning Test (AVLT) delayed recall (p = 0.004), category fluency (animals p = 0.005; vegetables p = 0.021), Trail Making Test A and B (p < 0.001), and others. There were no significant differences in demographic features or apolipoprotein E (APOE) e4 genotype between CU A-T+ and CI A-T+. DISCUSSION A-T+ participants show an association with lower cognitive performance.
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Affiliation(s)
| | - Jeyeon Lee
- College of MedicineHanyang UniversitySeoulSouth Korea
| | - Paul H. Min
- Departments of RadiologyMayo ClinicRochesterMinnesotaUSA
| | | | | | - David T. Jones
- Departments of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | | | - Mary M. Machulda
- Departments of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Julie A. Fields
- Departments of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Val J. Lowe
- Departments of RadiologyMayo ClinicRochesterMinnesotaUSA
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Khandalavala KR, Marinelli JP, Lohse CM, Przybelski SA, Petersen RC, Vassilaki M, Vemuri P, Carlson ML. Neuroimaging Characteristics of Hearing Loss in the Mayo Clinic Study of Aging. Otolaryngol Head Neck Surg 2024; 170:886-895. [PMID: 38018509 PMCID: PMC10922536 DOI: 10.1002/ohn.583] [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: 08/17/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE To investigate the association between standard pure tone and speech audiometry with neuroimaging characteristics reflective of aging and dementia in older adults. STUDY DESIGN Prospective population-based study. SETTING Single tertiary care referral center. METHODS Participants from the Mayo Clinic Study of aging 60 years old or older with normal cognition or mild cognitive impairment, baseline neuroimaging, and a behavioral audiogram associated with neuroimaging were eligible for study. Imaging modalities included structural MRI (sMRI) and fluid-attenuated inversion recovery MRI (FLAIR-MRI; N = 605), diffusion tensor imaging MRI (DTI-MRI; N = 444), and fluorodeoxyglucose-positron emission tomography (FDG-PET; N = 413). Multivariable logistic and linear regression models were used to evaluate associations with neuroimaging outcomes. RESULTS Mean (SD) pure tone average (PTA) was 33 (15) dB HL and mean (SD) word recognition score (WRS) was 91% (14). There were no significant associations between audiometric performance and cortical thinning assessed by sMRI. Each 10-dB increase in PTA was associated with increased likelihood of abnormal white-matter hyperintensity (WMH) from FLAIR-MRI (odds ratio 1.26, P = .02). From DTI-MRI, participants with <100% WRSs had significantly lower fractional anisotropy in the genu of the corpus callosum (parameter estimate [PE] -0.012, P = .008) compared to those with perfect WRSs. From FDG-PET, each 10% decrease in WRSs was associated with decreased uptake in the anterior cingulate cortex (PE -0.013, P = .001). CONCLUSION Poorer audiometric performance was not significantly associated with cortical thinning but was associated with white matter damage relevant to cerebrovascular disease (increased abnormal WMH, decreased corpus callosum diffusion). These neuroimaging results suggest a pathophysiologic link between hearing loss and cerebrovascular disease.
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Affiliation(s)
| | - John P. Marinelli
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
| | | | | | - Ronald C. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Neurology, Mayo Clinic, Rochester, MN
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Matthew L. Carlson
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, MN
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN
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8
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Oltra J, Habich A, Schwarz CG, Nedelska Z, Przybelski SA, Inguanzo A, Diaz‐Galvan P, Lowe VJ, Oppedal K, Gonzalez MC, Philippi N, Blanc F, Barkhof F, Lemstra AW, Hort J, Padovani A, Rektorova I, Bonanni L, Massa F, Kramberger MG, Taylor J, Snædal JG, Walker Z, Antonini A, Dierks T, Segura B, Junque C, Westman E, Boeve BF, Aarsland D, Kantarci K, Ferreira D. Sex differences in brain atrophy in dementia with Lewy bodies. Alzheimers Dement 2024; 20:1815-1826. [PMID: 38131463 PMCID: PMC10947875 DOI: 10.1002/alz.13571] [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: 07/19/2023] [Revised: 10/13/2023] [Accepted: 11/10/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Sex influences neurodegeneration, but it has been poorly investigated in dementia with Lewy bodies (DLB). We investigated sex differences in brain atrophy in DLB using magnetic resonance imaging (MRI). METHODS We included 436 patients from the European-DLB consortium and the Mayo Clinic. Sex differences and sex-by-age interactions were assessed through visual atrophy rating scales (n = 327; 73 ± 8 years, 62% males) and automated estimations of regional gray matter volume and cortical thickness (n = 165; 69 ± 9 years, 72% males). RESULTS We found a higher likelihood of frontal atrophy and smaller volumes in six cortical regions in males and thinner olfactory cortices in females. There were significant sex-by-age interactions in volume (six regions) and cortical thickness (seven regions) across the entire cortex. DISCUSSION We demonstrate that males have more widespread cortical atrophy at younger ages, but differences tend to disappear with increasing age, with males and females converging around the age of 75. HIGHLIGHTS Male DLB patients had higher odds for frontal atrophy on radiological visual rating scales. Male DLB patients displayed a widespread pattern of cortical gray matter alterations on automated methods. Sex differences in gray matter measures in DLB tended to disappear with increasing age.
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Affiliation(s)
- Javier Oltra
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | - Annegret Habich
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | | | - Zuzana Nedelska
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | | | - Anna Inguanzo
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | - Ketil Oppedal
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
| | - Maria C. Gonzalez
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Stavanger Medical Imaging Laboratory (SMIL)Department of RadiologyStavanger University HospitalStavangerNorway
- The Norwegian Centre for Movement DisordersStavanger University HospitalStavangerNorway
- Department of Quality and Health TechnologyFaculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Nathalie Philippi
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederic Blanc
- Geriatrics and Neurology UnitsResearch and Resources Memory Center (CM2R)Hôpitaux Universitaires de StrasbourgStrasbourgFrance
- ICube Laboratory (CNRS, UMR 7357)StrasbourgFrance
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine (AMC)Amsterdam UMC, Vrije UniversiteitAmsterdamthe Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing (CMIC)University College LondonLondonUK
| | - Afina W. Lemstra
- Alzheimer Center AmsterdamNeurologyVrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
- Amsterdam NeuroscienceNeurodegeneration, Vrije Universiteit Amsterdam, Amsterdam UMC location VumcAmsterdamThe Netherlands
| | - Jakub Hort
- Memory ClinicDepartment of NeurologyCharles University2nd Faculty of Medicine and Motol University HospitalPragueCzech Republic
| | - Alessandro Padovani
- Neurology UnitDepartment of Clinical and Experimental Sciences (DSCS)University of BresciaBresciaItaly
| | - Irena Rektorova
- Brain and Mind ResearchCentral European Institute of Technology (CEITET)Masaryk UniversityBrnoCzech Republic
| | - Laura Bonanni
- Department of Medicine and Aging Sciences University G. d'Annunzio of Chieti‐Pescara ChietiChietiItaly
| | - Federico Massa
- Department of NeuroscienceRehabilitationOphthalmology, Genetics, Maternal and Child HealthUniversity of GenovaGenovaItaly
| | | | - John‐Paul Taylor
- Translational and Clinical Research InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle upon TyneUK
| | | | - Zuzana Walker
- Division of PsychiatryUniversity College LondonLondonUK
- St Margaret's HospitalEssex Partnership University NHS Foundation TrustEssexUK
| | - Angelo Antonini
- Parkinson and Movement Disorders UnitStudy Center on Neurodegeneration (CESNE)PadovaItaly
| | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy Bern, University of BernBernSwitzerland
| | - Barbara Segura
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Carme Junque
- Medical Psychology UnitDepartment of MedicineInstitute of NeuroscienceUniversity of BarcelonaBarcelonaCataloniaSpain
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS)BarcelonaCataloniaSpain
- Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED: CB06/05/0018‐ISCIII)BarcelonaCataloniaSpain
| | - Eric Westman
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
| | | | - Dag Aarsland
- Center for Age‐Related MedicineStavanger University HospitalStavangerNorway
- Department of Old Age PsychiatryInstitute of PsychiatryPsychology & Neuroscience (IoPPN)King's College LondonLondonUK
| | | | - Daniel Ferreira
- Division of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of NeurobiologyCare Sciences and SocietyKarolinska InstitutetStockholmSweden
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
- Facultad de Ciencias de la SaludUniversidad Fernando Pessoa CanariasLas PalmasEspaña
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9
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Raghavan S, Przybelski SA, Lesnick TG, Fought AJ, Reid RI, Gebre RK, Windham BG, Algeciras‐Schimnich A, Machulda MM, Vassilaki M, Knopman DS, Jack CR, Petersen RC, Graff‐Radford J, Vemuri P. Vascular risk, gait, behavioral, and plasma indicators of VCID. Alzheimers Dement 2024; 20:1201-1213. [PMID: 37932910 PMCID: PMC10916988 DOI: 10.1002/alz.13540] [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: 07/11/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Cost-effective screening tools for vascular contributions to cognitive impairment and dementia (VCID) has significant implications. We evaluated non-imaging indicators of VCID using magnetic resonance imaging (MRI)-measured white matter (WM) damage and hypothesized that these indicators differ based on age. METHODS In 745 participants from the Mayo Clinic Study of Aging (≥50 years of age) with serial WM assessments from diffusion MRI and fluid-attenuated inversion recovery (FLAIR)-MRI, we examined associations between baseline non-imaging indicators (demographics, vascular risk factors [VRFs], gait, behavioral, plasma glial fibrillary acidic protein [GFAP], and plasma neurofilament light chain [NfL]) and WM damage across three age tertiles. RESULTS VRFs and gait were associated with diffusion changes even in low age strata. All measures (VRFs, gait, behavioral, plasma GFAP, plasma NfL) were associated with white matter hyperintensities (WMHs) but mainly in intermediate and high age strata. DISCUSSION Non-imaging indicators of VCID were related to WM damage and may aid in screening participants and assessing outcomes for VCID. HIGHLIGHTS Non-imaging indicators of VCID can aid in prediction of MRI-measured WM damage but their importance differed by age. Vascular risk and gait measures were associated with early VCID changes measured using diffusion MRI. Plasma markers explained variability in WMH across age strata. Most non-imaging measures explained variability in WMH and vascular WM scores in intermediate and older age groups. The framework developed here can be used to evaluate new non-imaging VCID indicators proposed in the future.
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Affiliation(s)
| | | | - Timothy G. Lesnick
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Angela J. Fought
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Robert I. Reid
- Department of Information TechnologyMayo ClinicRochesterMinnesotaUSA
| | | | - B. Gwen Windham
- Department of MedicineUniversity of Mississippi Medical CenterJacksonUSA
| | | | | | - Maria Vassilaki
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
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10
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Miyagawa T, Vernon C, Przybelski SA, Min HK, Fields JA, Kantarci K, Lowe VJ, Boeve BF. Marked Decreased Tracer Binding in 123 I-FP-CIT SPECT Scans From Lisdexafetamine Dismesylate Interaction: A Case Report. Clin Neuropharmacol 2024; 47:26-28. [PMID: 38193851 PMCID: PMC10872469 DOI: 10.1097/wnf.0000000000000579] [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: 01/10/2024]
Abstract
OBJECTIVES The objective of this case study is to raise awareness of potential 123 I-FP-CIT SPECT interference by lisdexafetamine dimesylate, a prodrug of d -amphetamine. METHODS A 69-year-old man with Rapid Eye Movement sleep behavior disorder and mild cognitive impairment had been treated with lisdexafetamine dimesylate for attention-deficit/hyperactivity disorder. The patient had annual or biennial 123 I-FP-CIT SPECT evaluations after their baseline visit at 69 years old. Nigrostriatal dopamine transporter uptake was semiquantitatively evaluated with 123 I-FP-CIT SPECT using DaTQUANT 2.0 software. Lisdexafetamine dimesylate was discontinued 3 months before the sixth-year visit (76 years old) by his primary care provider. RESULTS The patient had 4 123 I-FP-CIT SPECT scans with lisdexafetamine dimesylate and 2 scans after the discontinuation of lisdexafetamine dimesylate. The DaTQUANT z -scores of the putamen declined from -1.36 at the baseline visit to -3.02 at the fifth-year visit. After the discontinuation of lisdexafetamine dimesylate, DaTQUANT z -scores of the putamen increased to -0.63 at the sixth-year visit and remained in the normal range of -0.71 at the seventh-year visit. CONCLUSIONS This case suggests that lisdexafetamine dimesylate may have a strong interference with 123 I-FP-CIT SPECT, decreasing the tracer binding to the dopamine transporter and presenting false positive results.
