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Welhaf MS, Wilks H, Aschenbrenner AJ, Balota DA, Schindler SE, Benzinger TLS, Gordon BA, Cruchaga C, Xiong C, Morris JC, Hassenstab J. Naturalistic assessment of reaction time variability in older adults at risk for Alzheimer's disease. J Int Neuropsychol Soc 2024; 30:428-438. [PMID: 38282413 PMCID: PMC11078617 DOI: 10.1017/s1355617723011475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Maintaining attention underlies many aspects of cognition and becomes compromised early in neurodegenerative diseases like Alzheimer's disease (AD). The consistency of maintaining attention can be measured with reaction time (RT) variability. Previous work has focused on measuring such fluctuations during in-clinic testing, but recent developments in remote, smartphone-based cognitive assessments can allow one to test if these fluctuations in attention are evident in naturalistic settings and if they are sensitive to traditional clinical and cognitive markers of AD. METHOD Three hundred and seventy older adults (aged 75.8 +/- 5.8 years) completed a week of remote daily testing on the Ambulatory Research in Cognition (ARC) smartphone platform and also completed clinical, genetic, and conventional in-clinic cognitive assessments. RT variability was assessed in a brief (20-40 seconds) processing speed task using two different measures of variability, the Coefficient of Variation (CoV) and the Root Mean Squared Successive Difference (RMSSD) of RTs on correct trials. RESULTS Symptomatic participants showed greater variability compared to cognitively normal participants. When restricted to cognitively normal participants, APOE ε4 carriers exhibited greater variability than noncarriers. Both CoV and RMSSD showed significant, and similar, correlations with several in-clinic cognitive composites. Finally, both RT variability measures significantly mediated the relationship between APOE ε4 status and several in-clinic cognition composites. CONCLUSIONS Attentional fluctuations over 20-40 seconds assessed in daily life, are sensitive to clinical status and genetic risk for AD. RT variability appears to be an important predictor of cognitive deficits during the preclinical disease stage.
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Affiliation(s)
- Matthew S Welhaf
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Hannah Wilks
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Balota
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jason Hassenstab
- Department of Psychological & Brain Sciences, Washington University in St. Louis. St. Louis, MO, USA
- Department of Neurology. Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
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Li Y, Yen D, Hendrix RD, Gordon BA, Dlamini S, Barthélemy NR, Aschenbrenner AJ, Henson RL, Herries EM, Volluz K, Kirmess K, Eastwood S, Meyer M, Heller M, Jarrett L, McDade E, Holtzman DM, Benzinger TL, Morris JC, Bateman RJ, Xiong C, Schindler SE. Timing of Biomarker Changes in Sporadic Alzheimer's Disease in Estimated Years from Symptom Onset. Ann Neurol 2024; 95:951-965. [PMID: 38400792 PMCID: PMC11060905 DOI: 10.1002/ana.26891] [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: 08/30/2023] [Revised: 12/26/2023] [Accepted: 01/30/2024] [Indexed: 02/26/2024]
Abstract
OBJECTIVE A clock relating amyloid positron emission tomography (PET) to time was used to estimate the timing of biomarker changes in sporadic Alzheimer disease (AD). METHODS Research participants were included who underwent cerebrospinal fluid (CSF) collection within 2 years of amyloid PET. The ages at amyloid onset and AD symptom onset were estimated for each individual. The timing of change for plasma, CSF, imaging, and cognitive measures was calculated by comparing restricted cubic splines of cross-sectional data from the amyloid PET positive and negative groups. RESULTS The amyloid PET positive sub-cohort (n = 118) had an average age of 70.4 ± 7.4 years (mean ± standard deviation) and 16% were cognitively impaired. The amyloid PET negative sub-cohort (n = 277) included individuals with low levels of amyloid plaque burden at all scans who were cognitively unimpaired at the time of the scans. Biomarker changes were detected 15-19 years before estimated symptom onset for CSF Aβ42/Aβ40, plasma Aβ42/Aβ40, CSF pT217/T217, and amyloid PET; 12-14 years before estimated symptom onset for plasma pT217/T217, CSF neurogranin, CSF SNAP-25, CSF sTREM2, plasma GFAP, and plasma NfL; and 7-9 years before estimated symptom onset for CSF pT205/T205, CSF YKL-40, hippocampal volumes, and cognitive measures. INTERPRETATION The use of an amyloid clock enabled visualization and analysis of biomarker changes as a function of estimated years from symptom onset in sporadic AD. This study demonstrates that estimated years from symptom onset based on an amyloid clock can be used as a continuous staging measure for sporadic AD and aligns with findings in autosomal dominant AD. ANN NEUROL 2024;95:951-965.
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Affiliation(s)
- Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel Yen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel D. Hendrix
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A. Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sibonginkhosi Dlamini
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Nicolas R. Barthélemy
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Rachel L. Henson
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Elizabeth M. Herries
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Katherine Volluz
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | | | | | | | - Maren Heller
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Lea Jarrett
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
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3
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Deng C, Xiong C, Huo J, Liu Y, Man Y, Qu Y. Posterior open wound healing in immediate implant placement using reactive soft tissue versus absorbable collagen sponge: a retrospective cohort study. Int J Oral Maxillofac Surg 2024; 53:436-443. [PMID: 38103945 DOI: 10.1016/j.ijom.2023.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/13/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
The soft and hard tissue healing of open wounds in immediate implant placement are yet to be explored. The aim of this study was to compare the clinical outcomes of open wound healing using reactive soft tissue (RST) and absorbable collagen sponge (ACS). Forty implants placed immediately in posterior sockets were included; autologous RST was used in 20 and ACS substitute was used in 20. Soft tissue healing was primarily assessed through a novel scoring system and the evaluation of gingival recession. The horizontal bone width (HBW) and interproximal marginal bone level (MBL) were measured on radiographs to observe the hard tissue healing. No significant difference in total soft tissue healing score was observed at 2 weeks postoperatively. Notably, the ACS group showed better tissue colour (P = 0.016) but worse fibrous repair (P = 0.043) scores than the RST group. Gingival recession levels were comparable in the two groups, both before tooth extraction and after placement of the restoration. Regarding hard tissue, HBW and MBL changes showed no intergroup differences. Within the limitations of this study, both RST and ACS seemed effective for open wound closure, achieving ideal soft and hard tissue healing in immediate implant placement.
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Affiliation(s)
- C Deng
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - C Xiong
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - J Huo
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Liu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Man
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Y Qu
- State Key Laboratory of Oral Diseases and National Center for Stomatology and National Clinical Research Center for Oral Diseases and Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
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4
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Wisch JK, McKay NS, Boerwinkle AH, Kennedy J, Flores S, Handen BL, Christian BT, Head E, Mapstone M, Rafii MS, O'Bryant SE, Price JC, Laymon CM, Krinsky-McHale SJ, Lai F, Rosas HD, Hartley SL, Zaman S, Lott IT, Tudorascu D, Zammit M, Brickman AM, Lee JH, Bird TD, Cohen A, Chrem P, Daniels A, Chhatwal JP, Cruchaga C, Ibanez L, Jucker M, Karch CM, Day GS, Lee JH, Levin J, Llibre-Guerra J, Li Y, Lopera F, Roh JH, Ringman JM, Supnet-Bell C, van Dyck CH, Xiong C, Wang G, Morris JC, McDade E, Bateman RJ, Benzinger TLS, Gordon BA, Ances BM. Comparison of tau spread in people with Down syndrome versus autosomal-dominant Alzheimer's disease: a cross-sectional study. Lancet Neurol 2024; 23:500-510. [PMID: 38631766 DOI: 10.1016/s1474-4422(24)00084-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 02/01/2024] [Accepted: 02/21/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND In people with genetic forms of Alzheimer's disease, such as in Down syndrome and autosomal-dominant Alzheimer's disease, pathological changes specific to Alzheimer's disease (ie, accumulation of amyloid and tau) occur in the brain at a young age, when comorbidities related to ageing are not present. Studies including these cohorts could, therefore, improve our understanding of the early pathogenesis of Alzheimer's disease and be useful when designing preventive interventions targeted at disease pathology or when planning clinical trials. We compared the magnitude, spatial extent, and temporal ordering of tau spread in people with Down syndrome and autosomal-dominant Alzheimer's disease. METHODS In this cross-sectional observational study, we included participants (aged ≥25 years) from two cohort studies. First, we collected data from the Dominantly Inherited Alzheimer's Network studies (DIAN-OBS and DIAN-TU), which include carriers of autosomal-dominant Alzheimer's disease genetic mutations and non-carrier familial controls recruited in Australia, Europe, and the USA between 2008 and 2022. Second, we collected data from the Alzheimer Biomarkers Consortium-Down Syndrome study, which includes people with Down syndrome and sibling controls recruited from the UK and USA between 2015 and 2021. Controls from the two studies were combined into a single group of familial controls. All participants had completed structural MRI and tau PET (18F-flortaucipir) imaging. We applied Gaussian mixture modelling to identify regions of high tau PET burden and regions with the earliest changes in tau binding for each cohort separately. We estimated regional tau PET burden as a function of cortical amyloid burden for both cohorts. Finally, we compared the temporal pattern of tau PET burden relative to that of amyloid. FINDINGS We included 137 people with Down syndrome (mean age 38·5 years [SD 8·2], 74 [54%] male, and 63 [46%] female), 49 individuals with autosomal-dominant Alzheimer's disease (mean age 43·9 years [11·2], 22 [45%] male, and 27 [55%] female), and 85 familial controls, pooled from across both studies (mean age 41·5 years [12·1], 28 [33%] male, and 57 [67%] female), who satisfied the PET quality-control procedure for tau-PET imaging processing. 134 (98%) people with Down syndrome, 44 (90%) with autosomal-dominant Alzheimer's disease, and 77 (91%) controls also completed an amyloid PET scan within 3 years of tau PET imaging. Spatially, tau PET burden was observed most frequently in subcortical and medial temporal regions in people with Down syndrome, and within the medial temporal lobe in people with autosomal-dominant Alzheimer's disease. Across the brain, people with Down syndrome had greater concentrations of tau for a given level of amyloid compared with people with autosomal-dominant Alzheimer's disease. Temporally, increases in tau were more strongly associated with increases in amyloid for people with Down syndrome compared with autosomal-dominant Alzheimer's disease. INTERPRETATION Although the general progression of amyloid followed by tau is similar for people Down syndrome and people with autosomal-dominant Alzheimer's disease, we found subtle differences in the spatial distribution, timing, and magnitude of the tau burden between these two cohorts. These differences might have important implications; differences in the temporal pattern of tau accumulation might influence the timing of drug administration in clinical trials, whereas differences in the spatial pattern and magnitude of tau burden might affect disease progression. FUNDING None.
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Affiliation(s)
- Julie K Wisch
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA.
| | - Nicole S McKay
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Anna H Boerwinkle
- McGovern Medical School, University of Texas in Houston, Houston, TX, USA
| | - James Kennedy
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Shaney Flores
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Benjamin L Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley T Christian
- Department of Medical Physics and Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth Head
- Department of Pathology, Gillespie Neuroscience Research Facility, University of California, Irvine, CA, USA
| | - Mark Mapstone
- Department of Neurology, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Sid E O'Bryant
- Institute for Translational Research Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Julie C Price
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Charles M Laymon
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sharon J Krinsky-McHale
- Department of Psychology, New York State Institute for Basic Research in Developmental Disabilities, New York, NY, USA
| | - Florence Lai
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - H Diana Rosas
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA; Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Sigan L Hartley
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Shahid Zaman
- Cambridge Intellectual and Developmental Disabilities Research Group, University of Cambridge, Cambridge, UK
| | - Ira T Lott
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, CA, USA
| | - Dana Tudorascu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew Zammit
- Department of Medical Physics and Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Joseph H Lee
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA; Department of Epidemiology, Columbia University Irving Medical Center, New York, NY, USA
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Annie Cohen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Patricio Chrem
- Centro de Memoria y Envejecimiento, Buenos Aires, Argentina
| | - Alisha Daniels
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Laura Ibanez
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Celeste M Karch
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA; German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asian Medical Center, Seoul, South Korea
| | - Johannes Levin
- Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany; German Center for Neurodegenerative Diseases, site Munich, Munich, Germany; Munich Cluster for Systems Neurology, Munich, Germany
| | - Jorge Llibre-Guerra
- Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
| | - Jee Hoon Roh
- Departments of Physiology and Neurology, Korea University College of Medicine, Seoul, South Korea
| | - John M Ringman
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | | | | | - Chengjie Xiong
- Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Guoqiao Wang
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Department of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | | | - Brian A Gordon
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
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5
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Wagemann O, Liu H, Wang G, Shi X, Bittner T, Scelsi MA, Farlow MR, Clifford DB, Supnet-Bell C, Santacruz AM, Aschenbrenner AJ, Hassenstab JJ, Benzinger TLS, Gordon BA, Coalier KA, Cruchaga C, Ibanez L, Perrin RJ, Xiong C, Li Y, Morris JC, Lah JJ, Berman SB, Roberson ED, van Dyck CH, Galasko D, Gauthier S, Hsiung GYR, Brooks WS, Pariente J, Mummery CJ, Day GS, Ringman JM, Mendez PC, St. George-Hyslop P, Fox NC, Suzuki K, Okhravi HR, Chhatwal J, Levin J, Jucker M, Sims JR, Holdridge KC, Proctor NK, Yaari R, Andersen SW, Mancini M, Llibre-Guerra J, Bateman RJ, McDade E. Downstream Biomarker Effects of Gantenerumab or Solanezumab in Dominantly Inherited Alzheimer Disease: The DIAN-TU-001 Randomized Clinical Trial. JAMA Neurol 2024:2817630. [PMID: 38683602 PMCID: PMC11059071 DOI: 10.1001/jamaneurol.2024.0991] [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: 10/18/2023] [Accepted: 02/01/2024] [Indexed: 05/01/2024]
Abstract
Importance Effects of antiamyloid agents, targeting either fibrillar or soluble monomeric amyloid peptides, on downstream biomarkers in cerebrospinal fluid (CSF) and plasma are largely unknown in dominantly inherited Alzheimer disease (DIAD). Objective To investigate longitudinal biomarker changes of synaptic dysfunction, neuroinflammation, and neurodegeneration in individuals with DIAD who are receiving antiamyloid treatment. Design, Setting, and Participants From 2012 to 2019, the Dominantly Inherited Alzheimer Network Trial Unit (DIAN-TU-001) study, a double-blind, placebo-controlled, randomized clinical trial, investigated gantenerumab and solanezumab in DIAD. Carriers of gene variants were assigned 3:1 to either drug or placebo. The present analysis was conducted from April to June 2023. DIAN-TU-001 spans 25 study sites in 7 countries. Biofluids and neuroimaging from carriers of DIAD gene variants in the gantenerumab, solanezumab, and placebo groups were analyzed. Interventions In 2016, initial dosing of gantenerumab, 225 mg (subcutaneously every 4 weeks) was increased every 8 weeks up to 1200 mg. In 2017, initial dosing of solanezumab, 400 mg (intravenously every 4 weeks) was increased up to 1600 mg every 4 weeks. Main Outcomes and Measures Longitudinal changes in CSF levels of neurogranin, soluble triggering receptor expressed on myeloid cells 2 (sTREM2), chitinase 3-like 1 protein (YKL-40), glial fibrillary acidic protein (GFAP), neurofilament light protein (NfL), and plasma levels of GFAP and NfL. Results Of 236 eligible participants screened, 43 were excluded. A total of 142 participants (mean [SD] age, 44 [10] years; 72 female [51%]) were included in the study (gantenerumab, 52 [37%]; solanezumab, 50 [35%]; placebo, 40 [28%]). Relative to placebo, gantenerumab significantly reduced CSF neurogranin level at year 4 (mean [SD] β = -242.43 [48.04] pg/mL; P < .001); reduced plasma GFAP level at year 1 (mean [SD] β = -0.02 [0.01] ng/mL; P = .02), year 2 (mean [SD] β = -0.03 [0.01] ng/mL; P = .002), and year 4 (mean [SD] β = -0.06 [0.02] ng/mL; P < .001); and increased CSF sTREM2 level at year 2 (mean [SD] β = 1.12 [0.43] ng/mL; P = .01) and year 4 (mean [SD] β = 1.06 [0.52] ng/mL; P = .04). Solanezumab significantly increased CSF NfL (log) at year 4 (mean [SD] β = 0.14 [0.06]; P = .02). Correlation analysis for rates of change found stronger correlations between CSF markers and fluid markers with Pittsburgh compound B positron emission tomography for solanezumab and placebo. Conclusions and Relevance This randomized clinical trial supports the importance of fibrillar amyloid reduction in multiple AD-related processes of neuroinflammation and neurodegeneration in CSF and plasma in DIAD. Additional studies of antiaggregated amyloid therapies in sporadic AD and DIAD are needed to determine the utility of nonamyloid biomarkers in determining disease modification. Trial Registration ClinicalTrials.gov Identifier: NCT04623242.