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Affiliation(s)
- Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Cynthia Vernon
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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11
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Corriveau-Lecavalier N, Barnard LR, Przybelski SA, Gogineni V, Botha H, Graff-Radford J, Ramanan VK, Forsberg LK, Fields JA, Machulda MM, Rademakers R, Gavrilova RH, Lapid MI, Boeve BF, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Kantarci K, Jones DT. Assessing network degeneration and phenotypic heterogeneity in genetic frontotemporal lobar degeneration by decoding FDG-PET. Neuroimage Clin 2023; 41:103559. [PMID: 38147792 PMCID: PMC10944211 DOI: 10.1016/j.nicl.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 12/28/2023]
Abstract
Genetic mutations causative of frontotemporal lobar degeneration (FTLD) are highly predictive of a specific proteinopathy, but there exists substantial inter-individual variability in their patterns of network degeneration and clinical manifestations. We collected clinical and 18Fluorodeoxyglucose-positron emission tomography (FDG-PET) data from 39 patients with genetic FTLD, including 11 carrying the C9orf72 hexanucleotide expansion, 16 carrying a MAPT mutation and 12 carrying a GRN mutation. We performed a spectral covariance decomposition analysis between FDG-PET images to yield unbiased latent patterns reflective of whole brain patterns of metabolism ("eigenbrains" or EBs). We then conducted linear discriminant analyses (LDAs) to perform EB-based predictions of genetic mutation and predominant clinical phenotype (i.e., behavior/personality, language, asymptomatic). Five EBs were significant and explained 58.52 % of the covariance between FDG-PET images. EBs indicative of hypometabolism in left frontotemporal and temporo-parietal areas distinguished GRN mutation carriers from other genetic mutations and were associated with predominant language phenotypes. EBs indicative of hypometabolism in prefrontal and temporopolar areas with a right hemispheric predominance were mostly associated with predominant behavioral phenotypes and distinguished MAPT mutation carriers from other genetic mutations. The LDAs yielded accuracies of 79.5 % and 76.9 % in predicting genetic status and predominant clinical phenotype, respectively. A small number of EBs explained a high proportion of covariance in patterns of network degeneration across FTLD-related genetic mutations. These EBs contained biological information relevant to the variability in the pathophysiological and clinical aspects of genetic FTLD, and for offering valuable guidance in complex clinical decision-making, such as decisions related to genetic testing.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | | | - Hugo Botha
- Department of Neurology, Mayo Clinic Rochester, USA
| | | | | | | | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | - Rosa Rademakers
- Department of Neuroscience, Mayo Clinic Jacksonville, USA; VIB-UA Center for Molecular Neurology, VIB, University of Antwerp, Belgium
| | | | - Maria I Lapid
- Department of Psychiatry and Psychology, Mayo Clinic Rochester, USA
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic Rochester, USA
| | | | | | | | - David T Jones
- Department of Neurology, Mayo Clinic Rochester, USA; Department of Radiology, Mayo Clinic Rochester, USA.
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12
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Corriveau-Lecavalier N, Botha H, Graff-Radford J, Switzer AR, Przybelski SA, Wiste HJ, Murray ME, Reichard RR, Dickson DW, Nguyen AT, Ramanan VK, McCarter SJ, Boeve BF, Machulda MM, Fields JA, Stricker NH, Nelson PT, Grothe MJ, Knopman DS, Lowe VJ, Petersen RC, Jack CR, Jones DT. A limbic-predominant amnestic neurodegenerative syndrome associated with TDP-43 pathology. medRxiv 2023:2023.11.19.23298314. [PMID: 38045300 PMCID: PMC10690340 DOI: 10.1101/2023.11.19.23298314] [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] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a neuropathologically-defined disease that affects 40% of persons in advanced age, but its associated neurological syndrome is not defined. LATE neuropathological changes (LATE-NC) are frequently comorbid with Alzheimer's disease neuropathologic changes (ADNC). When seen in isolation, LATE-NC have been associated with a predominantly amnestic profile and slow clinical progression. We propose a set of clinical criteria for a limbic-predominant amnestic neurodegenerative syndrome (LANS) that is highly associated with LATE-NC but also other pathologic entities. The LANS criteria incorporate core, standard and advanced features that are measurable in vivo, including older age at evaluation, mild clinical syndrome, disproportionate hippocampal atrophy, impaired semantic memory, limbic hypometabolism, absence of neocortical degenerative patterns and low likelihood of neocortical tau, with degrees of certainty (highest, high, moderate, low). We operationalized this set of criteria using clinical, imaging and biomarker data to validate its associations with clinical and pathologic outcomes. We screened autopsied patients from Mayo Clinic (n = 922) and ADNI (n = 93) cohorts and applied the LANS criteria to those with an antemortem predominant amnestic syndrome (Mayo, n = 165; ADNI, n = 53). ADNC, ADNC/LATE-NC and LATE-NC accounted for 35%, 37% and 4% of cases in the Mayo cohort, respectively, and 30%, 22%, and 9% of cases in the ADNI cohort, respectively. The LANS criteria effectively categorized these cases, with ADNC having the lowest LANS likelihoods, LATE-NC patients having the highest likelihoods, and ADNC/LATE-NC patients having intermediate likelihoods. A logistic regression model using the LANS features as predictors of LATE-NC achieved a balanced accuracy of 74.6% in the Mayo cohort, and out-of-sample predictions in the ADNI cohort achieved a balanced accuracy of 73.3%. Patients with high LANS likelihoods had a milder and slower clinical course and more severe temporo-limbic degeneration compared to those with low likelihoods. Stratifying ADNC/LATE-NC patients from the Mayo cohort according to their LANS likelihood revealed that those with higher likelihoods had more temporo-limbic degeneration and a slower rate of cognitive decline, and those with lower likelihoods had more lateral temporo-parietal degeneration and a faster rate of cognitive decline. The implementation of LANS criteria has implications to disambiguate the different driving etiologies of progressive amnestic presentations in older age and guide prognosis, treatment, and clinical trials. The development of in vivo biomarkers specific to TDP-43 pathology are needed to refine molecular associations between LANS and LATE-NC and precise antemortem diagnoses of LATE.
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Affiliation(s)
- Nick Corriveau-Lecavalier
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Heather J. Wiste
- Department of Quantitative Health Sciences, Mayo Clinic Rochester, MN, USA
| | | | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, USA
| | | | - Aivi T. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, USA
| | | | | | | | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Nikki H. Stricker
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Peter T. Nelson
- Department of Pathology, University of Kentucky, Lexington, KY, USA
| | - Michel J. Grothe
- CIEN Foundation/Queen Sofia Foundation Alzheimer Center, Madrid, Spain
- Wallenberg Center for Molecular and Translational Medicine and Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Clifford R. Jack
- Department of Neuroscience, Mayo Clinic Jacksonville, FL, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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13
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Switzer A, Charidimou A, McCarter SJ, Vemuri P, Nguyen A, Przybelski SA, Lesnick TG, Rabinstein AA, Brown RD, Knopman DS, Petersen RC, Jack CR, Reichard RR, Graff-Radford J. Boston criteria v2.0 for cerebral amyloid angiopathy without hemorrhage: An MRI-neuropathological validation study. medRxiv 2023:2023.11.09.23298325. [PMID: 37986913 PMCID: PMC10659504 DOI: 10.1101/2023.11.09.23298325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND Updated criteria for the clinical-MRI diagnosis of cerebral amyloid angiopathy (CAA) have recently been proposed. However, their performance in individuals without intracerebral hemorrhage (ICH) or transient focal neurological episodes (TFNE) is unknown. We assessed the diagnostic performance of the Boston criteria version 2.0 for CAA diagnosis in a cohort of individuals presenting without symptomatic ICH. METHODS Fifty-four participants from the Mayo Clinic Study of Aging or Alzheimer's Disease Research Center were included if they had an antemortem MRI with gradient-recall echo sequences and a brain autopsy with CAA evaluation. Performance of the Boston criteria v2.0 was compared to v1.5 using histopathologically verified CAA as the reference standard. RESULTS Median age at MRI was 75 years (IQR 65-80) with 28/54 participants having histopathologically verified CAA (i.e., moderate-to-severe CAA in at least 1 lobar region). The sensitivity and specificity of the Boston criteria v2.0 were 28.6% (95%CI: 13.2-48.7%) and 65.3% (95%CI: 44.3-82.8%) for probable CAA diagnosis (AUC 0.47) and 75.0% (55.1-89.3) and 38.5% (20.2-59.4) for any CAA diagnosis (possible + probable; AUC: 0.57), respectively. The v2.0 Boston criteria was not superior in performance compared to the prior v1.5 criteria for either CAA diagnostic category. CONCLUSIONS The Boston criteria v2.0 have low accuracy in patients who are asymptomatic or only have cognitive symptoms.. Additional biomarkers need to be explored to optimize CAA diagnosis in this population.
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14
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Schwarz CG, Kremers WK, Weigand SD, Prakaashana CM, Senjem ML, Przybelski SA, Lowe VJ, Gunter JL, Kantarci K, Vemuri P, Graff-Radford J, Petersen RC, Knopman DS, Jack CR. Effects of de-facing software mri_reface on utility of imaging biomarkers used in Alzheimer's disease research. Neuroimage Clin 2023; 40:103507. [PMID: 37703605 PMCID: PMC10502400 DOI: 10.1016/j.nicl.2023.103507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/07/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023]
Abstract
Brain imaging research studies increasingly use "de-facing" software to remove or replace facial imagery before public data sharing. Several works have studied the effects of de-facing software on brain imaging biomarkers by directly comparing automated measurements from unmodified vs de-faced images, but most research brain images are used in analyses of correlations with cognitive measurements or clinical statuses, and the effects of de-facing on these types of imaging-to-cognition correlations has not been measured. In this work, we focused on brain imaging measures of amyloid (A), tau (T), neurodegeneration (N), and vascular (V) measures used in Alzheimer's Disease (AD) research. We created a retrospective sample of participants from three age- and sex-matched clinical groups (cognitively unimpaired, mild cognitive impairment, and AD dementia, and we performed region- and voxel-wise analyses of: hippocampal volume (N), white matter hyperintensity volume (V), amyloid PET (A), and tau PET (T) measures, each from multiple software pipelines, on their ability to separate cognitively defined groups and their degrees of correlation with age and Clinical Dementia Rating (CDR)-Sum of Boxes (CDR-SB). We performed each of these analyses twice: once with unmodified images and once with images de-faced with leading de-facing software mri_reface, and we directly compared the findings and their statistical strengths between the original vs. the de-faced images. Analyses with original and with de-faced images had very high agreement. There were no significant differences between any voxel-wise comparisons. Among region-wise comparisons, only three out of 55 correlations were significantly different between original and de-faced images, and these were not significant after correction for multiple comparisons. Overall, the statistical power of the imaging data for AD biomarkers was almost identical between unmodified and de-faced images, and their analyses results were extremely consistent.
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Affiliation(s)
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Division of Clinical Trials & Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Stephen D Weigand
- Department of Quantitative Health Sciences, Division of Clinical Trials & Biostatistics, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Division of Clinical Trials & Biostatistics, Mayo Clinic, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Carvalho DZ, McCarter SJ, St Louis EK, Przybelski SA, Johnson Sparrman KL, Somers VK, Boeve BF, Petersen RC, Jack CR, Graff-Radford J, Vemuri P. Association of Polysomnographic Sleep Parameters With Neuroimaging Biomarkers of Cerebrovascular Disease in Older Adults With Sleep Apnea. Neurology 2023; 101:e125-e136. [PMID: 37164654 PMCID: PMC10351545 DOI: 10.1212/wnl.0000000000207392] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 03/23/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Our objective was to determine whether polysomnographic (PSG) sleep parameters are associated with neuroimaging biomarkers of cerebrovascular disease (CVD) related to white matter (WM) integrity in older adults with obstructive sleep apnea (OSA). METHODS From the population-based Mayo Clinic Study of Aging, we identified participants without dementia who underwent at least 1 brain MRI and PSG. We quantified 2 CVD biomarkers: WM hyperintensities (WMHs) from fluid-attenuated inversion recovery (FLAIR)-MRI, and fractional anisotropy of the genu of the corpus callosum (genu FA) from diffusion MRI. For this cross-sectional analysis, we fit linear models to assess associations between PSG parameters (NREM stage 1 percentage, NREM stage 3 percentage [slow-wave sleep], mean oxyhemoglobin saturation, and log of apnea-hypopnea index [AHI]) and CVD biomarkers (log of WMH and log of genu FA), respectively, while adjusting for age (at MRI), sex, APOE ε4 status, composite cardiovascular and metabolic conditions (CMC) score, REM stage percentage, sleep duration, and interval between MRI and PSG. RESULTS We included 140 participants with FLAIR-MRI (of which 103 had additional diffusion MRI). The mean ± SD age was 72.7 ± 9.6 years at MRI with nearly 60% being men. The absolute median (interquartile range [IQR]) interval between MRI and PSG was 1.74 (0.9-3.2) years. 90.7% were cognitively unimpaired (CU) during both assessments. For every 10-point decrease in N3%, there was a 0.058 (95% CI 0.006-0.111, p = 0.030) increase in the log of WMH and 0.006 decrease (95% CI -0.012 to -0.0002, p = 0.042) in the log of genu FA. After matching for age, sex, and N3%, participants with severe OSA had higher WMH (median [IQR] 0.007 [0.005-0.015] vs 0.006 [0.003-0.009], p = 0.042) and lower genu FA (median [IQR] 0.57 [0.55-0.63] vs 0.63 [0.58-0.65], p = 0.007), when compared with those with mild/moderate OSA. DISCUSSION We found that reduced slow-wave sleep and severe OSA were associated with higher burden of WM abnormalities in predominantly CU older adults, which may contribute to greater risk of cognitive impairment, dementia, and stroke. Our study supports the association between sleep depth/fragmentation and intermittent hypoxia and CVD biomarkers. Longitudinal studies are required to assess causation.
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Affiliation(s)
- Diego Z Carvalho
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN.
| | - Stuart J McCarter
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Erik K St Louis
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Scott A Przybelski
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Kohl L Johnson Sparrman
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Virend K Somers
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Bradley F Boeve
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Ronald C Petersen
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Clifford R Jack
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Jonathan Graff-Radford
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
| | - Prashanthi Vemuri
- From the Department of Neurology (D.Z.C., S.J.M., E.K.S.L., B.F.B., R.C.P., J.G.-R.), Center for Sleep Medicine (D.Z.C., S.J.M., E.K.S.L., B.F.B.), Division of Pulmonary and Critical Care, Department of Internal Medicine, Department of Quantitative Health Sciences (S.A.P., R.C.P.), Department of Radiology (K.L.J.S., C.R.J., P.V.), and Department of Cardiovascular Medicine (V.K.S.), Mayo Clinic, Rochester, MN
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Diaz-Galvan P, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min HKP, Jain M, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff-Radford J, Jones DT, Botha H, St Louis EK, Knopman DS, Ramanan VK, Ross O, Graff-Radford N, Day GS, Dickson DW, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. β-Amyloid Load on PET Along the Continuum of Dementia With Lewy Bodies. Neurology 2023; 101:e178-e188. [PMID: 37202168 PMCID: PMC10351554 DOI: 10.1212/wnl.0000000000207393] [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: 08/08/2022] [Accepted: 03/23/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES β-Amyloid (Aβ) plaques can co-occur with Lewy-related pathology in patients with dementia with Lewy bodies (DLB), but Aβ load at prodromal stages of DLB still needs to be elucidated. We investigated Aβ load on PET throughout the DLB continuum, from an early prodromal stage of isolated REM sleep behavior disorder (iRBD) to a stage of mild cognitive impairment with Lewy bodies (MCI-LB), and finally DLB. METHODS We performed a cross-sectional study in patients with a diagnosis of iRBD, MCI-LB, or DLB from the Mayo Clinic Alzheimer Disease Research Center. Aβ levels were measured by Pittsburgh compound B (PiB) PET, and global cortical standardized uptake value ratio (SUVR) was calculated. Global cortical PiB SUVR values from each clinical group were compared with each other and with those of cognitively unimpaired (CU) individuals (n = 100) balanced on age and sex using analysis of covariance. We used multiple linear regression testing for interaction to study the influences of sex and APOE ε4 status on PiB SUVR along the DLB continuum. RESULTS Of the 162 patients, 16 had iRBD, 64 had MCI-LB, and 82 had DLB. Compared with CU individuals, global cortical PiB SUVR was higher in those with DLB (p < 0.001) and MCI-LB (p = 0.012). The DLB group included the highest proportion of Aβ-positive patients (60%), followed by MCI-LB (41%), iRBD (25%), and finally CU (19%). Global cortical PiB SUVR was higher in APOE ε4 carriers compared with that in APOE ε4 noncarriers in MCI-LB (p < 0.001) and DLB groups (p = 0.049). Women had higher PiB SUVR with older age compared with men across the DLB continuum (β estimate = 0.014, p = 0.02). DISCUSSION In this cross-sectional study, levels of Aβ load was higher further along the DLB continuum. Whereas Aβ levels were comparable with those in CU individuals in iRBD, a significant elevation in Aβ levels was observed in the predementia stage of MCI-LB and in DLB. Specifically, APOE ε4 carriers had higher Aβ levels than APOE ε4 noncarriers, and women tended to have higher Aβ levels than men as they got older. These findings have important implications in targeting patients within the DLB continuum for clinical trials of disease-modifying therapies.
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Affiliation(s)
- Patricia Diaz-Galvan
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Scott A Przybelski
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Timothy G Lesnick
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Christopher G Schwarz
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Matthew L Senjem
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Jeffrey L Gunter
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Clifford R Jack
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Hoon-Ki Paul Min
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Manoj Jain
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Toji Miyagawa
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Leah K Forsberg
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Julie A Fields
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Rodolfo Savica
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Jonathan Graff-Radford
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - David T Jones
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Hugo Botha
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Erik K St Louis
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - David S Knopman
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Vijay K Ramanan
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Owen Ross
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Neill Graff-Radford
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Gregory S Day
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Dennis W Dickson
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Tanis J Ferman
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Ronald C Petersen
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Val J Lowe
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Brad F Boeve
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL
| | - Kejal Kantarci
- From the Department of Radiology (P.D.-G., C.G.S., M.L.S., J.L.G., C.R.J., H.-K.P.M., V.J.L., K.K.), Department of Quantitative Health Sciences (S.A.P., T.G.L., R.C.P.), and Department of Information Technology (M.L.S.), Mayo Clinic, Rochester, MN; Department of Radiology (M.J.), Mayo Clinic, Jacksonville, FL; Department of Neurology (T.M., L.K.F., R.S., J.G.-R., D.T.J., H.B., E.K.S.L., D.S.K., V.K.R., R.C.P., B.F.B.), Department of Psychiatry and Psychology (J.A.F., E.K.S.L.), and Center for Sleep Medicine (E.K.S.L.), Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN; Mayo Clinic Health System Southwest Wisconsin (E.K.S.L.), La Crosse; Department of Neuroscience (O.R.), Department of Neurology (N.G.-R., G.S.D.), Laboratory of Medicine and Pathology (D.W.D.), and Department of Psychiatry and Psychology (T.J.F.), Mayo Clinic, Jacksonville, FL.
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Tian J, Raghavan S, Reid RI, Przybelski SA, Lesnick TG, Gebre RK, Graff-Radford J, Schwarz CG, Lowe VJ, Kantarci K, Knopman DS, Petersen RC, Jack CR, Vemuri P. White Matter Degeneration Pathways Associated With Tau Deposition in Alzheimer Disease. Neurology 2023; 100:e2269-e2278. [PMID: 37068958 PMCID: PMC10259272 DOI: 10.1212/wnl.0000000000207250] [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: 08/23/2022] [Accepted: 02/16/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The dynamics of white matter (WM) changes are understudied in Alzheimer disease (AD). Our goal was to study the association between flortaucipir PET and WM health using neurite orientation dispersion and density imaging (NODDI) and evaluate its association with cognitive performance. Specifically, we focused on NODDI's Neurite Density Index (NDI), which aids in capturing axonal degeneration in WM and has greater specificity than single-shell diffusion MRI methods. METHOD We estimated regional flortaucipir PET standard uptake value ratios (SUVRs) from 3 regions corresponding to Braak stage I, III/IV, and V/VI to capture the spatial distribution pattern of the 3R/4R tau in AD. Then, we evaluated the associations between these measurements and NDIs in 29 candidate WM tracts using Pearson correlation and multiple regression models. RESULTS Based on 223 participants who were amyloid positive (mean age of 78 years and 57.0% male, 119 cognitively unimpaired, 56 mild cognitive impairment, and 48 dementia), the results showed that WM tracts NDI decreased with increasing regional Braak tau SUVRs. Of all the significant WM tracts, the uncinate fasciculus (r = -0.274 for Braak I, -0.311 for Braak III/IV, and -0.292 for Braak V/VI, p < 0.05) and cingulum adjoining hippocampus (r = -0.274, -0.288, -0.233, p < 0.05), both tracts anatomically connected to areas of early tau deposition, were consistently found to be within the top 5 distinguishing WM tracts associated with flortaucipir SUVRs. The increase in tau deposition measurable outside the medial temporal lobes in Braak III-VI was associated with a decrease in NDI in the middle and inferior temporal WM tracts. For cognitive performance, WM NDI had similar coefficients of determination (r 2 = 31%) as regional Braak flortaucipir SUVRs (29%), and together WM NDI and regional Braak flortaucipir SUVRs explained 46% of the variance in cognitive performance. DISCUSSION We found spatially dependent WM degeneration associated with regional flortaucipir SUVRs in Braak stages, suggesting a spatial pattern in WM damage. NDI, a specific marker of axonal density, provides complementary information about disease staging and progression in addition to tau deposition. Measurements of WM changes are important for the mechanistic understanding of multifactorial pathways through which AD causes cognitive dysfunction.
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Affiliation(s)
- Jianqiao Tian
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Sheelakumari Raghavan
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Robert I Reid
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Scott A Przybelski
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Timothy G Lesnick
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Robel K Gebre
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Jonathan Graff-Radford
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Christopher G Schwarz
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Val J Lowe
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Kejal Kantarci
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - David S Knopman
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Ronald C Petersen
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Clifford R Jack
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN
| | - Prashanthi Vemuri
- From the Department of Radiology (J.T., S.R., R.K.G., C.G.S., V.J.L., K.K., C.R.J., P.V.), Mayo Clinic; Mayo Clinic Graduate School of Biomedical Sciences (J.T.); and Department of Information Technology (R.I.R.), Department of Quantitative Health Sciences (S.A.P., T.G.L.), and Department of Neurology (J.G.-R., D.S.K., R.C.P.), Mayo Clinic, Rochester, MN.
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18
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Cogswell PM, Lundt ES, Therneau TM, Mester CT, Wiste HJ, Graff-Radford J, Schwarz CG, Senjem ML, Gunter JL, Reid RI, Przybelski SA, Knopman DS, Vemuri P, Petersen RC, Jack CR. Evidence against a temporal association between cerebrovascular disease and Alzheimer's disease imaging biomarkers. Nat Commun 2023; 14:3097. [PMID: 37248223 PMCID: PMC10226977 DOI: 10.1038/s41467-023-38878-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/15/2023] [Indexed: 05/31/2023] Open
Abstract
Whether a relationship exists between cerebrovascular disease and Alzheimer's disease has been a source of controversy. Evaluation of the temporal progression of imaging biomarkers of these disease processes may inform mechanistic associations. We investigate the relationship of disease trajectories of cerebrovascular disease (white matter hyperintensity, WMH, and fractional anisotropy, FA) and Alzheimer's disease (amyloid and tau PET) biomarkers in 2406 Mayo Clinic Study of Aging and Mayo Alzheimer's Disease Research Center participants using accelerated failure time models. The model assumes a common pattern of progression for each biomarker that is shifted earlier or later in time for each individual and represented by a per participant age adjustment. An individual's amyloid and tau PET adjustments show very weak temporal association with WMH and FA adjustments (R = -0.07 to 0.07); early/late amyloid or tau timing explains <1% of the variation in WMH and FA adjustment. Earlier onset of amyloid is associated with earlier onset of tau (R = 0.57, R2 = 32%). These findings support a strong mechanistic relationship between amyloid and tau aggregation, but not between WMH or FA and amyloid or tau PET.