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Affiliation(s)
- Olivia Wagemann
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Haiyan Liu
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Guoqiao Wang
- Department of Biostatistics, Washington University in St Louis, St Louis, Missouri
| | - Xinyu Shi
- Department of Biostatistics, Washington University in St Louis, St Louis, Missouri
| | | | - Marzia A. Scelsi
- F. Hoffmann-La Roche Products Ltd, Welwyn Garden City, United Kingdom
| | - Martin R. Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis
| | - David B. Clifford
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Charlene Supnet-Bell
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Anna M. Santacruz
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | | | - Jason J. Hassenstab
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | | | - Brian A. Gordon
- Department of Radiology, Washington University in St Louis, St Louis, Missouri
| | | | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
| | - Laura Ibanez
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Psychiatry, Washington University in St Louis, St Louis, Missouri
| | - Richard J. Perrin
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
- Department of Pathology and Immunology, Washington University in St Louis, St Louis, Missouri
| | - Chengjie Xiong
- Department of Biostatistics, Washington University in St Louis, St Louis, Missouri
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - James J. Lah
- Department of Neurology, School of Medicine Emory University, Atlanta, Georgia
| | - Sarah B. Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erik D. Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham
| | | | - Douglas Galasko
- Department of Neurology, University of California, San Diego
| | - Serge Gauthier
- Department of Neurology & Psychiatry, McGill University, Montréal, Québec, Canada
| | - Ging-Yuek R. Hsiung
- Department of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
| | - William S. Brooks
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Clinical Medicine, University of New South Wales, Randwick, New South Wales, Australia
| | - Jérémie Pariente
- Department of Neurology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Catherine J. Mummery
- Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville
| | - John M. Ringman
- Department of Neurology, University of Southern California, Los Angeles
| | - Patricio Chrem Mendez
- Fundación Para la Lucha Contra las Enfermedades Neurológicas de la Infancia (FLENI), Buenos Aires, Argentina
| | | | - Nick C. Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, United Kingdom
| | | | - Hamid R. Okhravi
- Department of Geriatrics, Eastern Virginia Medical School, Norfolk
| | - Jasmeer Chhatwal
- Department of Neurology, Massachusetts General and Brigham & Women’s Hospitals, Harvard Medical School, Boston
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | | | | | | | - Roy Yaari
- Eli Lilly and Company, Indianapolis, Indiana
| | | | | | - Jorge Llibre-Guerra
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St Louis, Missouri
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6
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Shue F, White LJ, Hendrix R, Ulrich J, Henson RL, Knight W, Martens YA, Wang N, Roy B, Starling SC, Ren Y, Xiong C, Asmann YW, Syrjanen JA, Vassilaki M, Mielke MM, Timsina J, Sung YJ, Cruchaga C, Holtzman DM, Bu G, Petersen RC, Heckman MG, Kanekiyo T. CSF biomarkers of immune activation and Alzheimer's disease for predicting cognitive impairment risk in the elderly. Sci Adv 2024; 10:eadk3674. [PMID: 38569027 PMCID: PMC10990276 DOI: 10.1126/sciadv.adk3674] [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] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 02/23/2024] [Indexed: 04/05/2024]
Abstract
The immune system substantially influences age-related cognitive decline and Alzheimer's disease (AD) progression, affected by genetic and environmental factors. In a Mayo Clinic Study of Aging cohort, we examined how risk factors like APOE genotype, age, and sex affect inflammatory molecules and AD biomarkers in cerebrospinal fluid (CSF). Among cognitively unimpaired individuals over 65 (N = 298), we measured 365 CSF inflammatory molecules, finding age, sex, and diabetes status predominantly influencing their levels. We observed age-related correlations with AD biomarkers such as total tau, phosphorylated tau-181, neurofilament light chain (NfL), and YKL40. APOE4 was associated with lower Aβ42 and higher SNAP25 in CSF. We explored baseline variables predicting cognitive decline risk, finding age, CSF Aβ42, NfL, and REG4 to be independently correlated. Subjects with older age, lower Aβ42, higher NfL, and higher REG4 at baseline had increased cognitive impairment risk during follow-up. This suggests that assessing CSF inflammatory molecules and AD biomarkers could predict cognitive impairment risk in the elderly.
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Affiliation(s)
- Francis Shue
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Launia J. White
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Rachel Hendrix
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Jason Ulrich
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Rachel L. Henson
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - William Knight
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yuka A. Martens
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Ni Wang
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Bhaskar Roy
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Yingxue Ren
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 93110, USA
| | - Yan W. Asmann
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Jeremy A. Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester MN 55905, USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester MN 55905, USA
| | - Michelle M. Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester MN 55905, USA
| | - Jigyasha Timsina
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 93110, USA
| | - Yun Ju Sung
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 93110, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 93110, USA
| | - David M. Holtzman
- Department of Neurology, Hope Center for Neurological Disorders, Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
| | | | - Michael G. Heckman
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Takahisa Kanekiyo
- Department of Neuroscience, Mayo Clinic, Jacksonville, FL 32224, USA
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7
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Wang G, Li Y, Xiong C, Benzinger TLS, Gordon BA, Hassenstab J, Aschenbrenner AJ, McDade E, Clifford DB, Libre‐Guerra JJ, Shi X, Mummery CJ, van Dyck CH, Lah JJ, Honig LS, Day G, Ringman JM, Brooks WS, Fox NC, Suzuki K, Levin J, Jucker M, Delmar P, Bittner T, Bateman RJ. Examining amyloid reduction as a surrogate endpoint through latent class analysis using clinical trial data for dominantly inherited Alzheimer's disease. Alzheimers Dement 2024; 20:2698-2706. [PMID: 38400532 PMCID: PMC11032558 DOI: 10.1002/alz.13735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/18/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Increasing evidence suggests that amyloid reduction could serve as a plausible surrogate endpoint for clinical and cognitive efficacy. The double-blind phase 3 DIAN-TU-001 trial tested clinical and cognitive declines with increasing doses of solanezumab or gantenerumab. METHODS We used latent class (LC) analysis on data from the Dominantly Inherited Alzheimer Network Trials Unit 001 trial to test amyloid positron emission tomography (PET) reduction as a potential surrogate biomarker. RESULTS LC analysis categorized participants into three classes: amyloid no change, amyloid reduction, and amyloid growth, based on longitudinal amyloid Pittsburgh compound B PET standardized uptake value ratio data. The amyloid-no-change class was at an earlier disease stage for amyloid amounts and dementia. Despite similar baseline characteristics, the amyloid-reduction class exhibited reductions in the annual decline rates compared to the amyloid-growth class across multiple biomarker, clinical, and cognitive outcomes. DISCUSSION LC analysis indicates that amyloid reduction is associated with improved clinical outcomes and supports its use as a surrogate biomarker in clinical trials. HIGHLIGHTS We used latent class (LC) analysis to test amyloid reduction as a surrogate biomarker. Despite similar baseline characteristics, the amyloid-reduction class exhibited remarkably better outcomes compared to the amyloid-growth class across multiple measures. LC analysis proves valuable in testing amyloid reduction as a surrogate biomarker in clinical trials lacking significant treatment effects.
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Affiliation(s)
- Guoqiao Wang
- Washington University, School of MedicineSt. LouisMissouriUSA
| | - Yan Li
- Washington University, School of MedicineSt. LouisMissouriUSA
| | - Chengjie Xiong
- Washington University, School of MedicineSt. LouisMissouriUSA
| | | | - Brian A. Gordon
- Washington University, School of MedicineSt. LouisMissouriUSA
| | | | | | - Eric McDade
- Washington University, School of MedicineSt. LouisMissouriUSA
| | | | | | - Xinyu Shi
- Washington University, School of MedicineSt. LouisMissouriUSA
| | | | | | - James J. Lah
- Emory University Medical CenterAtlantaGeorgiaUSA
| | | | - Gregg Day
- Mayo Clinic JacksonvilleJacksonvilleFloridaUSA
| | - John M. Ringman
- Department of NeurologyKeck School of Medicine of USCLos AngelesCaliforniaUSA
| | - William S. Brooks
- Neuroscience Research Australia, Randwick NSW Australia, and School of Clinical MedicineUniversity of New South WalesRandwickNew South WalesAustralia
| | - Nick C. Fox
- Dementia Research CentreUniversity College LondonLondonUK
| | | | - Johannes Levin
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- German Center for Neurodegenerative DiseasesMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | - Mathias Jucker
- Department of Cellular NeurologyHertie Institute for Clinical Brain ResearchUniversity of TübingenTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE)TübingenGermany
| | | | - Tobias Bittner
- F.Hoffmann‐LaRoche, Ltd.BaselSwitzerland
- Genentech, Inc., a member of the Roche GroupSouth San FranciscoCaliforniaUSA
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8
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Joseph‐Mathurin N, Feldman RL, Lu R, Shirzadi Z, Toomer C, Saint Clair JR, Ma Y, McKay NS, Strain JF, Kilgore C, Friedrichsen KA, Chen CD, Gordon BA, Chen G, Hornbeck RC, Massoumzadeh P, McCullough AA, Wang Q, Li Y, Wang G, Keefe SJ, Schultz SA, Cruchaga C, Preboske GM, Jack CR, Llibre‐Guerra JJ, Allegri RF, Ances BM, Berman SB, Brooks WS, Cash DM, Day GS, Fox NC, Fulham M, Ghetti B, Johnson KA, Jucker M, Klunk WE, la Fougère C, Levin J, Niimi Y, Oh H, Perrin RJ, Reischl G, Ringman JM, Saykin AJ, Schofield PR, Su Y, Supnet‐Bell C, Vöglein J, Yakushev I, Brickman AM, Morris JC, McDade E, Xiong C, Bateman RJ, Chhatwal JP, Benzinger TLS. Presenilin-1 mutation position influences amyloidosis, small vessel disease, and dementia with disease stage. Alzheimers Dement 2024; 20:2680-2697. [PMID: 38380882 PMCID: PMC11032566 DOI: 10.1002/alz.13729] [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: 07/31/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 02/22/2024]
Abstract
INTRODUCTION Amyloidosis, including cerebral amyloid angiopathy, and markers of small vessel disease (SVD) vary across dominantly inherited Alzheimer's disease (DIAD) presenilin-1 (PSEN1) mutation carriers. We investigated how mutation position relative to codon 200 (pre-/postcodon 200) influences these pathologic features and dementia at different stages. METHODS Individuals from families with known PSEN1 mutations (n = 393) underwent neuroimaging and clinical assessments. We cross-sectionally evaluated regional Pittsburgh compound B-positron emission tomography uptake, magnetic resonance imaging markers of SVD (diffusion tensor imaging-based white matter injury, white matter hyperintensity volumes, and microhemorrhages), and cognition. RESULTS Postcodon 200 carriers had lower amyloid burden in all regions but worse markers of SVD and worse Clinical Dementia Rating® scores compared to precodon 200 carriers as a function of estimated years to symptom onset. Markers of SVD partially mediated the mutation position effects on clinical measures. DISCUSSION We demonstrated the genotypic variability behind spatiotemporal amyloidosis, SVD, and clinical presentation in DIAD, which may inform patient prognosis and clinical trials. HIGHLIGHTS Mutation position influences Aβ burden, SVD, and dementia. PSEN1 pre-200 group had stronger associations between Aβ burden and disease stage. PSEN1 post-200 group had stronger associations between SVD markers and disease stage. PSEN1 post-200 group had worse dementia score than pre-200 in late disease stage. Diffusion tensor imaging-based SVD markers mediated mutation position effects on dementia in the late stage.
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9
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Doering S, McCullough A, Gordon BA, Chen CD, McKay N, Hobbs D, Keefe S, Flores S, Scott J, Smith H, Jarman S, Jackson K, Hornbeck RC, Ances BM, Xiong C, Aschenbrenner AJ, Hassenstab J, Cruchaga C, Daniels A, Bateman RJ, Morris JC, Benzinger TLS. Deconstructing pathological tau by biological process in early stages of Alzheimer disease: a method for quantifying tau spatial spread in neuroimaging. EBioMedicine 2024; 103:105080. [PMID: 38552342 PMCID: PMC10995809 DOI: 10.1016/j.ebiom.2024.105080] [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: 07/14/2023] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND Neuroimaging studies often quantify tau burden in standardized brain regions to assess Alzheimer disease (AD) progression. However, this method ignores another key biological process in which tau spreads to additional brain regions. We have developed a metric for calculating the extent tau pathology has spread throughout the brain and evaluate the relationship between this metric and tau burden across early stages of AD. METHODS 445 cross-sectional participants (aged ≥ 50) who had MRI, amyloid PET, tau PET, and clinical testing were separated into disease-stage groups based on amyloid positivity and cognitive status (older cognitively normal control, preclinical AD, and symptomatic AD). Tau burden and tau spatial spread were calculated for all participants. FINDINGS We found both tau metrics significantly elevated across increasing disease stages (p < 0.0001) and as a function of increasing amyloid burden for participants with preclinical (p < 0.0001, p = 0.0056) and symptomatic (p = 0.010, p = 0.0021) AD. An interaction was found between tau burden and tau spatial spread when predicting amyloid burden (p = 0.00013). Analyses of slope between tau metrics demonstrated more spread than burden in preclinical AD (β = 0.59), but then tau burden elevated relative to spread (β = 0.42) once participants had symptomatic AD, when the tau metrics became highly correlated (R = 0.83). INTERPRETATION Tau burden and tau spatial spread are both strong biomarkers for early AD but provide unique information, particularly at the preclinical stage. Tau spatial spread may demonstrate earlier changes than tau burden which could have broad impact in clinical trial design. FUNDING This research was supported by the Knight Alzheimer Disease Research Center (Knight ADRC, NIH grants P30AG066444, P01AG026276, P01AG003991), Dominantly Inherited Alzheimer Network (DIAN, NIH grants U01AG042791, U19AG03243808, R01AG052550-01A1, R01AG05255003), and the Barnes-Jewish Hospital Foundation Willman Scholar Fund.
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Affiliation(s)
- Stephanie Doering
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Austin McCullough
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Brian A Gordon
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Charles D Chen
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Nicole McKay
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Diana Hobbs
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Sarah Keefe
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Shaney Flores
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Jalen Scott
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Hunter Smith
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Stephen Jarman
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Kelley Jackson
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Russ C Hornbeck
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Beau M Ances
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Chengjie Xiong
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | | | - Jason Hassenstab
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Carlos Cruchaga
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Alisha Daniels
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - Randall J Bateman
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
| | - John C Morris
- Washington University in Saint Louis School of Medicine, Saint Louis, MO, USA
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Meeker KL, Luckett PH, Barthélemy NR, Hobbs DA, Chen C, Bollinger J, Ovod V, Flores S, Keefe S, Henson RL, Herries EM, McDade E, Hassenstab JJ, Xiong C, Cruchaga C, Benzinger TLS, Holtzman DM, Schindler SE, Bateman RJ, Morris JC, Gordon BA, Ances BM. Comparison of cerebrospinal fluid, plasma and neuroimaging biomarker utility in Alzheimer's disease. Brain Commun 2024; 6:fcae081. [PMID: 38505230 PMCID: PMC10950051 DOI: 10.1093/braincomms/fcae081] [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: 10/05/2023] [Revised: 02/01/2024] [Accepted: 03/14/2024] [Indexed: 03/21/2024] Open
Abstract
Alzheimer's disease biomarkers are crucial to understanding disease pathophysiology, aiding accurate diagnosis and identifying target treatments. Although the number of biomarkers continues to grow, the relative utility and uniqueness of each is poorly understood as prior work has typically calculated serial pairwise relationships on only a handful of markers at a time. The present study assessed the cross-sectional relationships among 27 Alzheimer's disease biomarkers simultaneously and determined their ability to predict meaningful clinical outcomes using machine learning. Data were obtained from 527 community-dwelling volunteers enrolled in studies at the Charles F. and Joanne Knight Alzheimer Disease Research Center at Washington University in St Louis. We used hierarchical clustering to group 27 imaging, CSF and plasma measures of amyloid beta, tau [phosphorylated tau (p-tau), total tau t-tau)], neuronal injury and inflammation drawn from MRI, PET, mass-spectrometry assays and immunoassays. Neuropsychological and genetic measures were also included. Random forest-based feature selection identified the strongest predictors of amyloid PET positivity across the entire cohort. Models also predicted cognitive impairment across the entire cohort and in amyloid PET-positive individuals. Four clusters emerged reflecting: core Alzheimer's disease pathology (amyloid and tau), neurodegeneration, AT8 antibody-associated phosphorylated tau sites and neuronal dysfunction. In the entire cohort, CSF p-tau181/Aβ40lumi and Aβ42/Aβ40lumi and mass spectrometry measurements for CSF pT217/T217, pT111/T111, pT231/T231 were the strongest predictors of amyloid PET status. Given their ability to denote individuals on an Alzheimer's disease pathological trajectory, these same markers (CSF pT217/T217, pT111/T111, p-tau/Aβ40lumi and t-tau/Aβ40lumi) were largely the best predictors of worse cognition in the entire cohort. When restricting analyses to amyloid-positive individuals, the strongest predictors of impaired cognition were tau PET, CSF t-tau/Aβ40lumi, p-tau181/Aβ40lumi, CSF pT217/217 and pT205/T205. Non-specific CSF measures of neuronal dysfunction and inflammation were poor predictors of amyloid PET and cognitive status. The current work utilized machine learning to understand the interrelationship structure and utility of a large number of biomarkers. The results demonstrate that, although the number of biomarkers has rapidly expanded, many are interrelated and few strongly predict clinical outcomes. Examining the entire corpus of available biomarkers simultaneously provides a meaningful framework to understand Alzheimer's disease pathobiological change as well as insight into which biomarkers may be most useful in Alzheimer's disease clinical practice and trials.
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Affiliation(s)
- Karin L Meeker
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Patrick H Luckett
- Department of Neurosurgery, Washington University in St Louis, St Louis, MO 63110, USA
| | - Nicolas R Barthélemy
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Diana A Hobbs
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Charles Chen
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - James Bollinger
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Vitaliy Ovod
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Shaney Flores
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Sarah Keefe
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Rachel L Henson
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Elizabeth M Herries
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - Jason J Hassenstab
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63110, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - David M Holtzman
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
| | - John C Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Brian A Gordon
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St Louis, St Louis, MO 63110, USA
- Department of Radiology, Washington University in St Louis, St Louis, MO 63110, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, MO 63110, USA
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11
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Zhou X, Tang A, Xiong C, Zhang G, Huang L, Xu F. Oriented Graphene Oxide Scaffold Promotes Nerve Regeneration in vitro and in vivo. Int J Nanomedicine 2024; 19:2573-2589. [PMID: 38505172 PMCID: PMC10949378 DOI: 10.2147/ijn.s439656] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/14/2024] [Indexed: 03/21/2024] Open
Abstract
Background Treating peripheral nerve injuries (PNI) with defects remains challenging in clinical practice. The commercial conduits have shown suboptimal nerve regeneration and functional recovery due to their basic tubular design without electroactive and oriented topographical cues. Purpose To develop a new scaffold with oriented microstructure and electroactive Graphene oxide (GO) and investigate its' therapeutic effect on nerve regeneration in vitro and in vivo. Methods This study employed a straightforward approach to co-spin PCL and GO, yielding an oriented hybrid nanofibrous scaffold known as the O-GO/PCL scaffold. The physical and chemical properties of nanofibrous scaffold were tested by scanning electron microscopy (SEM), transmission electron microscope (TEM), tensile test and so on. Primary Schwann cells (SCs) and dorsal root ganglia (DRG) were used to investigate the impact of the newly developed scaffolds on the biological behavior of neural cells in vitro. Transcriptome sequencing (mRNA-seq) was employed to probe the underlying mechanisms of the synergistic effect of electroactive GO and longitudinal topographic guidance on nerve regeneration. Furthermore, the developed O-GO/PCL scaffold was utilized to bridge a 10-mm sciatic nerve defect in rat, aiming to investigate its therapeutic potential for peripheral nerve regeneration in vivo. Results and discussion The SEM and TEM revealed that the newly developed O-GO/PCL scaffold showed longitudinally oriented microstructure and GO particles were homogenously and uniformly distributed inside the nanofibers. Primary SCs were utilized to assess the biocompatibility of the GO-based scaffold, revealing that negligible cytotoxicity when GO concentration does not exceed 0.5%. In vitro analysis of nerve regeneration demonstrated that axons in the O-GO/PCL group exhibited an average length of 1054.88 ± 161.32 µm, significant longer than those in the other groups (P < 0.05). Moreover, mRNA sequencing results suggested that the O-GO/PCL scaffold could enhance nerve regeneration by upregulating genes associated with neural regeneration, encompassing ion transport, axon guidance and cell-cell interactions. Most importantly, we employed the O-GO/PCL scaffold to repair a 10-mm sciatic nerve defect in rat, resulting in augmented nerve regeneration, myelination, and functional recovery. Conclusion The O-GO/PCL scaffold with oriented microstructure and electroactive GO represents a promising heral nerve reconstruction.
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Affiliation(s)
- Xu Zhou
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
| | - Aolin Tang
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
- Department of Orthopaedics, Minda Hospital of Hubei Minzu University, Enshi, 445000, People’s Republic of China
| | - Chengjie Xiong
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
| | - Guoquan Zhang
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
| | - Liangliang Huang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
| | - Feng Xu
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, People’s Republic of China
- Department of Orthopaedics, General Hospital of Central Theater Command, Wuhan, 430070, People’s Republic of China
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12
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Bonomi S, Lu R, Schindler SE, Bui Q, Lah JJ, Wolk D, Gleason CE, Sperling R, Roberson ED, Levey AI, Shaw L, Van Hulle C, Benzinger T, Adams M, Manzanares C, Qiu D, Hassenstab J, Moulder KL, Balls-Berry JE, Johnson K, Johnson SC, Murchison CF, Luo J, Gremminger E, Agboola F, Grant EA, Hornbeck R, Massoumzadeh P, Keefe S, Dierker D, Gray JD, Henson RL, Streitz M, Mechanic-Hamilton D, Morris JC, Xiong C. Relationships of Cognitive Measures with Cerebrospinal Fluid but Not Imaging Biomarkers of Alzheimer Disease Vary between Black and White Individuals. Ann Neurol 2024; 95:495-506. [PMID: 38038976 PMCID: PMC10922199 DOI: 10.1002/ana.26838] [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: 07/25/2023] [Revised: 11/02/2023] [Accepted: 11/10/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE Biomarkers of Alzheimer disease vary between groups of self-identified Black and White individuals in some studies. This study examined whether the relationships between biomarkers or between biomarkers and cognitive measures varied by racialized groups. METHODS Cerebrospinal fluid (CSF), amyloid positron emission tomography (PET), and magnetic resonance imaging measures were harmonized across four studies of memory and aging. Spearman correlations between biomarkers and between biomarkers and cognitive measures were calculated within each racialized group, then compared between groups by standard normal tests after Fisher's Z-transformations. RESULTS The harmonized dataset included at least one biomarker measurement from 495 Black and 2,600 White participants. The mean age was similar between racialized groups. However, Black participants were less likely to have cognitive impairment (28% vs 36%) and had less abnormality of some CSF biomarkers including CSF Aβ42/40, total tau, p-tau181, and neurofilament light. CSF Aβ42/40 was negatively correlated with total tau and p-tau181 in both groups, but at a smaller magnitude in Black individuals. CSF Aβ42/40, total tau, and p-tau181 had weaker correlations with cognitive measures, especially episodic memory, in Black than White participants. Correlations of amyloid measures between CSF (Aβ42/40, Aβ42) and PET imaging were also weaker in Black than White participants. Importantly, no differences based on race were found in correlations between different imaging biomarkers, or in correlations between imaging biomarkers and cognitive measures. INTERPRETATION Relationships between CSF biomarkers but not imaging biomarkers varied by racialized groups. Imaging biomarkers performed more consistently across racialized groups in associations with cognitive measures. ANN NEUROL 2024;95:495-506.
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Affiliation(s)
- Samuele Bonomi
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ruijin Lu
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Suzanne E. Schindler
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Quoc Bui
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - James J. Lah
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA
| | - David Wolk
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Carey E. Gleason
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Disease Research Center, Madison, Wisconsin, USA
- Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Reisa Sperling
- Department of Neurology, Center for Alzheimer Research and Treatment, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Erik D. Roberson
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer’s Disease Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Allan I. Levey
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA
| | - Leslie Shaw
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Carol Van Hulle
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Disease Research Center, Madison, Wisconsin, USA
| | - Tammie Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Morgann Adams
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Cecelia Manzanares
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA
| | - Deqiang Qiu
- Goizueta Alzheimer’s Disease Research Center, Emory University, Atlanta, GA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Krista L. Moulder
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Joyce E. Balls-Berry
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Keith Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sterling C. Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
- Wisconsin Alzheimer’s Disease Research Center, Madison, Wisconsin, USA
- Geriatric Research, Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin, USA
| | - Charles F. Murchison
- Center for Neurodegeneration and Experimental Therapeutics, Alzheimer’s Disease Center, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jingqin Luo
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Emily Gremminger
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Folasade Agboola
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Elizabeth A. Grant
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Russ Hornbeck
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Parinaz Massoumzadeh
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Sarah Keefe
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Donna Dierker
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Julia D. Gray
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Rachel L. Henson
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Marissa Streitz
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Dawn Mechanic-Hamilton
- Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Wang C, Chen J, Li J, Xu Z, Huang L, Zhao Q, Chen L, Liang X, Hu H, Li G, Xiong C, Wu B, You H, Du D, Wang X, Li H, Wang Z, Chen L. An EBV-related CD4 TCR immunotherapy inhibits tumor growth in an HLA-DP5+ nasopharyngeal cancer mouse model. J Clin Invest 2024; 134:e172092. [PMID: 38412034 PMCID: PMC11014665 DOI: 10.1172/jci172092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 02/24/2024] [Indexed: 02/29/2024] Open
Abstract
Adoptive transfer of T cell receptor-engineered T cells (TCR-T) is a promising strategy for immunotherapy against solid tumors. However, the potential of CD4+ T cells in mediating tumor regression has been neglected. Nasopharyngeal cancer is consistently associated with EBV. Here, to evaluate the therapeutic potential of CD4 TCR-T in nasopharyngeal cancer, we screened for CD4 TCRs recognizing EBV nuclear antigen 1 (EBNA1) presented by HLA-DP5. Using mass spectrometry, we identified EBNA1567-581, a peptide naturally processed and presented by HLA-DP5. We isolated TCR135, a CD4 TCR with high functional avidity, that can function in both CD4+ and CD8+ T cells and recognizes HLA-DP5-restricted EBNA1567-581. TCR135-transduced T cells functioned in two ways: directly killing HLA-DP5+EBNA1+ tumor cells after recognizing EBNA1 presented by tumor cells and indirectly killing HLA-DP5-negative tumor cells after recognizing EBNA1 presented by antigen-presenting cells. TCR135-transduced T cells preferentially infiltrated into the tumor microenvironment and significantly inhibited tumor growth in xenograft nasopharyngeal tumor models. Additionally, we found that 62% of nasopharyngeal cancer patients showed 50%-100% expression of HLA-DP on tumor cells, indicating that nasopharyngeal cancer is well suited for CD4 TCR-T therapy. These findings suggest that TCR135 may provide a new strategy for EBV-related nasopharyngeal cancer immunotherapy in HLA-DP5+ patients.