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Affiliation(s)
- Petrice M Cogswell
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA.
| | - Emily S Lundt
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Terry M Therneau
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Carly T Mester
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Heather J Wiste
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | | | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Information Technology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Jeffrey L Gunter
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Robert I Reid
- Department of Information Technology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Ronald C Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
- Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA
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Sprung J, Laporta ML, Knopman DS, Petersen RC, Mielke MM, Jack CR, Martin DP, Hanson AC, Schroeder DR, Schulte PJ, Przybelski SA, Valencia Morales DJ, Weingarten TN, Vemuri P, Warner DO. Association of Indication for Hospitalization With Subsequent Amyloid Positron Emission Tomography and Magnetic Resonance Imaging Biomarkers. J Gerontol A Biol Sci Med Sci 2023; 78:304-313. [PMID: 35279026 PMCID: PMC9951063 DOI: 10.1093/gerona/glac064] [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: 01/09/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Hospitalization in older age is associated with accelerated cognitive decline, typically preceded by neuropathologic changes. We assess the association between indication for hospitalization and brain neurodegeneration. METHODS Included were participants from the Mayo Clinic Study of Aging, a population-based longitudinal study, with ≥1 brain imaging available in those older than 60 years of age between 2004 and 2017. Primary analyses used linear mixed-effects models to assess association of hospitalization with changes in longitudinal trajectory of cortical thinning, amyloid accumulation, and white matter hyperintensities (WMH). Additional analyses were performed with imaging outcomes dichotomized (normal vs abnormal) using Cox proportional hazards regression. RESULTS Of 2 480 participants, 1 966 had no hospitalization and 514 had ≥1 admission. Hospitalization was associated with accelerated cortical thinning (annual slope change -0.003 mm [95% confidence interval (CI) -0.005 to -0.001], p = .002), but not amyloid accumulation (0.003 [95% CI -0.001 to 0.006], p = .107), or WMH increase (0.011 cm3 [95% CI -0.001 to 0.023], p = .062). Interaction analyses assessing whether trajectory changes are dependent on admission type (medical vs surgical) found interactions for all outcomes. While surgical hospitalizations were not, medical hospitalizations were associated with accelerated cortical thinning (-0.004 mm [95% CI -0.008 to -0.001, p = .014); amyloid accumulation (0.010, [95% CI 0.002 to 0.017, p = .011), and WMH increase (0.035 cm3 [95% CI 0.012 to 0.058, p = .006). Hospitalization was not associated with developing abnormal cortical thinning (p = .407), amyloid accumulation (p = .596), or WMH/infarctions score (p = .565). CONCLUSIONS Medical hospitalizations were associated with accelerated cortical thinning, amyloid accumulation, and WMH increases. These changes were modest and did not translate to increased risk for crossing the abnormality threshold.
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Affiliation(s)
- Juraj Sprung
- Address correspondence to: Juraj Sprung, MD, PhD, Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. E-mail:
| | - Mariana L Laporta
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Michelle M Mielke
- Division of Epidemiology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - David P Martin
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrew C Hanson
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Darrell R Schroeder
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Phillip J Schulte
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Toby N Weingarten
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - David O Warner
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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20
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Ferreira D, Przybelski SA, Lesnick TG, Schwarz CG, Diaz-Galvan P, Graff-Radford J, Senjem ML, Fields JA, Knopman DS, Jones DT, Savica R, Ferman TJ, Graff-Radford N, Lowe VJ, Jack CR, Petersen RC, Westman E, Boeve BF, Kantarci K. Cross-sectional Associations of β-Amyloid, Tau, and Cerebrovascular Biomarkers With Neurodegeneration in Probable Dementia With Lewy Bodies. Neurology 2023; 100:e846-e859. [PMID: 36443011 PMCID: PMC9984215 DOI: 10.1212/wnl.0000000000201579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Although alpha-synuclein-related pathology is the hallmark of dementia with Lewy bodies (DLB), cerebrovascular and Alzheimer disease pathologies are common in patients with DLB. Little is known about the contribution of these pathologies to neurodegeneration in DLB. We investigated associations of cerebrovascular, β-amyloid, and tau biomarkers with gray matter (GM) volume in patients with probable DLB. METHODS We assessed patients with probable DLB and cognitively unimpaired (CU) controls with 11C-Pittsburgh compound B (PiB) and 18F-flortaucipir PET as markers of β-amyloid and tau, respectively. MRI was used to assess white matter hyperintensity (WMH) volume (a marker of cerebrovascular lesion load) and regional GM volume (a marker of neurodegeneration). We used correlations and analysis of covariance (ANCOVA) in the entire cohort and structural equation models (SEMs) in patients with DLB to investigate associations of WMH volume and regional β-amyloid and tau PET standardized uptake value ratios (SUVrs) with regional GM volume. RESULTS We included 30 patients with DLB (69.3 ± 10.2 years, 87% men) and 100 CU controls balanced on age and sex. Compared with CU controls, patients with DLB showed a lower GM volume across all cortical and subcortical regions except for the cuneus, putamen, and pallidum. A larger WMH volume was associated with a lower volume in the medial and orbital frontal cortices, insula, fusiform cortex, and thalamus in patients with DLB. A higher PiB SUVr was associated with a lower volume in the inferior temporal cortex, while flortaucipir SUVr did not correlate with GM volume. SEMs showed that a higher age and absence of the APOE ε4 allele were significant predictors of higher WMH volume, and WMH volume in turn was a significant predictor of GM volume in medial and orbital frontal cortices, insula, and inferior temporal cortex. By contrast, we observed 2 distinct paths for the fusiform cortex, with age having an effect through PiB and flortaucipir SUVr on one path and through WMH volume on the other path. DISCUSSION Patients with probable DLB have widespread cortical atrophy, most of which is likely influenced by alpha-synuclein-related pathology. Although cerebrovascular, β-amyloid, and tau pathologies often coexist in probable DLB, their contributions to neurodegeneration seem to be region specific.
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Affiliation(s)
- Daniel Ferreira
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Scott A Przybelski
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Timothy G Lesnick
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Christopher G Schwarz
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Patricia Diaz-Galvan
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Jonathan Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Matthew L Senjem
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Julie A Fields
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David S Knopman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - David T Jones
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Rodolfo Savica
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Tanis J Ferman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Neill Graff-Radford
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Val J Lowe
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Clifford R Jack
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Ronald C Petersen
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Eric Westman
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Brad F Boeve
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Kejal Kantarci
- From the Division of Clinical Geriatrics (D.F., P.D.-G., E.W.), Center for Alzheimer's Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Departments of Radiology (D.F., C.G.S., P.D.-G., M.L.S., V.J.L., C.R.J., K.K.), Quantitative Health Sciences (S.A.P., T.G.L.), Neurology (J.G.-R., D.S.K., D.T.J., R.S., R.C.P., B.F.B.), Information Technology (M.L.S.), and Psychiatry and Psychology (J.A.F.), Mayo Clinic, Rochester, MN; Departments of Psychiatry and Psychology (T.J.F.) and Neurology (N.G.-R.), Mayo Clinic, Jacksonville, FL; and Department of Neuroimaging (E.W.), Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
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21
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Diaz-Galvan P, Miyagawa T, Przybelski SA, Lesnick TG, Senjem ML, Jack CR, Forsberg LK, Min HK, St. Louis EK, Savica R, Fields JA, Benarroch EE, Lowe V, Petersen RC, Boeve BF, Kantarci K. Brain glucose metabolism and nigrostriatal degeneration in isolated rapid eye movement sleep behaviour disorder. Brain Commun 2023; 5:fcad021. [PMID: 36844148 PMCID: PMC9945851 DOI: 10.1093/braincomms/fcad021] [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: 04/04/2022] [Revised: 11/14/2022] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
Alterations of cerebral glucose metabolism can be detected in patients with isolated rapid eye movement sleep behaviour disorder, a prodromal feature of neurodegenerative diseases with α-synuclein pathology. However, metabolic characteristics that determine clinical progression in isolated rapid eye movement sleep behaviour disorder and their association with other biomarkers need to be elucidated. We investigated the pattern of cerebral glucose metabolism on 18F-fluorodeoxyglucose PET in patients with isolated rapid eye movement sleep behaviour disorder, differentiating between those who clinically progressed and those who remained stable over time. Second, we studied the association between 18F-fluorodeoxyglucose PET and lower dopamine transporter availability in the putamen, another hallmark of synucleinopathies. Patients with isolated rapid eye movement sleep behaviour disorder from the Mayo Clinic Alzheimer's Disease Research Center and Center for Sleep Medicine (n = 22) and age-and sex-matched clinically unimpaired controls (clinically unimpaired; n = 44) from the Mayo Clinic Study of Aging were included. All participants underwent 18F-fluorodeoxyglucose PET and dopamine transporter imaging with iodine 123-radiolabeled 2β-carbomethoxy-3β-(4-iodophenyl)-N-(3-fluoropropyl) nortropane on single-photon emission computerized tomography. A subset of patients with isolated rapid eye movement sleep behaviour disorder with follow-up evaluations (n = 17) was classified as isolated rapid eye movement sleep behaviour disorder progressors (n = 7) if they developed mild cognitive impairment or Parkinson's disease; or isolated rapid eye movement sleep behaviour disorder stables (n = 10) if they remained with a diagnosis of isolated rapid eye movement sleep behaviour disorder with no cognitive impairment. Glucose metabolic abnormalities in isolated rapid eye movement sleep behaviour disorder were determined by comparing atlas-based regional 18F-fluorodeoxyglucose PET uptake between isolated rapid eye movement sleep behaviour disorder and clinically unimpaired. Associations between 18F-fluorodeoxyglucose PET and dopamine transporter availability in the putamen were analyzed with Pearson's correlation within the nigrostriatal pathway structures and with voxel-based analysis in the cortex. Patients with isolated rapid eye movement sleep behaviour disorder had lower glucose metabolism in the substantia nigra, retrosplenial cortex, angular cortex, and thalamus, and higher metabolism in the amygdala and entorhinal cortex compared with clinically unimpaired. Patients with isolated rapid eye movement sleep behaviour disorder who clinically progressed over time were characterized by higher glucose metabolism in the amygdala and entorhinal cortex, and lower glucose metabolism in the cerebellum compared with clinically unimpaired. Lower dopamine transporter availability in the putamen was associated with higher glucose metabolism in the pallidum within the nigrostriatal pathway; and with higher 18F-fluorodeoxyglucose uptake in the amygdala, insula, and temporal pole on a voxel-based analysis, although these associations did not survive after correcting for multiple comparisons. Our findings suggest that cerebral glucose metabolism in isolated rapid eye movement sleep behaviour disorder is characterized by hypometabolism in regions frequently affected during the prodromal stage of synucleinopathies, potentially reflecting synaptic dysfunction. Hypermetabolism is also seen in isolated rapid eye movement sleep behaviour disorder, suggesting that synaptic metabolic disruptions may be leading to a lack of inhibition, compensatory mechanisms, or microglial activation, especially in regions associated with nigrostriatal degeneration.
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Affiliation(s)
| | - Toji Miyagawa
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Scott A Przybelski
- Department of Quantitative Health Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Science, Mayo Clinic, Rochester, MN 55905, USA
| | - Matthew L Senjem
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Leah K Forsberg
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Hoon-Ki Min
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Julie A Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Bradley F Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
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22
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Habich A, Oltra J, Schwarz CG, Przybelski SA, Oppedal K, Inguanzo A, Blanc F, Lemstra AW, Hort J, Westman E, Lowe VJ, Boeve BF, Dierks T, Aarsland D, Kantarci K, Ferreira D. Sex differences in grey matter networks in dementia with Lewy bodies. Res Sq 2023:rs.3.rs-2519935. [PMID: 36778448 PMCID: PMC9915801 DOI: 10.21203/rs.3.rs-2519935/v1] [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] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Objectives Sex differences permeate many aspects of dementia with Lewy bodies (DLB), including epidemiology, pathogenesis, disease progression, and symptom manifestation. However, less is known about potential sex differences in patterns of neurodegeneration in DLB. Here, we test whether grey matter networks also differ between female and male DLB patients. To assess the specificity of these sex differences to DLB, we additionally investigate sex differences in healthy controls (HCs). Methods A total of 119 (68.7 ± 8.4 years) male and 45 female (69.9 ± 9.1 years) DLB patients from three European centres and the Mayo Clinic were included in this study. Additionally, we included 119 male and 45 female age-matched HCs from the Mayo Clinic. Grey matter volumes of 58 cortical, subcortical, cerebellar, and pontine brain regions derived from structural magnetic resonance images were corrected for age, intracranial volume, and centre. Sex-specific grey matter networks for DLB patients and HCs were constructed by correlating each pair of brain regions. Network properties of the correlation matrices were compared between sexes and groups. Additional analyses were conducted on W-scored data to identify DLB-specific findings. Results Networks of male HCs and male DLB patients were characterised by a lower nodal strength compared to their respective female counterparts. In comparison to female HCs, the grey matter networks of male HCs showed a higher global efficiency, modularity, and a lower number of modules. None of the global and nodal network measures showed significant sex differences in DLB. Conclusions The disappearance of sex differences in the structural grey matter networks of DLB patients compared to HCs may indicate a sex-dependent network vulnerability to the alpha-synuclein pathology in DLB. Future studies might investigate whether the differences in structural network measures are associated with differences in cognitive scores and clinical symptoms between the sexes.