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Affiliation(s)
- Chenwei Wang
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jiewen Chen
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingyao Li
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhihong Xu
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lihong Huang
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Qian Zhao
- State Key Laboratory of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
| | - Lei Chen
- State Key Laboratory of Chemical Biology and Drug Discovery, Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China
- Laboratory for Synthetic Chemistry and Chemical Biology Limited, Hong Kong, China
| | - Xiaolong Liang
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hai Hu
- Department of Pathology, Air Force Hospital of Southern Theater Command, Guangzhou, Guangdong, China
| | - Gang Li
- Department of Otolaryngology–Head and Neck Surgery, Huiqiao Medicine Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chengjie Xiong
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Bin Wu
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hua You
- Laboratory for Excellence in Systems Biomedicine of Pediatric Oncology, Department of Pediatric Hematology and Oncology, Children’s Hospital of Chongqing Medical University, Chongqing, China
| | - Danyi Du
- Department of Otolaryngology–Head and Neck Surgery, Precision Medical Center, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiaoling Wang
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hongle Li
- Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Zibing Wang
- Department of Immunotherapy, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, Henan, China
| | - Lin Chen
- Guangzhou Medical University–Guangzhou Institute of Biomedicine and Health (GMU-GIBH) Joint School of Life Sciences and Guangdong–Hong Kong–Macau Joint Laboratory for Cell Fate Regulation and Diseases, Guangzhou Medical University, Guangzhou, Guangdong, China
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Xiong C, Schindler SE, Henson RL, Wolk D, Shaw LM, Agboola F, Morris JC, Lu R, Luo J. Correlational analyses of biomarkers that are harmonized through a bridging study due to measurement errors. Stat Methods Med Res 2024; 33:185-202. [PMID: 37994004 PMCID: PMC10939855 DOI: 10.1177/09622802231215810] [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: 11/24/2023]
Abstract
Evaluating correlations between disease biomarkers and clinical outcomes is crucial in biomedical research. During the early stages of many chronic diseases, changes in biomarkers and clinical outcomes are often subtle. A major challenge to detecting subtle correlations is that studies with large sample sizes are usually needed to achieve sufficient statistical power. This challenge is even greater when biofluid and imaging biomarker data are used because the required procedures are burdensome, perceived as invasive, and/or expensive, limiting sample sizes in individual studies. Combining data across multiple studies may increase statistical power, but biomarker data may be generated using different assay platforms, scanner types, or processing protocols, which may affect measured biomarker values. Therefore, harmonizing biomarker data is essential to combining data across studies. Bridging studies involve re-processing of a subset of samples or imaging scans to evaluate how biomarker values vary by studies. This presents an analytic challenge on how to best harmonize biomarker data across studies to allow unbiased and optimal estimates of their correlations with standardized clinical outcomes. We conceptualize that a latent biomarker underlies the observed biomarkers across studies, and propose a novel approach that integrates the data in the bridging study with the study-specific biomarker data for estimating the biological correlations between biomarkers and clinical outcomes. Through extensive simulations, we compare our method to several alternative methods/algorithms often used to estimate the correlations. Finally, we demonstrate the application of this methodology to a real-world multi-center Alzheimer's disease biomarker study to correlate cerebrospinal fluid biomarker concentrations with cognitive outcomes.
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Affiliation(s)
- Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Suzanne E. Schindler
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Rachel L. Henson
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - David Wolk
- Perelman School of Medicine, University of Pennsylvania
| | - Leslie M. Shaw
- Perelman School of Medicine, University of Pennsylvania
- Department of Pathology and Laboratory Medicine, University of Pennsylvania
| | - Folasade Agboola
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Departments of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ruijin Lu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jingqin Luo
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Siteman Cancer Center Biostatistics Core, Washington University School of Medicine, St. Louis, MO, USA
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15
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Xiong C, Schindler S, Luo J, Morris J, Bateman R, Holtzman D, Cruchaga C, Babulal G, Henson R, Benzinger T, Bui Q, Agboola F, Grant E, Emily G, Moulder K, Geldmacher D, Clay O, Roberson E, Murchison C, Wolk D, Shaw L. Baseline levels and longitudinal rates of change in plasma Aβ42/40 among self-identified Black/African American and White individuals. Res Sq 2024:rs.3.rs-3783571. [PMID: 38260384 PMCID: PMC10802715 DOI: 10.21203/rs.3.rs-3783571/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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
Objective The use of blood-based biomarkers of Alzheimer disease (AD) may facilitate access to biomarker testing of groups that have been historically under-represented in research. We evaluated whether plasma Aβ42/40 has similar or different baseline levels and longitudinal rates of change in participants racialized as Black or White. Methods The Study of Race to Understand Alzheimer Biomarkers (SORTOUT-AB) is a multi-center longitudinal study to evaluate for potential differences in AD biomarkers between individuals racialized as Black or White. Plasma samples collected at three AD Research Centers (Washington University, University of Pennsylvania, and University of Alabama-Birmingham) underwent analysis with C2N Diagnostics' PrecivityAD™ blood test for Aβ42 and Aβ40. General linear mixed effects models were used to estimate the baseline levels and rates of longitudinal change for plasma Aβ measures in both racial groups. Analyses also examined whether dementia status, age, sex, education, APOE ε4 carrier status, medical comorbidities, or fasting status modified potential racial differences. Results Of the 324 Black and 1,547 White participants, there were 158 Black and 759 White participants with plasma Aβ measures from at least two longitudinal samples over a mean interval of 6.62 years. At baseline, the group of Black participants had lower levels of plasma Aβ40 but similar levels of plasma Aβ42 as compared to the group of White participants. As a result, baseline plasma Aβ42/40 levels were higher in the Black group than the White group, consistent with the Black group having lower levels of amyloid pathology. Racial differences in plasma Aβ42/40 were not modified by age, sex, education, APOE ε4 carrier status, medical conditions (hypertension and diabetes), or fasting status. Despite differences in baseline levels, the Black and White groups had a similar longitudinal rate of change in plasma Aβ42/40. Interpretation Black individuals participating in AD research studies had a higher mean level of plasma Aβ42/40, consistent with a lower level of amyloid pathology, which, if confirmed, may imply a lower proportion of Black individuals being eligible for AD clinical trials in which the presence of amyloid is a prerequisite. However, there was no significant racial difference in the rate of change in plasma Aβ42/40, suggesting that amyloid pathology accumulates similarly across racialized groups.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Quoc Bui
- Washington University School of Medicine
| | | | | | | | | | | | | | | | | | - David Wolk
- Department of Neurology, University of Pennsylvania
| | - Leslie Shaw
- Perelman School of Medicine, University of Pennsylvania
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Wagemann O, Li Y, Hassenstab J, Aschenbrenner AJ, McKay NS, Gordon BA, Benzinger TLS, Xiong C, Cruchaga C, Renton AE, Perrin RJ, Berman SB, Chhatwal JP, Farlow MR, Day GS, Ikeuchi T, Jucker M, Lopera F, Mori H, Noble JM, Sánchez-Valle R, Schofield PR, Morris JC, Daniels A, Levin J, Bateman RJ, McDade E, Llibre-Guerra JJ. Investigation of sex differences in mutation carriers of the Dominantly Inherited Alzheimer Network. Alzheimers Dement 2024; 20:47-62. [PMID: 37740921 PMCID: PMC10841236 DOI: 10.1002/alz.13460] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 09/25/2023]
Abstract
INTRODUCTION Studies suggest distinct differences in the development, presentation, progression, and response to treatment of Alzheimer's disease (AD) between females and males. We investigated sex differences in cognition, neuroimaging, and fluid biomarkers in dominantly inherited AD (DIAD). METHODS Three hundred twenty-five mutation carriers (55% female) and one hundred eighty-six non-carriers (58% female) of the Dominantly Inherited Alzheimer Network Observational Study were analyzed. Linear mixed models and Spearman's correlation explored cross-sectional sex differences in cognition, cerebrospinal fluid (CSF) biomarkers, Pittsburgh compound B positron emission tomography (11 C-PiB PET) and structural magnetic resonance imaging (MRI). RESULTS Female carriers performed better than males on delayed recall and processing speed despite similar hippocampal volumes. As the disease progressed, symptomatic females revealed higher increases in MRI markers of neurodegeneration and memory impairment. PiB PET and established CSF AD markers revealed no sex differences. DISCUSSION Our findings suggest an initial cognitive reserve in female carriers followed by a pronounced increase in neurodegeneration coupled with worse performance on delayed recall at later stages of DIAD.
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Affiliation(s)
- Olivia Wagemann
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Yan Li
- Department of Biostatistics, Washington University St. Louis, St. Louis, Missouri, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
| | | | - Nicole S McKay
- Department of Radiology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Brian A Gordon
- Department of Radiology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Department of Biostatistics, Washington University St. Louis, St. Louis, Missouri, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University St. Louis, St. Louis, Missouri, USA
| | - Alan E Renton
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard J Perrin
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General and Brigham & Female's Hospitals, Harvard Medical School, Boston, Massachusetts, USA
| | - Martin R Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, Florida, USA
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Mathias Jucker
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia (GNA), Universidad de Antioquia, Medellin, Colombia
| | - Hiroshi Mori
- Department of Clinical Neuroscience, Osaka Metropolitan University Medical School, Nagaoka Sutoku University, Osaka, Japan
| | - James M Noble
- Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Raquel Sánchez-Valle
- Department of Neurology, Hospital Clínic de Barcelona (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - John C Morris
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Alisha Daniels
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Randall J Bateman
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
| | - Eric McDade
- Department of Neurology, Washington University St. Louis, St. Louis, Missouri, USA
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Xiong C, Chen P, Jiang ML, Chang BW, Niu CS. [Early brain imaging changes and its influence on electrode impedance after implantation of 3.0 T MRI-compatible deep brain stimulation system in Parkinson's disease subthalamic nucleus]. Zhonghua Yi Xue Za Zhi 2023; 103:3809-3815. [PMID: 38123221 DOI: 10.3760/cma.j.cn112137-20231009-00682] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To analyze the imaging changes of in the early period after subthalamic nucleus (STN) deep brain stimulation (DBS) surgery for Parkinson's disease (PD) and its impact on electrode impedance by the application of 3.0T MRI-compatible devices. Methods: A retrospective analysis was performed for the data of 43 PD patients who underwent 3.0T MRI-compatible STN-DBS surgery from October 2022 to April 2023 at the First Affiliated Hospital of USTC(Anhui Provincial Hospital), including 27 males and 16 females, aged 43-68 (56±5) years. All patients underwent postoperative 3.0T MRI, CT scans,and impedance measurements 1 week postoperatively.Fifteen patients underwent 3.0T MRI and impedance measurements 1 month postoperatively. The differences in impedance of electrode contacts before and after the 3.0T MRI scans were compared. The occurrence of peri-lead cerebral edema (PLE) in patients was analyzed, as well as the differences in PLE detection rates between the two imaging methods, and the differences in the incidence and volume of PLE at different microelectrode recordings, the occurrence and detection of postoperative PLE, and different microelectrode recording (MER) times and different time nodes were compared. The correlation between electrode impedance and the volume of edema around the nucleus was analyzed. Results: All 43 patients successfully underwent surgery, with a total of 86 electrodes implanted. There was no significant difference in electrode impedance values before and after the 3.0T MRI examinations at 1 week and 1 month postoperatively. The PLE detection rate with 3.0T MRI was 95.12%(39/43), which is significantly higher than that of CT imaging 17.07% (7/43)(χ2=50.705, P<0.001). One week after surgery, the incidence and volume of PLE were higher in the multiple MER group compared with the single MER group, but the difference was not statistically significant. The volume of PLE [M(Q1, Q3) 0 (0, 1.211) cm3] at 1 month was significantly smaller than that at 1 week [0.243 (0, 2.914) cm3] (Z=-3.408, P=0.001). The impedance of electrode contacts within 1 month postoperatively showed a trend of initial decrease followed by an increase, which was negatively correlated with SE volume(r=-0.317, P=0.014). Conclusions: The application of 3.0T MRI-compatible DBS devices in the surgical treatment of PD patients improves the accuracy of early postoperative imaging assessment. The electrode impedance is more stable as the edema around the nucleus subsided at 1 month after surgery, which is suitable for the first program control.
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Affiliation(s)
- C Xiong
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - P Chen
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - M L Jiang
- Department of Neuroelectrophysiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - B W Chang
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - C S Niu
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
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18
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Chen P, Xiong C, Jiang ML, Zhuang HX, Mei JM, Niu CS. [Analysis of complications and learning curve effects related to deep brain stimulation surgery in 822 Parkinson's disesase patients with the same surgeon]. Zhonghua Yi Xue Za Zhi 2023; 103:3822-3827. [PMID: 38123223 DOI: 10.3760/cma.j.cn112137-20231030-00945] [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] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Objective: To analyze the complications related to deep brain stimulation(DBS) surgery in Parkinson's disease(PD) patients and to determine whether there is a learning curve effect in terms of complications. Methods: Retrospective analysis of the DBS surgical data of 822 PD patients performed by the same surgeon at the First Affiliated Hospital of the University of Science and Technology of China (Anhui Provincial Hospital) from December 2012 to December 2022. The complications related to DBS were evaluated and analyzed the complications of every 100 DBS surgery were further analyzed. Results: A total of 822 PD patients, 453 males and 369 females, aged 31-80 years old, were included. The minimum follow-up period after DBS surgery is 6 months. Surgical related complications occurred in 55 patients (6.69%), including 5 patients (0.61%) with slight bleeding around the electrode, 1 patient (0.12%) with cerebral infarction, 4 patients (0.49%) with postoperative epilepsy, 42 patients (5.11%) with postoperative delirium, 2 patients (0.24%) with respiratory distress, and 1 patient (0.12%) with acute cardiac insufficiency. There were 16 cases (1.94%) of hardware related complications in DBS, of which 4 cases (0.48%) had infection, 1 case (0.12%) had a broken angle at the connection between the pulse generator and the extension wire, 8 cases (0.97%) had an excessively tight extension wire, and 3 cases (0.36%) had an IPG bag hematoma. In the infected cases, 2 patients removed IPG and extension wires. There were 7 cases (0.85%) of stimulus related complications, including 4 cases (0.61%) with programmed sensory abnormalities, 1 case (0.12%) with postoperative abnormal movements and dance like movements, and 2 cases (0.24%) with psychiatric symptoms. A comprehensive analysis was conducted on the above complications, among which 8 cases (0.97%) were relatively serious complications. After active treatment, satisfactory results were achieved, and none of them affected the patient's DBS treatment effect and no patients died. For every 100 cases of DBS surgery complications were analyzed, the percentage of complications decreased significantly from 14.50% (58 cases) in the first 400 cases to 4.73% (20 cases) in the last 400 cases (P<0.001). Conclusion: DBS surgery is safe and has an acceptable low incidence of complications. The incidence of complications also decreases with the accumulation of experience, showing a learning curve effect.
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Affiliation(s)
- P Chen
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - C Xiong
- Department of Neuroelectrophysiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - M L Jiang
- Department of Neuroelectrophysiology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230036, China
| | - H X Zhuang
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - J M Mei
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
| | - C S Niu
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Anhui Provincial Key Laboratory of Brain Function and Disease, Hefei 230001, China
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Millar PR, Gordon BA, Wisch JK, Schultz SA, Benzinger TL, Cruchaga C, Hassenstab JJ, Ibanez L, Karch C, Llibre-Guerra JJ, Morris JC, Perrin RJ, Supnet-Bell C, Xiong C, Allegri RF, Berman SB, Chhatwal JP, Chrem Mendez PA, Day GS, Hofmann A, Ikeuchi T, Jucker M, Lee JH, Levin J, Lopera F, Niimi Y, Sánchez-González VJ, Schofield PR, Sosa-Ortiz AL, Vöglein J, Bateman RJ, Ances BM, McDade EM. Advanced structural brain aging in preclinical autosomal dominant Alzheimer disease. Mol Neurodegener 2023; 18:98. [PMID: 38111006 PMCID: PMC10729487 DOI: 10.1186/s13024-023-00688-3] [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: 07/03/2023] [Accepted: 11/28/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND "Brain-predicted age" estimates biological age from complex, nonlinear features in neuroimaging scans. The brain age gap (BAG) between predicted and chronological age is elevated in sporadic Alzheimer disease (AD), but is underexplored in autosomal dominant AD (ADAD), in which AD progression is highly predictable with minimal confounding age-related co-pathology. METHODS We modeled BAG in 257 deeply-phenotyped ADAD mutation-carriers and 179 non-carriers from the Dominantly Inherited Alzheimer Network using minimally-processed structural MRI scans. We then tested whether BAG differed as a function of mutation and cognitive status, or estimated years until symptom onset, and whether it was associated with established markers of amyloid (PiB PET, CSF amyloid-β-42/40), phosphorylated tau (CSF and plasma pTau-181), neurodegeneration (CSF and plasma neurofilament-light-chain [NfL]), and cognition (global neuropsychological composite and CDR-sum of boxes). We compared BAG to other MRI measures, and examined heterogeneity in BAG as a function of ADAD mutation variants, APOE ε4 carrier status, sex, and education. RESULTS Advanced brain aging was observed in mutation-carriers approximately 7 years before expected symptom onset, in line with other established structural indicators of atrophy. BAG was moderately associated with amyloid PET and strongly associated with pTau-181, NfL, and cognition in mutation-carriers. Mutation variants, sex, and years of education contributed to variability in BAG. CONCLUSIONS We extend prior work using BAG from sporadic AD to ADAD, noting consistent results. BAG associates well with markers of pTau, neurodegeneration, and cognition, but to a lesser extent, amyloid, in ADAD. BAG may capture similar signal to established MRI measures. However, BAG offers unique benefits in simplicity of data processing and interpretation. Thus, results in this unique ADAD cohort with few age-related confounds suggest that brain aging attributable to AD neuropathology can be accurately quantified from minimally-processed MRI.
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Affiliation(s)
- Peter R Millar
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA.
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Julie K Wisch
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Stephanie A Schultz
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Tammie Ls Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Jason J Hassenstab
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura Ibanez
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
- NeuroGenomics & Informatics Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Celeste Karch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | | | - John C Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Pathology & Immunology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Chengjie Xiong
- Department of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Anna Hofmann
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), 72076, Tübingen, Germany
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076, Tübingen, Germany
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | | - Yoshiki Niimi
- Unit for Early and Exploratory Clinical Development, The University of Tokyo Hospital, Bunkyo-Ku, Tokyo, Japan
| | - Victor J Sánchez-González
- Departamento de Clínicas, CUALTOS, Universidad de Guadalajara, Tepatitlán de Morelos, Jalisco, México
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Ana Luisa Sosa-Ortiz
- Instituto Nacional de Neurologia y Neurocirugía MVS, CDMX, Ciudad de México, Mexico
| | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
| | - Randall J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Eric M McDade
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
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Chen G, McKay NS, Gordon BA, Liu J, Joseph-Mathurin N, Schindler SE, Hassenstab J, Aschenbrenner AJ, Wang Q, Schultz SA, Su Y, LaMontagne PJ, Keefe SJ, Massoumzadeh P, Cruchaga C, Xiong C, Morris JC, Benzinger TLS. Predicting cognitive decline: Which is more useful, baseline amyloid levels or longitudinal change? Neuroimage Clin 2023; 41:103551. [PMID: 38150745 PMCID: PMC10788301 DOI: 10.1016/j.nicl.2023.103551] [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: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/29/2023]
Abstract
The use of biomarkers for the early detection of Alzheimer's disease (AD) is crucial for developing potential therapeutic treatments. Positron Emission Tomography (PET) is a well-established tool used to detect β-amyloid (Aβ) plaques in the brain. Previous studies have shown that cross-sectional biomarkers can predict cognitive decline (Schindler et al.,2021). However, it is still unclear whether longitudinal Aβ-PET may have additional value for predicting time to cognitive impairment in AD. The current study aims to evaluate the ability of baseline- versus longitudinal rate of change in-11C-Pittsburgh compound B (PiB) Aβ-PET to predict cognitive decline. A cohort of 153 participants who previously underwent PiB-PET scans and comprehensive clinical assessments were used in this study. Our analyses revealed that baseline Aβ is significantly associated with the rate of change in cognitive composite scores, with cognition declining more rapidly when baseline PiB Aβ levels were higher. In contrast, no signification association was identified between the rate of change in PiB-PET Aβ and cognitive decline. Additionally, the ability of the rate of change in the PiB-PET measures to predict cognitive decline was significantly influenced by APOE ε4 carrier status. These results suggest that a single PiB-PET scan is sufficient to predict cognitive decline and that longitudinal measures of Aβ accumulation do not improve the prediction of cognitive decline once someone is amyloid positive.
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Affiliation(s)
- Gengsheng Chen
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nicole S McKay
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jingxia Liu
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Andrew J Aschenbrenner
- Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Qing Wang
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Stephanie A Schultz
- Department of Neurology Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | - Pamela J LaMontagne
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Sarah J Keefe
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Parinaz Massoumzadeh
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Divison of Biostatistics, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Departments of Radiology, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Knight Alzheimer's Disease Research Center, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St. Louis School of Medicine, St. Louis, MO, USA.
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21
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Rahmani F, Brier MR, Gordon BA, McKay N, Flores S, Keefe S, Hornbeck R, Ances B, Joseph‐Mathurin N, Xiong C, Wang G, Raji CA, Libre‐Guerra JJ, Perrin RJ, McDade E, Daniels A, Karch C, Day GS, Brickman AM, Fulham M, Jack CR, la La Fougère C, Reischl G, Schofield PR, Oh H, Levin J, Vöglein J, Cash DM, Yakushev I, Ikeuchi T, Klunk WE, Morris JC, Bateman RJ, Benzinger TLS. T1 and FLAIR signal intensities are related to tau pathology in dominantly inherited Alzheimer disease. Hum Brain Mapp 2023; 44:6375-6387. [PMID: 37867465 PMCID: PMC10681640 DOI: 10.1002/hbm.26514] [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: 07/24/2023] [Revised: 09/17/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
Carriers of mutations responsible for dominantly inherited Alzheimer disease provide a unique opportunity to study potential imaging biomarkers. Biomarkers based on routinely acquired clinical MR images, could supplement the extant invasive or logistically challenging) biomarker studies. We used 1104 longitudinal MR, 324 amyloid beta, and 87 tau positron emission tomography imaging sessions from 525 participants enrolled in the Dominantly Inherited Alzheimer Network Observational Study to extract novel imaging metrics representing the mean (μ) and standard deviation (σ) of standardized image intensities of T1-weighted and Fluid attenuated inversion recovery (FLAIR) MR scans. There was an exponential decrease in FLAIR-μ in mutation carriers and an increase in FLAIR and T1 signal heterogeneity (T1-σ and FLAIR-σ) as participants approached the symptom onset in both supramarginal, the right postcentral and right superior temporal gyri as well as both caudate nuclei, putamina, thalami, and amygdalae. After controlling for the effect of regional atrophy, FLAIR-μ decreased and T1-σ and FLAIR-σ increased with increasing amyloid beta and tau deposition in numerous cortical regions. In symptomatic mutation carriers and independent of the effect of regional atrophy, tau pathology demonstrated a stronger relationship with image intensity metrics, compared with amyloid pathology. We propose novel MR imaging intensity-based metrics using standard clinical T1 and FLAIR images which strongly associates with the progression of pathology in dominantly inherited Alzheimer disease. We suggest that tau pathology may be a key driver of the observed changes in this cohort of patients.
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Affiliation(s)
| | | | - Brian A. Gordon
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Nicole McKay
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Shaney Flores
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Sarah Keefe
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Russ Hornbeck
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Beau Ances
- Washington University School of MedicineSt. LouisMissouriUSA
| | | | - Chengjie Xiong
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Guoqiao Wang
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Cyrus A. Raji
- Washington University School of MedicineSt. LouisMissouriUSA
| | | | | | - Eric McDade
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Alisha Daniels
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Celeste Karch
- Washington University School of MedicineSt. LouisMissouriUSA
| | - Gregory S. Day
- Mayo Clinic, Department of NeurologyJacksonvilleFloridaUSA
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer's Disease & the Aging Brain, and Department of Neurology College of Physicians and SurgeonsColumbia UniversityNew YorkNew YorkUSA
| | | | | | - Christian la La Fougère
- Department of Nuclear Medicine and Clinical Molecular ImagingUniversity Hospital TuebingenTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) TuebingenTübingenGermany
- Department of Preclinical Imaging and RadiopharmacyEberhard Karls University TübingenTübingenGermany
| | - Gerald Reischl
- Department of Nuclear Medicine and Clinical Molecular ImagingUniversity Hospital TuebingenTübingenGermany
- German Center for Neurodegenerative Diseases (DZNE) TuebingenTübingenGermany
- Department of Preclinical Imaging and RadiopharmacyEberhard Karls University TübingenTübingenGermany
| | - Peter R. Schofield
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- School of Biomedical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Hwamee Oh
- Brown UniversityProvidenceRhode IslandUSA
| | - Johannes Levin
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- German Center for Neurodegenerative Diseases (DZNE), site MunichMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | - Jonathan Vöglein
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- German Center for Neurodegenerative Diseases (DZNE), site MunichMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | - David M. Cash
- UK Dementia Research Institute at University College LondonLondonUK
- Dementia Research CentreUCL Queen Square Institute of NeurologyLondonUK
| | - Igor Yakushev
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- German Center for Neurodegenerative Diseases (DZNE), site MunichMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | | | | | - John C. Morris
- Washington University School of MedicineSt. LouisMissouriUSA
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Shirzadi Z, Schultz SA, Yau WYW, Joseph-Mathurin N, Fitzpatrick CD, Levin R, Kantarci K, Preboske GM, Jack CR, Farlow MR, Hassenstab J, Jucker M, Morris JC, Xiong C, Karch CM, Levey AI, Gordon BA, Schofield PR, Salloway SP, Perrin RJ, McDade E, Levin J, Cruchaga C, Allegri RF, Fox NC, Goate A, Day GS, Koeppe R, Chui HC, Berman S, Mori H, Sanchez-Valle R, Lee JH, Rosa-Neto P, Ruthirakuhan M, Wu CY, Swardfager W, Benzinger TLS, Sohrabi HR, Martins RN, Bateman RJ, Johnson KA, Sperling RA, Greenberg SM, Schultz AP, Chhatwal JP. Etiology of White Matter Hyperintensities in Autosomal Dominant and Sporadic Alzheimer Disease. JAMA Neurol 2023; 80:1353-1363. [PMID: 37843849 PMCID: PMC10580156 DOI: 10.1001/jamaneurol.2023.3618] [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: 06/02/2023] [Accepted: 06/26/2023] [Indexed: 10/17/2023]
Abstract
Importance Increased white matter hyperintensity (WMH) volume is a common magnetic resonance imaging (MRI) finding in both autosomal dominant Alzheimer disease (ADAD) and late-onset Alzheimer disease (LOAD), but it remains unclear whether increased WMH along the AD continuum is reflective of AD-intrinsic processes or secondary to elevated systemic vascular risk factors. Objective To estimate the associations of neurodegeneration and parenchymal and vessel amyloidosis with WMH accumulation and investigate whether systemic vascular risk is associated with WMH beyond these AD-intrinsic processes. Design, Setting, and Participants This cohort study used data from 3 longitudinal cohort studies conducted in tertiary and community-based medical centers-the Dominantly Inherited Alzheimer Network (DIAN; February 2010 to March 2020), the Alzheimer's Disease Neuroimaging Initiative (ADNI; July 2007 to September 2021), and the Harvard Aging Brain Study (HABS; September 2010 to December 2019). Main Outcome and Measures The main outcomes were the independent associations of neurodegeneration (decreases in gray matter volume), parenchymal amyloidosis (assessed by amyloid positron emission tomography), and vessel amyloidosis (evidenced by cerebral microbleeds [CMBs]) with cross-sectional and longitudinal WMH. Results Data from 3960 MRI sessions among 1141 participants were included: 252 pathogenic variant carriers from DIAN (mean [SD] age, 38.4 [11.2] years; 137 [54%] female), 571 older adults from ADNI (mean [SD] age, 72.8 [7.3] years; 274 [48%] female), and 318 older adults from HABS (mean [SD] age, 72.4 [7.6] years; 194 [61%] female). Longitudinal increases in WMH volume were greater in individuals with CMBs compared with those without (DIAN: t = 3.2 [P = .001]; ADNI: t = 2.7 [P = .008]), associated with longitudinal decreases in gray matter volume (DIAN: t = -3.1 [P = .002]; ADNI: t = -5.6 [P < .001]; HABS: t = -2.2 [P = .03]), greater in older individuals (DIAN: t = 6.8 [P < .001]; ADNI: t = 9.1 [P < .001]; HABS: t = 5.4 [P < .001]), and not associated with systemic vascular risk (DIAN: t = 0.7 [P = .40]; ADNI: t = 0.6 [P = .50]; HABS: t = 1.8 [P = .06]) in individuals with ADAD and LOAD after accounting for age, gray matter volume, CMB presence, and amyloid burden. In older adults without CMBs at baseline, greater WMH volume was associated with CMB development during longitudinal follow-up (Cox proportional hazards regression model hazard ratio, 2.63; 95% CI, 1.72-4.03; P < .001). Conclusions and Relevance The findings suggest that increased WMH volume in AD is associated with neurodegeneration and parenchymal and vessel amyloidosis but not with elevated systemic vascular risk. Additionally, increased WMH volume may represent an early sign of vessel amyloidosis preceding the emergence of CMBs.