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Affiliation(s)
- Annegret Habich
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Javier Oltra
- Medical Psychology Unit, Department of Medicine, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | | | | | - Ketil Oppedal
- Center for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
| | - Anna Inguanzo
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Frédéric Blanc
- Day Hospital of Geriatrics, Memory Resource and Research Centre (CM2R) of Strasbourg, Department of Geriatrics, Hopitaux Universitaires de Strasbourg, Strasbourg, France
| | - Afina W Lemstra
- Department of Neurology and Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| | - Jakub Hort
- Motol University Hospital, Prague, Czech Republic
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, USA
| | | | - Thomas Dierks
- University Hospital of Psychiatry and Psychotherapy Bern, University of Bern, Bern, Switzerland
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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23
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Oltra J, Habich A, Schwarz CG, Nedelska Z, Przybelski SA, Inguanzo A, Diaz-Galvan P, Lowe VJ, Oppedal K, Blanc F, Lemstra AW, Hort J, Padovani A, Rektorova I, Bonanni L, Massa F, Kramberge MG, Taylor JP, Snædal J, Walker Z, Antonini A, Segura B, Junque C, Westman E, Boeve BF, Aarsland D, Kantarci K, Ferreira D. Sex differences in brain atrophy in dementia with Lewy bodies. Res Sq 2023:rs.3.rs-2516427. [PMID: 36747755 PMCID: PMC9901042 DOI: 10.21203/rs.3.rs-2516427/v1] [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] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background and objectives Sex is an important contributing factor to neuroimaging phenotypes in brain disorders. However, little is known about the contribution of sex differences to the neurodegeneration in dementia with Lewy bodies (DLB). We investigated sex differences in probable DLB patients by using both visual rating scales of lobar atrophy and automated estimations of regional atrophy. Methods We included 442 probable DLB patients from the European-DLB consortium and the Mayo Clinic who have magnetic resonance imaging (MRI) data available. We assessed sex differences and the sex-by-age interaction in two largely independent samples through visual rating scales of lobar atrophy (n = 333; mean age 73 ± 8 years, 62% males) and automated regional estimations of gray matter (GM) volume and mean cortical thickness (CTh) (n = 165; mean age 69 ± 9 years, 72% males). We used binary logistic regression and ANOVA for statistical analysis. Results We found a statistically significantly higher likelihood of frontal atrophy measured by the global cortical atrophy-frontal subscale (GCA-F) in males (40% of males had an abnormal GCA-F score versus 29% of females, P-value = 0.006). Using automated estimations, we found smaller GM volumes in 6 cortical regions in males compared with females, as well as smaller GM volume in the entorhinal cortex and thinner olfactory cortices in females, compared with males. The sex-by-age interaction showed statistically significant results in 6 cortical volumes and 7 mean CTh estimations (P-value ≤ 0.05), accentuated in the right middle frontal gyrus (FDR-adjusted P-value = 0.047). These cross-sectional interactions indicated that while females have statistically significantly less atrophy than males at younger ages, differences become non-significant at older ages, with females showing the same level of atrophy than males around the age of 75. Conclusions This study demonstrates sex differences on brain atrophy in probable DLB. While male DLB patients have a more widespread pattern of cortical atrophy at younger ages, these sex differences tend to disappear with increasing age. Longitudinal studies will help establish these cross-sectional findings and inform on sex and age considerations to the use of MRI in clinical routine, as the field moves towards precision medicine.
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24
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Nguyen AT, Kouri N, Labuzan SA, Przybelski SA, Lesnick TG, Raghavan S, Reid RI, Reichard RR, Knopman DS, Petersen RC, Jack CR, Mielke MM, Dickson DW, Graff-Radford J, Murray ME, Vemuri P. Neuropathologic scales of cerebrovascular disease associated with diffusion changes on MRI. Acta Neuropathol 2022; 144:1117-1125. [PMID: 35841412 PMCID: PMC9637622 DOI: 10.1007/s00401-022-02465-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 01/20/2022] [Revised: 06/29/2022] [Accepted: 06/29/2022] [Indexed: 01/26/2023]
Abstract
Summarizing the multiplicity and heterogeneity of cerebrovascular disease (CVD) features into a single measure has been difficult in both neuropathology and imaging studies. The objective of this work was to evaluate the association between neuroimaging surrogates of CVD and two available neuropathologic CVD scales in those with both antemortem imaging CVD measures and postmortem CVD evaluation. Individuals in the Mayo Clinic Study of Aging with MRI scans within 5 years of death (N = 51) were included. Antemortem CVD measures were computed from diffusion MRI (dMRI), FLAIR, and T2* GRE imaging modalities and compared with postmortem neuropathologic findings using Kalaria and Strozyk Scales. Of all the neuroimaging measures, both regional and global dMRI measures were associated with Kalaria and Strozyk Scales (p < 0.05) and modestly correlated with global cognitive performance. The major conclusions from this study were: (i) microstructural white matter injury measurements using dMRI may be meaningful surrogates of neuropathologic CVD scales, because they aid in capturing diffuse (and early) changes to white matter and secondary neurodegeneration due to lesions; (ii) vacuolation in the corpus callosum may be associated with white matter changes measured on antemortem dMRI imaging; (iii) Alzheimer's disease neuropathologic change did not associate with neuropathologic CVD scales; and (iv) future work should be focused on developing better quantitative measures utilizing dMRI to optimally assess CVD-related neuropathologic changes.
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Affiliation(s)
- Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Naomi Kouri
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Sydney A Labuzan
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Sheelakumari Raghavan
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA
| | - Robert I Reid
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - R Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Clifford R Jack
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA
| | - Michelle M Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Dennis W Dickson
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | | | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA.
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25
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Tian J, Reid RI, Przybelski SA, Raghavan S, Gebre RK, Graff‐Radford J, Lowe VJ, Kantarci K, Knopman DS, Petersen RC, Jack CR, Vemuri P. White Matter Degeneration Pathways Associated with Tau Deposition in Alzheimer’s Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.062596] [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]
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26
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Boeve BF, Miyagawa T, Przybelski SA, Min PH, Jordan L, Lesnick T, Savica R, Graff‐Radford J, Jones DT, Botha H, Ramanan VK, Knopman DS, Petersen RC, Graff‐Radford NR, Day GS, Fields JA, Machulda MM, Ferman TJ, Forsberg LK, Diaz‐Galvan P, Li W, Christine CBJ, Jack CR, Jain MK, Kantarci K, Lowe VJ. Baseline and Longitudinal Ioflupane SPECT Findings in DLB and MCI‐LB. Alzheimers Dement 2022. [DOI: 10.1002/alz.067066] [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]
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27
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Diaz‐Galvan P, Przybelski SA, Lesnick TG, Schwarz CG, Senjem ML, Gunter JL, Jack CR, Min PH, Jain MK, Miyagawa T, Forsberg LK, Fields JA, Savica R, Graff‐Radford J, St EK, Knopman DS, Graff‐Radford NR, Ferman TJ, Petersen RC, Lowe VJ, Boeve BF, Kantarci K. Amyloid PET in the Lewy Body disease continuum. Alzheimers Dement 2022. [DOI: 10.1002/alz.067319] [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]
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28
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Graff‐Radford J, Mielke MM, Hofrenning EI, Kouri N, Lesnick T, Moloney CM, Rabinstein A, Cabrera‐Rodriguez JN, Rothberg DM, Przybelski SA, Petersen RC, Knopman DS, Dickson DW, Nguyen AT, Murray ME, Vemuri P. Plasma Biomarkers of Amyloid and Neurodegeneration predictive of Neuropathologic Scales of Cerebrovascular Disease. Alzheimers Dement 2022. [DOI: 10.1002/alz.067350] [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]
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29
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Nguyen AT, Przybelski SA, Lesnick TG, Ramanan VK, Petersen RC, Graff‐Radford J, Knopman DS, Jack CR, Dickson DW, Van Deerlin VM, Lee EB, Reichard RR, Vemuri P. Characterizing Amyloid Responsive Microglia in a Cognitively Resilient Patient with Alzheimer’s Disease Neuropathologic Change: A Case Report. Alzheimers Dement 2022. [DOI: 10.1002/alz.066640] [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)
| | | | | | | | | | | | | | | | | | - Vivianna M Van Deerlin
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
| | - Eddie B Lee
- Translational Neuropathology Research Laboratory, Perelman School of Medicine, University of Pennsylvania Philadelphia PA USA
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30
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Raghavan S, Przybelski SA, Reid RI, Lesnick TG, Ramanan VK, Botha H, Matchett BJ, Murray ME, Reichard RR, Knopman DS, Radford JG, Jones DT, Lowe VJ, Mielke MM, Machulda MM, Petersen RC, Kantarci K, Whitwell JL, Josephs KA, Jack CR, Vemuri P. White matter health in the context of Alzheimer’s disease pathophysiology. Alzheimers Dement 2022. [DOI: 10.1002/alz.063199] [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]
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31
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Raghavan S, Przybelski SA, Kamykowski MG, Reid RI, Lesnick TG, Murray ME, Reichard RR, Graff‐Radford J, Nguyen AT, Knopman DS, Mielke MM, Jack CR, Petersen RC, Vemuri P. Comparing cerebrovascular disease diffusion MRI markers using post‐mortem and longitudinal imaging data. Alzheimers Dement 2022. [DOI: 10.1002/alz.063705] [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]
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32
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Graff-Radford J, Mielke MM, Hofrenning EI, Kouri N, Lesnick TG, Moloney CM, Rabinstein A, Cabrera-Rodriguez JN, Rothberg DM, Przybelski SA, Petersen RC, Knopman DS, Dickson DW, Jack CR, Algeciras-Schimnich A, Nguyen AT, Murray ME, Vemuri P. Association of plasma biomarkers of amyloid and neurodegeneration with cerebrovascular disease and Alzheimer's disease. Neurobiol Aging 2022; 119:1-7. [PMID: 35952440 PMCID: PMC9732897 DOI: 10.1016/j.neurobiolaging.2022.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/30/2022] [Accepted: 07/20/2022] [Indexed: 12/13/2022]
Abstract
The objective of this study was to determine the differential mapping of plasma biomarkers to postmortem neuropathology measures. We identified 64 participants in a population-based study with antemortem plasma markers (amyloid-β [Aβ] x-42, Aβx-40, neurofilament light [NfL], and total tau [T-tau]) who also had neuropathologic assessments of Alzheimer's and cerebrovascular pathology. We conducted weighted linear-regression models to evaluate relationships between plasma measures and neuropathology. Higher plasma NfL and Aβ42/40 ratio were associated with cerebrovascular neuropathologic scales (p < 0.05) but not with Braak stage, neuritic plaque score, or Thal phase. Plasma Aβ42/40 and NfL explained up to 18% of the variability in cerebrovascular neuropathologic scales. In participants predominantly with modest levels of Alzheimer's pathologic change, biomarkers of amyloid and neurodegeneration were associated with cerebrovascular neuropathology. NfL is a non-specific marker of brain injury, therefore its association with cerebrovascular neuropathology was expected. The association between elevated Aβ42/40 and cerebrovascular disease pathology needs further investigation but could be due to the use of less specific amyloid-β assays (x-40, x-42).