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Affiliation(s)
- Zahra Shirzadi
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Stephanie A. Schultz
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Wai-Ying W. Yau
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | | | - Colleen D. Fitzpatrick
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Raina Levin
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | | | | | | | - Jason Hassenstab
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Mathias Jucker
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Tübingen, Germany
| | - John C. Morris
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Chengjie Xiong
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Celeste M. Karch
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | | | - Brian A. Gordon
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | | | - Richard J. Perrin
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Eric McDade
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, German Center for Neurodegenerative Diseases, site Munich, Munich Cluster for Systems Neurology, Munich, Germany
| | - Carlos Cruchaga
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | | | - Nick C. Fox
- UK Dementia Research Institute, University College London, London, United Kingdom
| | - Alison Goate
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor
| | - Helena C. Chui
- Keck School of Medicine, University of Southern California, Los Angeles
| | - Sarah Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Hiroshi Mori
- Osaka Metropolitan University Medical School, Osaka, Nagaoka Sutoku University, Osaka City, Niigata, Japan
| | | | - Jae-Hong Lee
- Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Pedro Rosa-Neto
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Myuri Ruthirakuhan
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Che-Yuan Wu
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Walter Swardfager
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | | | - Hamid R. Sohrabi
- Centre for Healthy Ageing, School of Psychology, Health Future Institute, Murdoch University, Perth, Western Australia, Australia
| | - Ralph N. Martins
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Randall J. Bateman
- Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Reisa A. Sperling
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Steven M. Greenberg
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Aaron P. Schultz
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
| | - Jasmeer P. Chhatwal
- Massachusetts General Hospital, Brigham and Women’s Hospital, Harvard Medical School, Boston
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23
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Llibre-Guerra JJ, Iaccarino L, Coble D, Edwards L, Li Y, McDade E, Strom A, Gordon B, Mundada N, Schindler SE, Tsoy E, Ma Y, Lu R, Fagan AM, Benzinger TLS, Soleimani-Meigooni D, Aschenbrenner AJ, Miller Z, Wang G, Kramer JH, Hassenstab J, Rosen HJ, Morris JC, Miller BL, Xiong C, Perrin RJ, Allegri R, Chrem P, Surace E, Berman SB, Chhatwal J, Masters CL, Farlow MR, Jucker M, Levin J, Fox NC, Day G, Gorno-Tempini ML, Boxer AL, La Joie R, Rabinovici GD, Bateman R. Longitudinal clinical, cognitive and biomarker profiles in dominantly inherited versus sporadic early-onset Alzheimer's disease. Brain Commun 2023; 5:fcad280. [PMID: 37942088 PMCID: PMC10629466 DOI: 10.1093/braincomms/fcad280] [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: 06/01/2023] [Revised: 10/02/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
Approximately 5% of Alzheimer's disease cases have an early age at onset (<65 years), with 5-10% of these cases attributed to dominantly inherited mutations and the remainder considered as sporadic. The extent to which dominantly inherited and sporadic early-onset Alzheimer's disease overlap is unknown. In this study, we explored the clinical, cognitive and biomarker profiles of early-onset Alzheimer's disease, focusing on commonalities and distinctions between dominantly inherited and sporadic cases. Our analysis included 117 participants with dominantly inherited Alzheimer's disease enrolled in the Dominantly Inherited Alzheimer Network and 118 individuals with sporadic early-onset Alzheimer's disease enrolled at the University of California San Francisco Alzheimer's Disease Research Center. Baseline differences in clinical and biomarker profiles between both groups were compared using t-tests. Differences in the rates of decline were compared using linear mixed-effects models. Individuals with dominantly inherited Alzheimer's disease exhibited an earlier age-at-symptom onset compared with the sporadic group [43.4 (SD ± 8.5) years versus 54.8 (SD ± 5.0) years, respectively, P < 0.001]. Sporadic cases showed a higher frequency of atypical clinical presentations relative to dominantly inherited (56.8% versus 8.5%, respectively) and a higher frequency of APOE-ε4 (50.0% versus 28.2%, P = 0.001). Compared with sporadic early onset, motor manifestations were higher in the dominantly inherited cohort [32.5% versus 16.9% at baseline (P = 0.006) and 46.1% versus 25.4% at last visit (P = 0.001)]. At baseline, the sporadic early-onset group performed worse on category fluency (P < 0.001), Trail Making Test Part B (P < 0.001) and digit span (P < 0.001). Longitudinally, both groups demonstrated similar rates of cognitive and functional decline in the early stages. After 10 years from symptom onset, dominantly inherited participants experienced a greater decline as measured by Clinical Dementia Rating Sum of Boxes [3.63 versus 1.82 points (P = 0.035)]. CSF amyloid beta-42 levels were comparable [244 (SD ± 39.3) pg/ml dominantly inherited versus 296 (SD ± 24.8) pg/ml sporadic early onset, P = 0.06]. CSF phosphorylated tau at threonine 181 levels were higher in the dominantly inherited Alzheimer's disease cohort (87.3 versus 59.7 pg/ml, P = 0.005), but no significant differences were found for t-tau levels (P = 0.35). In summary, sporadic and inherited Alzheimer's disease differed in baseline profiles; sporadic early onset is best distinguished from dominantly inherited by later age at onset, high frequency of atypical clinical presentations and worse executive performance at baseline. Despite these differences, shared pathways in longitudinal clinical decline and CSF biomarkers suggest potential common therapeutic targets for both populations, offering valuable insights for future research and clinical trial design.
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Affiliation(s)
| | - Leonardo Iaccarino
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Dean Coble
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Lauren Edwards
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Yan Li
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Amelia Strom
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Brian Gordon
- Malinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Nidhi Mundada
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Elena Tsoy
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Yinjiao Ma
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Ruijin Lu
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Tammie L S Benzinger
- Malinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO 63108, USA
| | - David Soleimani-Meigooni
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | | | - Zachary Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Guoqiao Wang
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Joel H Kramer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Howard J Rosen
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - John C Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
| | - Bruce L Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University in St Louis, St Louis, MO 63108, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
- Department of Pathology and Immunology, Washington University in St Louis, St. Louis, MO 63108, USA
| | - Ricardo Allegri
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires, Argentina
| | - Patricio Chrem
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires, Argentina
| | - Ezequiel Surace
- Department of Cognitive Neurology, Institute for Neurological Research Fleni, Buenos Aires, Argentina
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Jasmeer Chhatwal
- Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Colin L Masters
- Florey Institute, The University of Melbourne, Melbourne 3052, Australia
| | - Martin R Farlow
- Neuroscience Center, Indiana University School of Medicine at Indianapolis, IN 46202, USA
| | - Mathias Jucker
- DZNE-German Center for Neurodegenerative Diseases, Tübingen 72076, Germany
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen 72076, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-University, Munich 80539, Germany
- German Center for Neurodegenerative Diseases, Munich 81377, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich 81377, Germany
| | - Nick C Fox
- Dementia Research Centre, Department of Neurodegenerative Disease, University College London Institute of Neurology, London WC1N 3BG, UK
| | - Gregory Day
- Department of Neurology, Mayo Clinic Florida, Jacksonville, FL 33224, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Adam L Boxer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Renaud La Joie
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Gil D Rabinovici
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA 94158, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA 94158, USA
| | - Randall Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO 63108, USA
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24
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Chen Y, Yang L, Gao X, Tang A, He H, Xiong C, Xu F, Sun C. The Impact of Diabetes Mellitus on Patient-Reported Outcomes of Chronic Low Back Pain with Modic Changes at One Year: A Prospective Cohort Study. Global Spine J 2023:21925682231206962. [PMID: 37824194 DOI: 10.1177/21925682231206962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
STUDY DESIGN Prospective cohort study. OBJECTIVES Diabetes mellitus (DM) is associated with unfavourable patient-reported outcomes after spine surgery. Chronic low back pain (CLBP) with Modic Changes (MCs) in the lumbar vertebrae, as observed on MRI, forms a specific subgroup. This study aims to investigate the potential influence of DM on CLBP with MCs. METHODS This study involved 259 patients with CLBP accompanied MCs. We recorded the patient-reported outcomes (visual analogue scale (VAS), Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ)) at baseline, 3, 6, and 12 months. Multivariable linear regression analyses were performed to determine predictors of patient-reported outcomes. RESULTS 103 patients had DM. Patients with DM exhibited higher VAS (P < .05), ODI (P < .001), and RMDQ (P < .001) scores at 3, 6, and 12 months, while patients without DM experienced more significant improvements in the scores over time (P < .001). Patients with DM reported longer durations of physical exercise (P = .007). Additionally, patients without DM had a significantly higher patient satisfaction index (P < .001) and a lower prevalence of hypertension (P < .001). Notably, significant differences were observed in the distribution of MCs of lumbar vertebrae (P = .034) and Pfirrmann grades of intervertebral disc degeneration between two groups (P < .001). CONCLUSION Patients with DM demonstrated poorer patient-reported outcomes compared to those without DM in 1-year. DM emerged as an independent predictor of adverse patient-reported outcomes. It can be utilized to enhance the management and treatment of CLBP in patients with MCs.
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Affiliation(s)
- Yongkang Chen
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Lei Yang
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Xiaofeng Gao
- School of Basic Medical Sciences, Xianning Medical College, Hubei University of Science and Technology, Xianning, China
| | - Aolin Tang
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Hang He
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Chengjie Xiong
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
| | - Feng Xu
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Chao Sun
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan, China
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25
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Strain JF, Phuah CL, Adeyemo B, Cheng K, Womack KB, McCarthy J, Goyal M, Chen Y, Sotiras A, An H, Xiong C, Scharf A, Newsom-Stewart C, Morris JC, Benzinger TLS, Lee JM, Ances BM. White matter hyperintensity longitudinal morphometric analysis in association with Alzheimer disease. Alzheimers Dement 2023; 19:4488-4497. [PMID: 37563879 PMCID: PMC10592317 DOI: 10.1002/alz.13377] [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: 11/29/2022] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Vascular damage in Alzheimer's disease (AD) has shown conflicting findings particularly when analyzing longitudinal data. We introduce white matter hyperintensity (WMH) longitudinal morphometric analysis (WLMA) that quantifies WMH expansion as the distance from lesion voxels to a region of interest boundary. METHODS WMH segmentation maps were derived from 270 longitudinal fluid-attenuated inversion recovery (FLAIR) ADNI images. WLMA was performed on five data-driven WMH patterns with distinct spatial distributions. Amyloid accumulation was evaluated with WMH expansion across the five WMH patterns. RESULTS The preclinical group had significantly greater expansion in the posterior ventricular WM compared to controls. Amyloid significantly associated with frontal WMH expansion primarily within AD individuals. WLMA outperformed WMH volume changes for classifying AD from controls primarily in periventricular and posterior WMH. DISCUSSION These data support the concept that localized WMH expansion continues to proliferate with amyloid accumulation throughout the entirety of the disease in distinct spatial locations.
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Affiliation(s)
- Jeremy Fuller Strain
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chia-Ling Phuah
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Babatunde Adeyemo
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kathleen Cheng
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Kyle B Womack
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John McCarthy
- Department of Mathematics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Manu Goyal
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Yasheng Chen
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Aristeidis Sotiras
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Institute for Informatics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Hongyu An
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Division of Biostatics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Andrea Scharf
- Department of Biological Sciences, Missouri University for Science and Technology, Rolla, Missouri, USA
| | - Catherine Newsom-Stewart
- Department of Developmental Biology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John Carl Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Knight Alzheimer Disease Research Center, St. Louis, Missouri, USA
| | - Tammie Lee Smith Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Knight Alzheimer Disease Research Center, St. Louis, Missouri, USA
| | - Jin-Moo Lee
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Beau M Ances
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
- Department of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
- Knight Alzheimer Disease Research Center, St. Louis, Missouri, USA
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26
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McKay NS, Gordon BA, Hornbeck RC, Dincer A, Flores S, Keefe SJ, Joseph-Mathurin N, Jack CR, Koeppe R, Millar PR, Ances BM, Chen CD, Daniels A, Hobbs DA, Jackson K, Koudelis D, Massoumzadeh P, McCullough A, Nickels ML, Rahmani F, Swisher L, Wang Q, Allegri RF, Berman SB, Brickman AM, Brooks WS, Cash DM, Chhatwal JP, Day GS, Farlow MR, la Fougère C, Fox NC, Fulham M, Ghetti B, Graff-Radford N, Ikeuchi T, Klunk W, Lee JH, Levin J, Martins R, Masters CL, McConathy J, Mori H, Noble JM, Reischl G, Rowe C, Salloway S, Sanchez-Valle R, Schofield PR, Shimada H, Shoji M, Su Y, Suzuki K, Vöglein J, Yakushev I, Cruchaga C, Hassenstab J, Karch C, McDade E, Perrin RJ, Xiong C, Morris JC, Bateman RJ, Benzinger TLS. Positron emission tomography and magnetic resonance imaging methods and datasets within the Dominantly Inherited Alzheimer Network (DIAN). Nat Neurosci 2023; 26:1449-1460. [PMID: 37429916 PMCID: PMC10400428 DOI: 10.1038/s41593-023-01359-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 03/10/2022] [Accepted: 05/15/2023] [Indexed: 07/12/2023]
Abstract
The Dominantly Inherited Alzheimer Network (DIAN) is an international collaboration studying autosomal dominant Alzheimer disease (ADAD). ADAD arises from mutations occurring in three genes. Offspring from ADAD families have a 50% chance of inheriting their familial mutation, so non-carrier siblings can be recruited for comparisons in case-control studies. The age of onset in ADAD is highly predictable within families, allowing researchers to estimate an individual's point in the disease trajectory. These characteristics allow candidate AD biomarker measurements to be reliably mapped during the preclinical phase. Although ADAD represents a small proportion of AD cases, understanding neuroimaging-based changes that occur during the preclinical period may provide insight into early disease stages of 'sporadic' AD also. Additionally, this study provides rich data for research in healthy aging through inclusion of the non-carrier controls. Here we introduce the neuroimaging dataset collected and describe how this resource can be used by a range of researchers.
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Affiliation(s)
| | | | | | - Aylin Dincer
- Washington University in St. Louis, St. Louis, MO, USA
| | - Shaney Flores
- Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah J Keefe
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | | | | | - Beau M Ances
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Diana A Hobbs
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | | | | | | | | | - Laura Swisher
- Washington University in St. Louis, St. Louis, MO, USA
| | - Qing Wang
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Adam M Brickman
- Columbia University Irving Medical Center, New York, NY, USA
| | - William S Brooks
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - David M Cash
- UK Dementia Research Institute at University College London, London, UK
- University College London, London, UK
| | - Jasmeer P Chhatwal
- Massachusetts General and Brigham & Women's Hospitals, Harvard Medical School, Boston, MA, USA
| | | | | | - Christian la Fougère
- Department of Radiology, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Nick C Fox
- UK Dementia Research Institute at University College London, London, UK
- University College London, London, UK
| | - Michael Fulham
- Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | | | | | | | | | | | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Ralph Martins
- Edith Cowan University, Joondalup, Western Australia, Australia
| | | | | | | | - James M Noble
- Columbia University Irving Medical Center, New York, NY, USA
| | - Gerald Reischl
- Department of Radiology, University of Tübingen, Tübingen, Germany
| | | | | | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Yi Su
- Banner Alzheimer's Institute, Phoenix, AZ, USA
| | | | - Jonathan Vöglein
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Department of Neurology, Ludwig-Maximilians-Universität München, München, Germany
| | - Igor Yakushev
- School of Medicine, Technical University of Munich, Munich, Germany
| | | | | | - Celeste Karch
- Washington University in St. Louis, St. Louis, MO, USA
| | - Eric McDade
- Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - John C Morris
- Washington University in St. Louis, St. Louis, MO, USA
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27
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Johnson ECB, Bian S, Haque RU, Carter EK, Watson CM, Gordon BA, Ping L, Duong DM, Epstein MP, McDade E, Barthélemy NR, Karch CM, Xiong C, Cruchaga C, Perrin RJ, Wingo AP, Wingo TS, Chhatwal JP, Day GS, Noble JM, Berman SB, Martins R, Graff-Radford NR, Schofield PR, Ikeuchi T, Mori H, Levin J, Farlow M, Lah JJ, Haass C, Jucker M, Morris JC, Benzinger TLS, Roberts BR, Bateman RJ, Fagan AM, Seyfried NT, Levey AI. Cerebrospinal fluid proteomics define the natural history of autosomal dominant Alzheimer's disease. Nat Med 2023; 29:1979-1988. [PMID: 37550416 PMCID: PMC10427428 DOI: 10.1038/s41591-023-02476-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 25.0] [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: 02/23/2023] [Accepted: 06/27/2023] [Indexed: 08/09/2023]
Abstract
Alzheimer's disease (AD) pathology develops many years before the onset of cognitive symptoms. Two pathological processes-aggregation of the amyloid-β (Aβ) peptide into plaques and the microtubule protein tau into neurofibrillary tangles (NFTs)-are hallmarks of the disease. However, other pathological brain processes are thought to be key disease mediators of Aβ plaque and NFT pathology. How these additional pathologies evolve over the course of the disease is currently unknown. Here we show that proteomic measurements in autosomal dominant AD cerebrospinal fluid (CSF) linked to brain protein coexpression can be used to characterize the evolution of AD pathology over a timescale spanning six decades. SMOC1 and SPON1 proteins associated with Aβ plaques were elevated in AD CSF nearly 30 years before the onset of symptoms, followed by changes in synaptic proteins, metabolic proteins, axonal proteins, inflammatory proteins and finally decreases in neurosecretory proteins. The proteome discriminated mutation carriers from noncarriers before symptom onset as well or better than Aβ and tau measures. Our results highlight the multifaceted landscape of AD pathophysiology and its temporal evolution. Such knowledge will be critical for developing precision therapeutic interventions and biomarkers for AD beyond those associated with Aβ and tau.
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Affiliation(s)
- Erik C B Johnson
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.
| | - Shijia Bian
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rafi U Haque
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
| | - E Kathleen Carter
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Caroline M Watson
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Brian A Gordon
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Lingyan Ping
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Duc M Duong
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Michael P Epstein
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | | | - Celeste M Karch
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA
| | - Chengjie Xiong
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
- Division of Biostatistics, Washington University in St Louis, St Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
- Department of Pathology and Immunology, Washington University in St Louis, St Louis, MO, USA
| | - Aliza P Wingo
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA
- Division of Mental Health, Atlanta VA Medical Center, Atlanta, GA, USA
| | - Thomas S Wingo
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Jasmeer P Chhatwal
- Massachusetts General and Brigham & Women's Hospitals, Harvard Medical School, Boston, MA, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - James M Noble
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and GH Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA
| | - Sarah B Berman
- Departments of Neurology and Clinical and Translational Science, Pittsburgh Institute for Neurodegenerative Diseases, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ralph Martins
- Edith Cowan University, Perth, Western Australia, Australia
| | | | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, Japan
| | - Hiroshi Mori
- Osaka Metropolitan University Medical School, Nagaoka Sutoku University, Nagaoka, Japan
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - James J Lah
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Christian Haass
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Metabolic Biochemistry, Biomedical Center (BMC), Ludwig-Maximilians University, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Mathias Jucker
- Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - John C Morris
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Blaine R Roberts
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Nicholas T Seyfried
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan I Levey
- Goizueta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Schultz SA, Shirzadi Z, Schultz AP, Liu L, Fitzpatrick CD, McDade E, Barthelemy NR, Renton A, Esposito B, Joseph‐Mathurin N, Cruchaga C, Chen CD, Goate A, Allegri RF, Benzinger TLS, Berman S, Chui HC, Fagan AM, Farlow MR, Fox NC, Gordon BA, Day GS, Graff‐Radford NR, Hassenstab JJ, Hanseeuw BJ, Hofmann A, Jack CR, Jucker M, Karch CM, Koeppe RA, Lee J, Levey AI, Levin J, Martins RN, Mori H, Morris JC, Noble J, Perrin RJ, Rosa‐Neto P, Salloway SP, Sanchez‐Valle R, Schofield PR, Xiong C, Johnson KA, Bateman RJ, Sperling RA, Chhatwal JP. Location of pathogenic variants in PSEN1 impacts progression of cognitive, clinical, and neurodegenerative measures in autosomal-dominant Alzheimer's disease. Aging Cell 2023; 22:e13871. [PMID: 37291760 PMCID: PMC10410059 DOI: 10.1111/acel.13871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 04/30/2023] [Accepted: 05/03/2023] [Indexed: 06/10/2023] Open
Abstract
Although pathogenic variants in PSEN1 leading to autosomal-dominant Alzheimer disease (ADAD) are highly penetrant, substantial interindividual variability in the rates of cognitive decline and biomarker change are observed in ADAD. We hypothesized that this interindividual variability may be associated with the location of the pathogenic variant within PSEN1. PSEN1 pathogenic variant carriers participating in the Dominantly Inherited Alzheimer Network (DIAN) observational study were grouped based on whether the underlying variant affects a transmembrane (TM) or cytoplasmic (CY) protein domain within PSEN1. CY and TM carriers and variant non-carriers (NC) who completed clinical evaluation, multimodal neuroimaging, and lumbar puncture for collection of cerebrospinal fluid (CSF) as part of their participation in DIAN were included in this study. Linear mixed effects models were used to determine differences in clinical, cognitive, and biomarker measures between the NC, TM, and CY groups. While both the CY and TM groups were found to have similarly elevated Aβ compared to NC, TM carriers had greater cognitive impairment, smaller hippocampal volume, and elevated phosphorylated tau levels across the spectrum of pre-symptomatic and symptomatic phases of disease as compared to CY, using both cross-sectional and longitudinal data. As distinct portions of PSEN1 are differentially involved in APP processing by γ-secretase and the generation of toxic β-amyloid species, these results have important implications for understanding the pathobiology of ADAD and accounting for a substantial portion of the interindividual heterogeneity in ongoing ADAD clinical trials.
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Affiliation(s)
| | - Zahra Shirzadi
- Massachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Aaron P. Schultz
- Massachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
| | - Lei Liu
- Brigham and Women's HospitalBostonMassachusettsUSA
- Ann Romney Center for Neurologic DiseasesBostonMassachusettsUSA
| | | | - Eric McDade
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | | | - Alan Renton
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Bianca Esposito
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | | | - Carlos Cruchaga
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Charles D. Chen
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Alison Goate
- Department of Genetics and Genomic SciencesIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | | | | | - Sarah Berman
- University of PittsburghPittsburghPennsylvaniaUSA
| | - Helena C. Chui
- Department of Neurology, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Anne M. Fagan
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Martin R. Farlow
- Indiana Alzheimer's Disease Research CenterIndianapolisIndianaUSA
| | - Nick C. Fox
- Dementia Research Centre & UK Dementia Research InstituteUCL Institute of NeurologyLondonUK
| | - Brian A. Gordon
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | | | | | | | - Bernard J. Hanseeuw
- Institute of Neuroscience, UCLouvainBrusselsBelgium
- Gordon Center for Medical Imaging in the Radiology Department of MGHBostonMassachusettsUSA
| | - Anna Hofmann
- German Center for Neurodegenerative Diseases (DZNE)TuebingenGermany
| | | | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE)TuebingenGermany
| | - Celeste M. Karch
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | | | - Jae‐Hong Lee
- Asan Medical CenterUniversity of Ulsan College of MedicineSeoulSouth Korea
| | - Allan I. Levey
- Emory Goizueta Alzheimer's Disease Research CenterAtlantaGeorgiaUSA
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE)MunichGermany
- Department of NeurologyLudwig‐Maximilians‐Universität MünchenMunichGermany
- Munich Cluster for Systems Neurology (SyNergy)MunichGermany
| | | | | | - John C. Morris
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | | | - Richard J. Perrin
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Pedro Rosa‐Neto
- Translational Neuroimaging Laboratory, Le Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Ouest‐de‐l'Île‐de‐Montréal; Department of Neurology and NeurosurgeryMcGill UniversityMontrealCanada
| | | | - Raquel Sanchez‐Valle
- Alzheimer's disease and other cognitive disorders Unit, Neurology Department, Hospital Clínic de BarcelonaInstitut d'Investigacions BiomediquesBarcelonaSpain
| | - Peter R. Schofield
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Chengjie Xiong
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Keith A. Johnson
- Massachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Brigham and Women's HospitalBostonMassachusettsUSA
| | - Randall J. Bateman
- Washington University in St. Louis School of MedicineSt. LouisMissouriUSA
| | - Reisa A. Sperling
- Massachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Brigham and Women's HospitalBostonMassachusettsUSA
| | - Jasmeer P. Chhatwal
- Massachusetts General Hospital, Harvard Medical SchoolBostonMassachusettsUSA
- Brigham and Women's HospitalBostonMassachusettsUSA
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29
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Luo J, Ma Y, Agboola FJ, Grant E, Morris JC, McDade E, Fagan AM, Benzinger TLS, Hassenstab J, Bateman RJ, Perrin RJ, Gordon BA, Goyal M, Strain JF, Yakushev I, Day GS, Xiong C. Longitudinal Relationships of White Matter Hyperintensities and Alzheimer Disease Biomarkers Across the Adult Life Span. Neurology 2023; 101:e164-e177. [PMID: 37202169 PMCID: PMC10351551 DOI: 10.1212/wnl.0000000000207378] [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: 07/07/2022] [Accepted: 03/20/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES White matter hyperintensities (WMH) correlate with Alzheimer disease (AD) biomarkers cross-sectionally and modulate AD pathogenesis. Longitudinal changes have been reported for AD biomarkers, including concentrations of CSF β-amyloid (Aβ) 42, Aβ40, total tau and phosphorylated tau181, standardized uptake value ratio from the molecular imaging of cerebral fibrillar Aβ with PET using [11C] Pittsburgh Compound-B, MRI-based hippocampal volume, and cortical thickness. Correlations between established AD biomarkers and the longitudinal change for WMH have not been fully evaluated, especially among cognitively normal individuals across the adult life span. METHODS We jointly analyzed the longitudinal data of WMH volume and each of the established AD biomarkers and cognition from 371 cognitively normal individuals whose baseline age spanned from 19.6 to 88.20 years from 4 longitudinal studies of aging and AD. A 2-stage algorithm was applied to identify the inflection point of baseline age whereby older participants had an accelerated longitudinal change in WMH volume, in comparison with the younger participants. The longitudinal correlations between WMH volume and AD biomarkers were estimated from the bivariate linear mixed-effects models. RESULTS A longitudinal increase in WMH volume was associated with a longitudinal increase in PET amyloid uptake and a decrease in MRI hippocampal volume, cortical thickness, and cognition. The inflection point of baseline age in WMH volume was identified at 60.46 (95% CI 56.43-64.49) years, with the annual increase for the older participants (83.12 [SE = 10.19] mm3 per year) more than 13 times faster (p < 0.0001) than that for the younger participants (6.35 [SE = 5.63] mm3 per year). Accelerated rates of change among the older participants were similarly observed in almost all the AD biomarkers. Longitudinal correlations of WMH volume with MRI, PET amyloid biomarkers, and cognition seemed to be numerically stronger for the younger participants, but not significantly different from those for the older participants. Carrying APOE ε4 alleles did not alter the longitudinal correlations between WMH and AD biomarkers. DISCUSSION Longitudinal increases in WMH volume started to accelerate around a baseline age of 60.46 years and correlated with the longitudinal change in PET amyloid uptake, MRI structural outcomes, and cognition.