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Affiliation(s)
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Naomi Kouri
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | - Aivi T Nguyen
- Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN, USA
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33
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Butts AM, Machulda MM, Martin P, Przybelski SA, Duffy JR, Graff-Radford J, Knopman DS, Petersen RC, Jack CR, Lowe VJ, Josephs KA, Whitwell JL. Temporal Cortical Thickness and Cognitive Associations among Typical and Atypical Phenotypes of Alzheimer's Disease. J Alzheimers Dis Rep 2022; 6:479-491. [PMID: 36186727 PMCID: PMC9484150 DOI: 10.3233/adr-220010] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/29/2022] [Indexed: 11/15/2022] Open
Abstract
Background The hippocampus and temporal lobe are atrophic in typical amnestic Alzheimer's disease (tAD) and are used as imaging biomarkers in treatment trials. However, a better understanding of how temporal structures differ across atypical AD phenotypes and relate to cognition is needed. Objective Our goal was to compare temporal lobe regions between tAD and two atypical AD phenotypes (logopenic progressive aphasia (LPA) and posterior cortical atrophy (PCA)), and assess cognitive associations. Methods We age and gender-matched 77 tAD participants to 50 LPA and 27 PCA participants, all of which were amyloid-positive. We used linear mixed-effects models to compare FreeSurfer-derived hippocampal volumes and cortical thickness of entorhinal, inferior and middle temporal, and fusiform gyri, and to assess relationships between imaging and memory, naming, and visuospatial function across and within AD phenotype. Results Hippocampal volume and entorhinal thickness were smaller bilaterally in tAD than LPA and PCA. PCA showed greater right inferior temporal and bilateral fusiform thinning and LPA showed greater left middle and inferior temporal and left fusiform thinning. Atypical AD phenotypes differed with greater right hemisphere thinning in PCA and greater left hemisphere thinning in LPA. Verbal and visual memory related most strongly to hippocampal volume; naming related to left temporal thickness; and visuospatial related to bilateral fusiform thickness. Fewer associations remained when examined within AD group. Conclusion Atypical AD phenotypes are associated with greater thinning of lateral temporal structures, with relative sparing of medial temporal lobe, compared to tAD. These findings may have implications for future clinical trials in AD.
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Affiliation(s)
- Alissa M. Butts
- Department of Neurology, Division of Neuropsychology, Medical College of Wisconsin, Milwaukee, WI, USA,External Research Collaborator, Mayo Clinic, Rochester, MN, USA
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Division of Neuropsychology, Mayo Clinic, Rochester, MN, USA
| | - Peter Martin
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Jennifer L. Whitwell
- Department of Radiology, Mayo Clinic, Rochester, MN, USA,Correspondence to: Jennifer L. Whitwell, PhD, Professor of Radiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA. E-mail:
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34
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Zeydan B, Schwarz CG, Przybelski SA, Lesnick TG, Kremers WK, Senjem ML, Kantarci OH, Min PH, Kemp BJ, Jack CR, Kantarci K, Lowe VJ. Comparison of 11C-Pittsburgh Compound B and 18F-Flutemetamol White Matter Binding in PET. J Nucl Med 2022; 63:1239-1244. [PMID: 34916245 PMCID: PMC9364341 DOI: 10.2967/jnumed.121.263281] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/30/2021] [Indexed: 02/03/2023] Open
Abstract
PET imaging with β-amyloid ligands is emerging as a molecular imaging technique targeting white matter integrity and demyelination. β-amyloid PET ligands such as 11C-Pittsburgh compound B (11C-PiB) have been considered for quantitative measurement of myelin content changes in multiple sclerosis, but 11C-PiB is not commercially available given its short half-life. A 18F PET ligand such as flutemetamol with a longer half-life may be an alternative, but its ability to differentiate white matter hyperintensities (WMH) from normal-appearing white matter (NAWM) and its relationship with age remains to be investigated. Methods: Cognitively unimpaired (CU) older and younger adults (n = 61) were recruited from the community responding to a study advertisement for β-amyloid PET. Participants prospectively underwent MRI, 11C-PiB, and 18F-flutemetamol PET scans. MRI fluid-attenuated inversion recovery images were segmented into WMH and NAWM and registered to the T1-weighted MRI. 11C-PiB and 18F-flutemetamol PET images were also registered to the T1-weighted MRI. 11C-PiB and 18F-flutemetamol SUV ratios (SUVrs) from the WMH and NAWM were calculated using cerebellar crus uptake as a reference for both 11C-PiB and 18F-flutemetamol. Results: The median age was 38 y (range, 30-48 y) in younger adults and 67 y (range, 61-83 y) in older adults. WMH and NAWM SUVrs were higher with 18F-flutemetamol than with 11C-PiB in both older (P < 0.001) and younger (P < 0.001) CU adults. 11C-PiB and 18F-flutemetamol SUVrs were higher in older than in younger CU adults in both WMH (P < 0.001) and NAWM (P < 0.001). 11C-PiB and 18F-flutemetamol SUVrs were higher in NAWM than WMH in both older (P < 0.001) and younger (P < 0.001) CU adults. There was no apparent difference between 11C-PiB and 18F-flutemetamol SUVrs in differentiating WMH from NAWM in older and in younger adults. Conclusion:11C-PiB and 18F-flutemetamol show a similar topographic pattern of uptake in white matter with a similar association with age in WMH and NAWM. 11C-PiB and 18F-flutemetamol can also effectively distinguish between WMH and NAWM. However, given its longer half-life, commercial availability, and higher binding potential, 18F-flutemetamol can be an alternative to 11C-PiB in molecular imaging studies specifically targeting multiple sclerosis to evaluate white matter integrity.
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Affiliation(s)
- Burcu Zeydan
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota; and
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota; and
| | - Walter K Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota; and
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
- Department of Information Technology, Mayo Clinic, Rochester, Minnesota
| | | | - Paul H Min
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Bradley J Kemp
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, Minnesota;
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35
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Carvalho DZ, St. Louis EK, Przybelski SA, Morgenthaler TI, Machulda MM, Boeve BF, Petersen RC, Jack CR, Graff-Radford J, Vemuri P, Mielke MM. Sleepiness in Cognitively Unimpaired Older Adults Is Associated With CSF Biomarkers of Inflammation and Axonal Integrity. Front Aging Neurosci 2022; 14:930315. [PMID: 35898322 PMCID: PMC9309557 DOI: 10.3389/fnagi.2022.930315] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Sleepiness has been associated with cognitive decline and dementia in the elderly. Older adults with excessive daytime sleepiness appear to be more vulnerable to longitudinal amyloid PET accumulation before the onset of the dementia. However, it remains unclear whether sleepiness is similarly associated with other biomarkers of Alzheimer’s disease (AD), axonal integrity, and inflammation, which may also contribute to neurodegeneration and cognitive decline. Methods In this cross-sectional analysis, we identified 260 cognitively unimpaired adults (>60 years) from the Mayo Clinic Study of Aging, a population-based cohort from Olmsted County (MN), who underwent CSF quantification of AD biomarkers (Aβ42, p-tau, p-tau/Aβ42) in addition to at least one of the following biomarkers [neurofilament light chain (NfL) interleukin-6 (IL-6), IL-10, and tumor necrosis factor-α (TNF-α)]. We fit linear regression models to assess associations between sleepiness, as measured by the Epworth Sleepiness Scale (ESS), and CSF biomarkers, controlling for age, sex, APOε4 status, body mass index, hypertension, dyslipidemia, and prior diagnosis of obstructive sleep apnea. Results Higher ESS scores were associated with higher CSF IL-6 and NfL, but not with the other CSF biomarkers. For every ESS score point increase, there was a 0.009 ([95% CI 0.001–0.016], p = 0.033) increase in the log of IL-6 and 0.01 ([95% CI 0.002–0.018], p = 0.016) increase in the log of NfL. A sensitivity analysis showed an association between ESS scores and log of p-tau/Aβ42 only in participants with an abnormal ratio (>0.023), highly predictive of amyloid positivity. For every ESS score point increase, there was a 0.006 ([95% CI 0.001–0.012], p = 0.021) increase in the log of CSF p-tau/Aβ42. Conclusion Sleepiness was associated with greater CSF IL-6 and NfL levels, which could contribute to neurodegeneration or alternatively cause sleepiness. Higher NfL levels may result from sleep disruption and/or contribute to sleepiness via disturbed connectivity or damage to wake-promoting centers. Associations between sleepiness and p-tau/Aβ42 in participants with abnormal ratio suggest that amyloid positivity contributes to vulnerability to sleep disturbance, which may further amyloid accumulation in a feed-forward loop process. Prospective studies of these markers are needed to determine cause-effect relationships between these associations.
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Affiliation(s)
- Diego Z. Carvalho
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
- *Correspondence: Diego Z. Carvalho,
| | - Erik K. St. Louis
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Timothy I. Morgenthaler
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Mary M. Machulda
- Department of Psychology, Mayo Clinic, Rochester, MN, United States
| | - Bradley F. Boeve
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Center for Sleep Medicine, Division of Pulmonary and Critical Care, Department of Medicine, Mayo Clinic, Rochester, MN, United States
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Clifford R. Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, United States
| | | | | | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic, Rochester, MN, United States
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Ramanan VK, Heckman MG, Przybelski SA, Lesnick TG, Lowe VJ, Graff-Radford J, Mielke M, Jack CR, Knopman DS, Petersen RC, Ross OA, Vemuri P. Polygenic Scores of Alzheimer’s Disease Risk Genes Add Only Modestly to APOE in Explaining Variation in Amyloid PET Burden. J Alzheimers Dis 2022; 88:1615-1625. [DOI: 10.3233/jad-220164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Brain accumulation of amyloid-β is a hallmark event in Alzheimer’s disease (AD) whose underlying mechanisms are incompletely understood. Case-control genome-wide association studies have implicated numerous genetic variants in risk of clinically diagnosed AD dementia. Objective: To test for associations between case-control AD risk variants and amyloid PET burden in older adults, and to assess whether a polygenic measure encompassing these factors would account for a large proportion of the unexplained variance in amyloid PET levels in the wider population. Methods: We analyzed data from the Mayo Clinic Study of Aging (MCSA) and the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Global cortical amyloid PET burden was the primary outcome. The 38 gene variants from Wightman et al. (2021) were analyzed as predictors, with PRSice-2 used to assess the collective phenotypic variance explained. Results: Known AD risk variants in APOE, PICALM, CR1, and CLU were associated with amyloid PET levels. In aggregate, the AD risk variants were strongly associated with amyloid PET levels in the MCSA (p = 1.51×10–50) and ADNI (p = 3.21×10–64). However, in both cohorts the non-APOE variants uniquely contributed only modestly (MCSA = 2.1%, ADNI = 4.4%) to explaining variation in amyloid PET levels. Conclusion: Additional case-control AD risk variants added only modestly to APOE in accounting for individual variation in amyloid PET burden, results which were consistent across independent cohorts with distinct recruitment strategies and subject characteristics. Our findings suggest that advancing precision medicine for dementia may require integration of strategies complementing case-control approaches, including biomarker-specific genetic associations, gene-by-environment interactions, and markers of disease progression and heterogeneity.
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Affiliation(s)
- Vijay K. Ramanan
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Michael G. Heckman
- Department of Quantitative Health Sciences, Mayo Clinic-Florida, Jacksonville, FL, USA
| | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Timothy G. Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | | | - M. Mielke
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Clifford R. Jack
- Department of Radiology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - David S. Knopman
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Owen A. Ross
- Department of Neuroscience, Mayo Clinic-Florida, Jacksonville, FL, USA
- Department of Clinical Genomics, Mayo Clinic-Florida, Jacksonville, FL, USA
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Shen X, Raghavan S, Przybelski SA, Lesnick TG, Ma S, Reid RI, Graff-Radford J, Mielke MM, Knopman DS, Petersen RC, Jack CR, Simon GJ, Vemuri P. Causal structure discovery identifies risk factors and early brain markers related to evolution of white matter hyperintensities. Neuroimage Clin 2022; 35:103077. [PMID: 35696810 PMCID: PMC9194644 DOI: 10.1016/j.nicl.2022.103077] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/25/2022] [Accepted: 06/03/2022] [Indexed: 11/25/2022]
Abstract
White matter health mediates the effect of vascular health on white matter hyperintensity. Midlife physical activities and smoking status impact late-life white matter health. Causal methods help understand the biological mechanisms underlying increased dementia risk.
Our goal was to understand the complex relationship between age, sex, midlife risk factors, and early white matter changes measured by diffusion tensor imaging (DTI) and their role in the evolution of longitudinal white matter hyperintensities (WMH). We identified 1564 participants (1396 cognitively unimpaired, 151 mild cognitive impairment and 17 dementia participants) with age ranges of 30–90 years from the population-based sample of Mayo Clinic Study of Aging. We used computational causal structure discovery and regression analyses to evaluate the predictors of WMH and DTI, and to ascertain the mediating effect of DTI on WMH. We further derived causal graphs to understand the complex interrelationships between midlife protective factors, vascular risk factors, diffusion changes, and WMH. Older age, female sex, and hypertension were associated with higher baseline and progression of WMH as well as DTI measures (P ≤ 0.003). The effects of hypertension and sex on WMH were partially mediated by microstructural changes measured on DTI. Higher midlife physical activity was predictive of lower WMH through a direct impact on better white matter tract integrity as well as an indirect effect through reducing the risk of hypertension by lowering BMI. This study identified key risks factors, early brain changes, and pathways that may lead to the evolution of WMH.
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Affiliation(s)
- Xinpeng Shen
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA; Departments of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Robert I Reid
- Information Technology, Mayo Clinic, Rochester, MN, USA
| | | | - Michelle M Mielke
- Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Departments of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - György J Simon
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
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38
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Chen Q, Przybelski SA, Senjem ML, Schwarz CG, Lesnick TG, Botha H, Knopman DS, Graff‐Radford J, Savica R, Jones DT, Fields JA, Jain MK, Graff‐Radford NR, Ferman TJ, Kremers WK, Jack CR, Petersen RC, Boeve BF, Lowe VJ, Kantarci K. Longitudinal Tau Positron Emission Tomography in Dementia with Lewy Bodies. Mov Disord 2022; 37:1256-1264. [PMID: 35261094 PMCID: PMC9232920 DOI: 10.1002/mds.28973] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/03/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Patients with dementia with Lewy bodies (DLB) may have overlapping Alzheimer's disease pathology. We investigated the longitudinal rate of tau accumulation and its association with neurodegeneration and clinical disease progression in DLB. METHODS Consecutive patients with probable DLB (n = 22) from the Mayo Clinic Alzheimer's Disease Research Center and age-matched and sex-matched cognitively unimpaired controls (CU; n = 22) with serial magnetic resonance imaging and flortaucipir positron emission tomography scans within an average of 1.6 years were included. Regional annualized rates of flortaucipir uptake standardized uptake value ratios (SUVr) were calculated. Regional annualized rates of cortical volume change were measured with the Tensor Based Morphometry-Syn algorithm. RESULTS The annual increase of flortaucipir SUVr was greater in the middle and superior occipital, fusiform, and inferior parietal cortices in DLB (mean: 0.017, 0.019, 0.019, and 0.015, respectively) compared with the CU (mean: -0.006, -0.009, -0.003, and - 0.005, respectively; P < 0.05). In patients with DLB (but not the CU), a longitudinal increase in flortaucipir SUVr was associated with longitudinal cortical atrophy rates in the lateral occipital and inferior temporoparietal cortices, hippocampus, and the temporal pole as well as a concurrent decline on Mini-Mental State Examination and Clinical Dementia Rating-Sum of Boxes in the lateral occipital and the fusiform cortices. CONCLUSIONS Tau accumulation was faster in DLB compared with the CU, with increased accumulation rates in the lateral occipital and temporoparietal cortices. These increased rates of tau accumulation were associated with neurodegeneration and faster disease progression in DLB. Tau may be a potential treatment target in a subset of patients with DLB. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Qin Chen
- Department of NeurologyWest China Hospital of Sichuan UniversityChengduChina
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | - Timothy G. Lesnick
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | - Hugo Botha
- Department of NeurologyMayo ClinicRochesterMinnesotaUSA
| | | | | | | | | | - Julie A. Fields
- Department of Psychiatry and PsychologyMayo ClinicRochesterMinnesotaUSA
| | - Manoj K. Jain
- Department of RadiologyMayo ClinicJacksonvilleFloridaUSA
| | | | - Tanis J. Ferman
- Department of Psychology and PsychiatryMayo ClinicJacksonvilleFloridaUSA
| | - Walter K. Kremers
- Department of Quantitative Health SciencesMayo ClinicRochesterMinnesotaUSA
| | | | | | | | - Val J. Lowe
- Department of RadiologyMayo ClinicRochesterMinnesotaUSA
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39
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Ramanan VK, Heckman MG, Lesnick TG, Przybelski SA, Cahn EJ, Kosel ML, Murray ME, Mielke MM, Botha H, Graff-Radford J, Jones DT, Lowe VJ, Machulda MM, Jack CR, Knopman DS, Petersen RC, Ross OA, Vemuri P. Tau polygenic risk scoring: a cost-effective aid for prognostic counseling in Alzheimer's disease. Acta Neuropathol 2022; 143:571-583. [PMID: 35412102 PMCID: PMC9109940 DOI: 10.1007/s00401-022-02419-2] [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] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/07/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
Tau deposition is one of two hallmark features of biologically defined Alzheimer's disease (AD) and is more closely related to cognitive decline than amyloidosis. Further, not all amyloid-positive individuals develop tauopathy, resulting in wide heterogeneity in clinical outcomes across the population with AD. We hypothesized that a polygenic risk score (PRS) based on tau PET (tau PRS) would capture the aggregate inherited susceptibility/resistance architecture influencing tau accumulation, beyond solely the measurement of amyloid-β burden. Leveraging rich multimodal data from a population-based sample of older adults, we found that this novel tau PRS was a strong surrogate of tau PET deposition and captured a significant proportion of the variance in tau PET levels as compared with amyloid PET burden, APOE (apolipoprotein E) ε4 (the most common risk allele for AD), and a non-APOE PRS of clinical case-control AD risk variants. In independent validation samples, the tau PRS was associated with cerebrospinal fluid phosphorylated tau levels in one cohort and with postmortem Braak neurofibrillary tangle stage in another. We also observed an association of the tau PRS with longitudinal cognitive trajectories, including a statistical interaction of the tau PRS with amyloid burden on cognitive decline. Although additional study is warranted, these findings demonstrate the potential utility of a tau PRS for capturing the collective genetic background influencing tau deposition in the general population. In the future, a tau PRS could be leveraged for cost-effective screening and risk stratification to guide trial enrollment and clinical interventions in AD.
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Affiliation(s)
- Vijay K Ramanan
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Michael G Heckman
- Department of Quantitative Health Sciences, Mayo Clinic-Florida, Jacksonville, FL, 32224, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Elliot J Cahn
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Matthew L Kosel
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Melissa E Murray
- Department of Neuroscience, Mayo Clinic-Florida, Jacksonville, FL, 32224, USA
| | - Michelle M Mielke
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - Jonathan Graff-Radford
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - David T Jones
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Radiology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Clifford R Jack
- Department of Radiology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
| | - Ronald C Petersen
- Department of Neurology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA
- Department of Quantitative Health Sciences, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Owen A Ross
- Department of Neuroscience, Mayo Clinic-Florida, Jacksonville, FL, 32224, USA
- Department of Clinical Genomics, Mayo Clinic-Florida, Jacksonville, FL, 32224, USA
| | - Prashanthi Vemuri
- Department of Neuroscience, Mayo Clinic-Florida, Jacksonville, FL, 32224, USA.
- Department of Radiology, Mayo Clinic-Minnesota, 200 First Street SW, Rochester, MN, 55905, USA.
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40
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Kara F, Joers JM, Deelchand DK, Park YW, Przybelski SA, Lesnick TG, Senjem ML, Zeydan B, Knopman DS, Lowe VJ, Vemuri P, Mielke MM, Machulda MM, Jack CR, Petersen RC, Öz G, Kantarci K. 1H MR spectroscopy biomarkers of neuronal and synaptic function are associated with tau deposition in cognitively unimpaired older adults. Neurobiol Aging 2022; 112:16-26. [PMID: 35038671 PMCID: PMC8976711 DOI: 10.1016/j.neurobiolaging.2021.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 12/25/2022]
Abstract
Proton magnetic resonance spectroscopy (1H MRS) may provide information on pathophysiological changes associated with tau deposition in cognitively unimpaired older adults. In this study, the associations of posterior cingulate gyrus tau and amyloid beta (Aβ) deposition on PET with 1H MRS metabolite ratios acquired from bilateral posterior cingulate gyri were investigated in cognitively unimpaired older adults. Participants (n = 40) from the Mayo Clinic Study of Aging underwent single-voxel sLASER 1H MRS from the posterior cingulate gyrus at 3 Tesla, 18F-flortaucipir, and 11C- Pittsburgh Compound B (PiB) PET. An increase in posterior cingulate gyrus tau deposition, but not elevated Aβ, was associated with lower N-acetylaspartate/total creatine (tCr) and glutamate (Glu)/tCr ratios, and sex by tau interaction was observed in association with Glu/tCr. Higher tau levels in cognitively unimpaired older adults are associated with biomarkers of neural and synaptic injury even in the absence of cognitive impairment and these relationships appear to be stronger in women than in men.
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Affiliation(s)
- Firat Kara
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - James M Joers
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Dinesh K Deelchand
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Young Woo Park
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Timothy G Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Burcu Zeydan
- Department of Radiology, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - David S Knopman
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Michelle M Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychiatry and Psychology, Mayo Clinic-Minnesota, Rochester, MN, USA
| | | | | | - Gülin Öz
- Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, USA
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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41
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Shir D, Graff-Radford J, Hofrenning EI, Lesnick TG, Przybelski SA, Lowe VJ, Knopman DS, Petersen RC, Jack CR, Vemuri P, Algeciras-Schimnich A, Campbell MR, Stricker NH, Mielke MM. Association of plasma glial fibrillary acidic protein (GFAP) with neuroimaging of Alzheimer's disease and vascular pathology. Alzheimers Dement (Amst) 2022; 14:e12291. [PMID: 35252538 PMCID: PMC8883441 DOI: 10.1002/dad2.12291] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/18/2021] [Accepted: 01/16/2022] [Indexed: 11/28/2022]
Abstract
Introduction: Plasma glial fibrillary acidic protein (GFAP) may be associated with amyloid burden, neurodegeneration, and stroke but its specificity for Alzheimer's disease (AD) in the general population is unclear. We examined associations of plasma GFAP with amyloid and tau positron emission tomography (PET), cortical thickness, white matter hyperintensities (WMH), and cerebral microbleeds (CMBs). Methods: The study included 200 individuals from the Mayo Clinic Study of Aging who underwent amyloid and tau PET and magnetic resonance imaging and had plasma GFAP concurrently assayed; multiple linear regression and hurdle model analyses were used to investigate associations controlling for age and sex. Results: GFAP was associated with amyloid and tau PET in multivariable models. After adjusting for amyloid, the association with tau PET was no longer significant. GFAP was associated with cortical thickness, WMH, and lobar CMBs only among those who were amyloid‐positive. Discussion: This cross‐sectional analysis demonstrates the utility of GFAP as a plasma biomarker for AD‐related pathologies.
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Affiliation(s)
- Dror Shir
- Department of Neurology Mayo Clinic Rochester Minnesota USA
| | | | | | - Timothy G Lesnick
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | - Scott A Przybelski
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | - Val J Lowe
- Department of Radiology Mayo Clinic Rochester Minnesota USA
| | | | - Ronald C Petersen
- Department of Neurology Mayo Clinic Rochester Minnesota USA.,Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | | | | | | | - Michelle R Campbell
- Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota USA
| | - Nikki H Stricker
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | - Michelle M Mielke
- Department of Neurology Mayo Clinic Rochester Minnesota USA.,Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
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Raghavan S, Przybelski SA, Reid RI, Lesnick TG, Ramanan VK, Botha H, Matchett BJ, Murray ME, Reichard RR, Knopman DS, Graff-Radford J, Jones DT, Lowe VJ, Mielke MM, Machulda MM, Petersen RC, Kantarci K, Whitwell JL, Josephs KA, Jack CR, Vemuri P. White matter damage due to vascular, tau, and TDP-43 pathologies and its relevance to cognition. Acta Neuropathol Commun 2022; 10:16. [PMID: 35123591 PMCID: PMC8817561 DOI: 10.1186/s40478-022-01319-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 12/27/2022] Open
Abstract
Multi-compartment modelling of white matter microstructure using Neurite Orientation Dispersion and Density Imaging (NODDI) can provide information on white matter health through neurite density index and free water measures. We hypothesized that cerebrovascular disease, Alzheimer's disease, and TDP-43 proteinopathy would be associated with distinct NODDI readouts of white matter damage which would be informative for identifying the substrate for cognitive impairment. We identified two independent cohorts with multi-shell diffusion MRI, amyloid and tau PET, and cognitive assessments: specifically, a population-based cohort of 347 elderly randomly sampled from the Olmsted county, Minnesota, population and a clinical research-based cohort of 61 amyloid positive Alzheimer's dementia participants. We observed an increase in free water and decrease in neurite density using NODDI measures in the genu of the corpus callosum associated with vascular risk factors, which we refer to as the vascular white matter component. Tau PET signal reflective of 3R/4R tau deposition was associated with worsening neurite density index in the temporal white matter where we measured parahippocampal cingulum and inferior temporal white matter bundles. Worsening temporal white matter neurite density was associated with (antemortem confirmed) FDG TDP-43 signature. Post-mortem neuropathologic data on a small subset of this sample lend support to our findings. In the community-dwelling cohort where vascular disease was more prevalent, the NODDI vascular white matter component explained variability in global cognition (partial R2 of free water and neurite density = 8.3%) and MMSE performance (8.2%) which was comparable to amyloid PET (7.4% for global cognition and 6.6% for memory). In the AD dementia cohort, tau deposition was the greatest contributor to cognitive performance (9.6%), but there was also a non-trivial contribution of the temporal white matter component (8.5%) to cognitive performance. The differences observed between the two cohorts were reflective of their distinct clinical composition. White matter microstructural damage assessed using advanced diffusion models may add significant value for distinguishing the underlying substrate (whether cerebrovascular disease versus neurodegenerative disease caused by tau deposition or TDP-43 pathology) for cognitive impairment in older adults.
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Affiliation(s)
| | - Scott A. Przybelski
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905 USA
| | - Robert I. Reid
- Department of Information Technology, Mayo Clinic, Rochester, MN 55905 USA
| | - Timothy G. Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905 USA
| | | | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN 55905 USA
| | | | | | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905 USA
| | | | | | - David T. Jones
- Department of Neurology, Mayo Clinic, Rochester, MN 55905 USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Michelle M. Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN 55905 USA
- Department of Neurology, Mayo Clinic, Rochester, MN 55905 USA
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN 55905 USA
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Jennifer L. Whitwell
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | | | - Clifford R. Jack
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905 USA
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Saboo KV, Hu C, Varatharajah Y, Przybelski SA, Reid RI, Schwarz CG, Graff-Radford J, Knopman DS, Machulda MM, Mielke MM, Petersen RC, Arnold PM, Worrell GA, Jones DT, Jack Jr CR, Iyer RK, Vemuri P. Deep learning identifies brain structures that predict cognition and explain heterogeneity in cognitive aging. Neuroimage 2022; 251:119020. [PMID: 35196565 PMCID: PMC9045384 DOI: 10.1016/j.neuroimage.2022.119020] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/20/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Specific brain structures (gray matter regions and white matter tracts) play a dominant role in determining cognitive decline and explain the heterogeneity in cognitive aging. Identification of these structures is crucial for screening of older adults at risk of cognitive decline. Using deep learning models augmented with a model-interpretation technique on data from 1432 Mayo Clinic Study of Aging participants, we identified a subset of brain structures that were most predictive of individualized cognitive trajectories and indicative of cognitively resilient vs. vulnerable individuals. Specifically, these structures explained why some participants were resilient to the deleterious effects of elevated brain amyloid and poor vascular health. Of these, medial temporal lobe and fornix, reflective of age and pathology-related degeneration, and corpus callosum, reflective of inter-hemispheric disconnection, accounted for 60% of the heterogeneity explained by the most predictive structures. Our results are valuable for identifying cognitively vulnerable individuals and for developing interventions for cognitive decline.
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Kantarci K, Nedelska Z, Chen Q, Senjem ML, Schwarz CG, Gunter JL, Przybelski SA, Lesnick TG, Kremers WK, Fields JA, Graff-Radford J, Savica R, Jones D, Botha H, Knopman DS, Lowe V, Graff-Radford NR, Murray MM, Dickson DW, Reichard RR, Jack CR, Petersen RC, Ferman TJ, Boeve BF. OUP accepted manuscript. Brain Commun 2022; 4:fcac013. [PMID: 35415608 PMCID: PMC8994111 DOI: 10.1093/braincomms/fcac013] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 11/10/2021] [Accepted: 02/02/2022] [Indexed: 12/02/2022] Open
Abstract
Mild cognitive impairment with the core clinical features of dementia with Lewy bodies is recognized as a prodromal stage of dementia with Lewy bodies. Although grey matter atrophy has been demonstrated in prodromal dementia with Lewy bodies, longitudinal rates of atrophy during progression to probable dementia with Lewy bodies are unknown. We investigated the regional patterns of cross-sectional and longitudinal rates of grey matter atrophy in prodromal dementia with Lewy bodies, including those who progressed to probable dementia with Lewy bodies. Patients with mild cognitive impairment with at least one core clinical feature of dementia with Lewy bodies (mean age = 70.5; 95% male), who were enrolled in the Mayo Clinic Alzheimer’s Disease Research Center and followed for at least two clinical evaluations and MRI examinations, were included (n = 56). A cognitively unimpaired control group (n = 112) was matched 2:1 to the patients with mild cognitive impairment by age and sex. Patients either remained stable (n = 28) or progressed to probable dementia with Lewy bodies (n = 28) during a similar follow-up period and pathologic confirmation was available in a subset of cases (n = 18). Cross-sectional and longitudinal rates of grey matter atrophy were assessed using voxel-based and atlas-based region of interest analyses. At baseline, prodromal dementia with Lewy bodies was characterized by atrophy in the nucleus basalis of Meynert both in those who remained stable and those who progressed to probable dementia with Lewy bodies (P < 0.05 false discovery rate corrected). Increase in longitudinal grey matter atrophy rates were widespread, with greatest rates of atrophy observed in the enthorhinal and parahippocampal cortices, temporoparietal association cortices, thalamus and the basal ganglia, in mild cognitive impairment patients who progressed to probable dementia with Lewy bodies at follow-up (P < 0.05 false discovery rate corrected). Rates of inferior temporal atrophy were associated with greater rates of worsening on the clinical dementia rating–sum of boxes. Seventeen of the 18 (94%) autopsied cases had Lewy body disease. Results show that atrophy in the nucleus basalis of Meynert is a feature of prodromal dementia with Lewy bodies regardless of proximity to progression to probable dementia with Lewy bodies. Longitudinally, grey matter atrophy progresses in regions with significant cholinergic innervation, in alignment with clinical disease progression, with widespread and accelerated rates of atrophy in patients who progress to probable dementia with Lewy bodies. Given the prominent neurodegeneration in the cholinergic system, patients with prodromal dementia with Lewy bodies may be candidates for cholinesterase inhibitor treatment.
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Affiliation(s)
- Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Correspondence to: Kejal Kantarci, MD, MS Department of Radiology Mayo Clinic 200 First Street SW Rochester, MN 55905, USA E-mail:
| | - Zuzana Nedelska
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Charles University, Prague, Czech Republic
| | - Qin Chen
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | | | | | | | | | | | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Julie A. Fields
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - David Jones
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Val Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Melissa M. Murray
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Dennis W. Dickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - R. Ross Reichard
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | | | | | - Tanis J. Ferman
- Department of Psychology and Psychiatry, Mayo Clinic, Jacksonville, FL, USA
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McCarter SJ, Lesnick TG, Lowe VJ, Rabinstein AA, Przybelski SA, Algeciras-Schimnich A, Ramanan VK, Jack CR, Petersen RC, Knopman DS, Boeve BF, Kantarci K, Vemuri P, Mielke MM, Graff-Radford J. Association Between Plasma Biomarkers of Amyloid, Tau, and Neurodegeneration with Cerebral Microbleeds. J Alzheimers Dis 2022; 87:1537-1547. [PMID: 35527558 PMCID: PMC9472282 DOI: 10.3233/jad-220158] [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: 01/03/2023]
Abstract
BACKGROUND Cerebral microbleeds (CMBs) are a common vascular pathology associated with future intracerebral hemorrhage. Plasma biomarkers of amyloid, tau, and neurodegeneration may provide a screening avenue to identify those with CMBs, but evidence is conflicting. OBJECTIVE To determine the association between plasma biomarkers (Aβ40, Aβ42, t-tau, p-tau181, p-tau217, neurofilament light chain (NfL)) and CMBs in a population-based study of aging and whether these biomarkers predict higher signal on Aβ-PET imaging in patients with multiple CMBs. METHODS 712 participants from the Mayo Clinic Study of Aging with T2* GRE MRI and plasma biomarkers were included. Biomarkers were analyzed utilizing Simoa (Aβ40, Aβ42, t-tau, NfL) or Meso Scale Discovery (p-tau181, p-tau217) platforms. Cross-sectional associations between CMBs, plasma biomarkers and Aβ-PET were evaluated using hurdle models and multivariable regression models. RESULTS Among the 188 (26%) individuals with≥1 CMB, a lower plasma Aβ42/Aβ40 ratio was associated with more CMBs after adjusting for covariables (IRR 568.5 95% CI 2.8-116,127). No other biomarkers were associated with risk or number CMBs. In 81 individuals with≥2 CMBs, higher plasma t-tau, p-tau181, and p-tau217 all were associated with higher Aβ-PET signal, with plasma p-tau217 having the strongest predictive value (r2 0.603, AIC -53.0). CONCLUSION Lower plasma Aβ42/Aβ40 ratio and higher plasma p-tau217 were associated with brain amyloidosis in individuals with CMBs from the general population. Our results suggest that in individuals with multiple CMBs and/or lobar intracranial hemorrhage that a lower plasma Aβ42/Aβ40 ratio or elevated p-tau217 may indicate underlying cerebral amyloid angiopathy.
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Affiliation(s)
- Stuart J. McCarter
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Center for Sleep Medicine, Mayo Clinic, Rochester, MN, USA
| | - Timothy G. Lesnick
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | | | | | | | | | | | | | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
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46
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Zeydan B, Schwarz CG, Przybelski SA, Lesnick TG, Kremers WK, Senjem ML, Kantarci OH, Min PH, Kemp BJ, Jack CR, Kantarci K, Lowe VJ. Comparison of Pittsburgh compound‐B and flutemetamol white matter binding. Alzheimers Dement 2021. [DOI: 10.1002/alz.050233] [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)
- Burcu Zeydan
- Mayo Clinic, Radiology Rochester MN USA
- Mayo Clinic, Neurology Rochester MN USA
| | | | | | | | | | - Matthew L. Senjem
- Mayo Clinic, Radiology Rochester MN USA
- Mayo Clinic, Information Technology Rochester MN USA
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47
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Miyagawa T, Przybelski SA, Maltais DD, Min H, Jordan L, Lesnick TG, St. Louis EK, Silber MH, Graff‐Radford J, Jones DT, Savica R, Knopman DS, Petersen RC, Kremers WK, Forsberg LK, Fields JA, Ferman TJ, Allen LA, Kantarci K, Lowe VJ, Boeve BF. Potential utility of longitudinal
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I‐FP‐CIT SPECT imaging in predicting phenoconversion to overt synucleinopathy in isolated REM sleep behavior disorder. Alzheimers Dement 2021. [DOI: 10.1002/alz.056563] [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]
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48
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Vemuri P, Kouri N, Przybelski SA, Labuzan SA, Lesnick TG, Reid RI, Reichard RR, Knopman DS, Petersen RC, Jack CR, Mielke MM, Dickson DW, Graff‐Radford J, Murray ME. Correlates of neuroimaging measures with pathological scales of cerebrovascular disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.056145] [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: 11/11/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Ronald C. Petersen
- Mayo Clinic Rochester MN USA
- Mayo Clinic Alzheimer's Disease Research Center Rochester MN USA
| | - Clifford R. Jack
- Mayo Clinic Rochester MN USA
- Mayo Clinic, Radiology Rochester MN USA
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49
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Arenaza‐Urquijo EM, Castillo A, Przybelski SA, Lesnick TG, Pillai SKR, Mielke MM, Machulda MM, Knopman DS, Radford JG, Jack CR, Petersen RC, Vemuri P. Successful cognitive aging definitions and associated demographic, biomarker profiles and lifestyles in the 80+ MCSA population. Alzheimers Dement 2021. [DOI: 10.1002/alz.055700] [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)
- Eider M Arenaza‐Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation Barcelona Spain
- IMIM (Hospital del Mar Medical Research Institute) Barcelona Spain
- Mayo Clinic Rochester MN USA
| | | | | | | | | | | | | | | | | | - Clifford R. Jack
- Mayo Clinic, Radiology Rochester MN USA
- Mayo Clinic College of Medicine Rochester MN USA
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic Rochester MN USA
- Mayo Clinic Alzheimer's Disease Research Center Rochester MN USA
- U.S. Advisory Council on Alzheimer’s Research, Care, and Services Washington DC USA
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50
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Kara F, Joers JM, Deelchand DK, Park YW, Przybelski SA, Lesnick TG, Knopman DS, Lowe VJ, Vemuri P, Machulda MM, Mielke MM, Jack CR, Petersen RC, Öz G, Kantarci K. Neurochemical levels measured by
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H MR spectroscopy are associated with amyloid‐β and tau deposition in cognitively unimpaired older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.054632] [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: 11/06/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Gülin Öz
- University of Minnesota Minneapolis MN USA
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