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Affiliation(s)
- Jingqin Luo
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Yinjiao Ma
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Folasade Jane Agboola
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Elizabeth Grant
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - John C Morris
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Eric McDade
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Anne M Fagan
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Tammie L S Benzinger
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Jason Hassenstab
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Randall J Bateman
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Richard J Perrin
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Brian A Gordon
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Manu Goyal
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Jeremy F Strain
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Igor Yakushev
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Gregory S Day
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL
| | - Chengjie Xiong
- From the Division of Public Health Sciences (J.L.), Department of Surgery, Siteman Cancer Center Biostatistics Core (J.L.), Division of Biostatistics (J.L., Y.M., F.J.A., E.G., C.X.), Knight Alzheimer Disease Research Center (Y.M., F.J.A., E.G., J.C.M., A.M.F., T.L.S.B., J.H., R.J.B., R.J.P., B.A.G., C.X.), Department of Neurology (J.C.M., E.M., A.M.F., J.H., R.J.B., R.J.P., M.G., J.F.S.), Department of Pathology and Immunology (J.C.M., R.J.P.), and Department of Radiology (T.L.S.B., B.A.G., M.G.), Washington University School of Medicine, St. Louis, MO; Department of Nuclear Medicine (I.Y.), and Klinikum rechts der Isar (I.Y.), School of Medicine, Neuroimaging Center (TUM-NIC), Technical University of Munich, Germany; and Department of Neurology (G.S.D.), Mayo Clinic, Jacksonville, FL.
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Wheelock MD, Strain JF, Mansfield P, Tu JC, Tanenbaum A, Preische O, Chhatwal JP, Cash DM, Cruchaga C, Fagan AM, Fox NC, Graff-Radford NR, Hassenstab J, Jack CR, Karch CM, Levin J, McDade EM, Perrin RJ, Schofield PR, Xiong C, Morris JC, Bateman RJ, Jucker M, Benzinger TLS, Ances BM, Eggebrecht AT, Gordon BA, Allegri R, Araki A, Barthelemy N, Bateman R, Bechara J, Benzinger T, Berman S, Bodge C, Brandon S, Brooks W, Brosch J, Buck J, Buckles V, Carter K, Cash D, Cash L, Chen C, Chhatwal J, Chrem P, Chua J, Chui H, Cruchaga C, Day GS, De La Cruz C, Denner D, Diffenbacher A, Dincer A, Donahue T, Douglas J, Duong D, Egido N, Esposito B, Fagan A, Farlow M, Feldman B, Fitzpatrick C, Flores S, Fox N, Franklin E, Friedrichsen N, Fujii H, Gardener S, Ghetti B, Goate A, Goldberg S, Goldman J, Gonzalez A, Gordon B, Gräber-Sultan S, Graff-Radford N, Graham M, Gray J, Gremminger E, Grilo M, Groves A, Haass C, Häsler L, Hassenstab J, Hellm C, Herries E, Hoechst-Swisher L, Hofmann A, Holtzman D, Hornbeck R, Igor Y, Ihara R, Ikeuchi T, Ikonomovic S, Ishii K, Jack C, Jerome G, Johnson E, Jucker M, Karch C, Käser S, Kasuga K, Keefe S, Klunk W, Koeppe R, Koudelis D, Kuder-Buletta E, Laske C, Lee JH, Levey A, Levin J, Li Y, Lopez O, Marsh J, Martinez R, Martins R, Mason NS, Masters C, Mawuenyega K, McCullough A, McDade E, Mejia A, Morenas-Rodriguez E, Mori H, Morris J, Mountz J, Mummery C, Nadkami N, Nagamatsu A, Neimeyer K, Niimi Y, Noble J, Norton J, Nuscher B, O'Connor A, Obermüller U, Patira R, Perrin R, Ping L, Preische O, Renton A, Ringman J, Salloway S, Sanchez-Valle R, Schofield P, Senda M, Seyfried N, Shady K, Shimada H, Sigurdson W, Smith J, Smith L, Snitz B, Sohrabi H, Stephens S, Taddei K, Thompson S, Vöglein J, Wang P, Wang Q, Weamer E, Xiong C, Xu J, Xu X. Brain network decoupling with increased serum neurofilament and reduced cognitive function in Alzheimer's disease. Brain 2023; 146:2928-2943. [PMID: 36625756 PMCID: PMC10316768 DOI: 10.1093/brain/awac498] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 11/21/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Neurofilament light chain, a putative measure of neuronal damage, is measurable in blood and CSF and is predictive of cognitive function in individuals with Alzheimer's disease. There has been limited prior work linking neurofilament light and functional connectivity, and no prior work has investigated neurofilament light associations with functional connectivity in autosomal dominant Alzheimer's disease. Here, we assessed relationships between blood neurofilament light, cognition, and functional connectivity in a cross-sectional sample of 106 autosomal dominant Alzheimer's disease mutation carriers and 76 non-carriers. We employed an innovative network-level enrichment analysis approach to assess connectome-wide associations with neurofilament light. Neurofilament light was positively correlated with deterioration of functional connectivity within the default mode network and negatively correlated with connectivity between default mode network and executive control networks, including the cingulo-opercular, salience, and dorsal attention networks. Further, reduced connectivity within the default mode network and between the default mode network and executive control networks was associated with reduced cognitive function. Hierarchical regression analysis revealed that neurofilament levels and functional connectivity within the default mode network and between the default mode network and the dorsal attention network explained significant variance in cognitive composite scores when controlling for age, sex, and education. A mediation analysis demonstrated that functional connectivity within the default mode network and between the default mode network and dorsal attention network partially mediated the relationship between blood neurofilament light levels and cognitive function. Our novel results indicate that blood estimates of neurofilament levels correspond to direct measurements of brain dysfunction, shedding new light on the underlying biological processes of Alzheimer's disease. Further, we demonstrate how variation within key brain systems can partially mediate the negative effects of heightened total serum neurofilament levels, suggesting potential regions for targeted interventions. Finally, our results lend further evidence that low-cost and minimally invasive blood measurements of neurofilament may be a useful marker of brain functional connectivity and cognitive decline in Alzheimer's disease.
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Affiliation(s)
- Muriah D Wheelock
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Jeremy F Strain
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - Jiaxin Cindy Tu
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Aaron Tanenbaum
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Jasmeer P Chhatwal
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - David M Cash
- Dementia Research Center, UCL Queen Square, London, UK.,UK Dementia Research Institute, College London, London, UK
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Nick C Fox
- Dementia Research Center, UCL Queen Square, London, UK.,UK Dementia Research Institute, College London, London, UK
| | | | - Jason Hassenstab
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | | | - Celeste M Karch
- Department of Psychiatry, Washington University in St. Louis, MO, USA
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Eric M McDade
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA.,Department of Pathology & Immunology, Washington University in St. Louis, MO, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Chengjie Xiong
- Division of Biostatistics, Washington University in St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Randal J Bateman
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Tammie L S Benzinger
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in Saint Louis, St. Louis, MO, USA
| | - Adam T Eggebrecht
- Department of Radiology, Washington University in St. Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University in St. Louis, MO, USA
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Chen CD, McCullough A, Gordon B, Joseph-Mathurin N, Flores S, McKay NS, Hobbs DA, Hornbeck R, Fagan AM, Cruchaga C, Goate AM, Perrin RJ, Wang G, Li Y, Shi X, Xiong C, Pontecorvo MJ, Klein G, Su Y, Klunk WE, Jack C, Koeppe R, Snider BJ, Berman SB, Roberson ED, Brosch J, Surti G, Jiménez-Velázquez IZ, Galasko D, Honig LS, Brooks WS, Clarnette R, Wallon D, Dubois B, Pariente J, Pasquier F, Sanchez-Valle R, Shcherbinin S, Higgins I, Tunali I, Masters CL, van Dyck CH, Masellis M, Hsiung R, Gauthier S, Salloway S, Clifford DB, Mills S, Supnet-Bell C, McDade E, Bateman RJ, Benzinger TLS. Longitudinal head-to-head comparison of 11C-PiB and 18F-florbetapir PET in a Phase 2/3 clinical trial of anti-amyloid-β monoclonal antibodies in dominantly inherited Alzheimer's disease. Eur J Nucl Med Mol Imaging 2023; 50:2669-2682. [PMID: 37017737 PMCID: PMC10330155 DOI: 10.1007/s00259-023-06209-0] [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: 12/08/2022] [Accepted: 03/18/2023] [Indexed: 04/06/2023]
Abstract
PURPOSE Pittsburgh Compound-B (11C-PiB) and 18F-florbetapir are amyloid-β (Aβ) positron emission tomography (PET) radiotracers that have been used as endpoints in Alzheimer's disease (AD) clinical trials to evaluate the efficacy of anti-Aβ monoclonal antibodies. However, comparing drug effects between and within trials may become complicated if different Aβ radiotracers were used. To study the consequences of using different Aβ radiotracers to measure Aβ clearance, we performed a head-to-head comparison of 11C-PiB and 18F-florbetapir in a Phase 2/3 clinical trial of anti-Aβ monoclonal antibodies. METHODS Sixty-six mutation-positive participants enrolled in the gantenerumab and placebo arms of the first Dominantly Inherited Alzheimer Network Trials Unit clinical trial (DIAN-TU-001) underwent both 11C-PiB and 18F-florbetapir PET imaging at baseline and during at least one follow-up visit. For each PET scan, regional standardized uptake value ratios (SUVRs), regional Centiloids, a global cortical SUVR, and a global cortical Centiloid value were calculated. Longitudinal changes in SUVRs and Centiloids were estimated using linear mixed models. Differences in longitudinal change between PET radiotracers and between drug arms were estimated using paired and Welch two sample t-tests, respectively. Simulated clinical trials were conducted to evaluate the consequences of some research sites using 11C-PiB while other sites use 18F-florbetapir for Aβ PET imaging. RESULTS In the placebo arm, the absolute rate of longitudinal change measured by global cortical 11C-PiB SUVRs did not differ from that of global cortical 18F-florbetapir SUVRs. In the gantenerumab arm, global cortical 11C-PiB SUVRs decreased more rapidly than global cortical 18F-florbetapir SUVRs. Drug effects were statistically significant across both Aβ radiotracers. In contrast, the rates of longitudinal change measured in global cortical Centiloids did not differ between Aβ radiotracers in either the placebo or gantenerumab arms, and drug effects remained statistically significant. Regional analyses largely recapitulated these global cortical analyses. Across simulated clinical trials, type I error was higher in trials where both Aβ radiotracers were used versus trials where only one Aβ radiotracer was used. Power was lower in trials where 18F-florbetapir was primarily used versus trials where 11C-PiB was primarily used. CONCLUSION Gantenerumab treatment induces longitudinal changes in Aβ PET, and the absolute rates of these longitudinal changes differ significantly between Aβ radiotracers. These differences were not seen in the placebo arm, suggesting that Aβ-clearing treatments may pose unique challenges when attempting to compare longitudinal results across different Aβ radiotracers. Our results suggest converting Aβ PET SUVR measurements to Centiloids (both globally and regionally) can harmonize these differences without losing sensitivity to drug effects. Nonetheless, until consensus is achieved on how to harmonize drug effects across radiotracers, and since using multiple radiotracers in the same trial may increase type I error, multisite studies should consider potential variability due to different radiotracers when interpreting Aβ PET biomarker data and, if feasible, use a single radiotracer for the best results. TRIAL REGISTRATION ClinicalTrials.gov NCT01760005. Registered 31 December 2012. Retrospectively registered.
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Affiliation(s)
- Charles D Chen
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
- Washington University School of Medicine, 660 South Euclid, Campus Box 8225, St. Louis, MO, 63110, USA
| | - Austin McCullough
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Brian Gordon
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nelly Joseph-Mathurin
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Shaney Flores
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Nicole S McKay
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Diana A Hobbs
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Russ Hornbeck
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University in St. Louis, St. Louis, MO, USA
| | - Alison M Goate
- Department of Genetics and Genomic Sciences, Ichan School of Medicine at Mount Sinai, New York, NY, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, USA
| | - Guoqiao Wang
- Department of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Xinyu Shi
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Chengjie Xiong
- Department of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Michael J Pontecorvo
- Avid Radiopharmaceuticals, Philadelphia, PA, USA
- Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Yi Su
- Banner Alzheimer's Institute, Banner Health, Phoenix, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - William E Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - B Joy Snider
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah B Berman
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jared Brosch
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ghulam Surti
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Douglas Galasko
- Department of Neurology, University of California San Diego, San Diego, CA, USA
| | | | - William S Brooks
- Prince of Wales Medical Research Institute, University of New South Wales, Sydney, NSW, Australia
| | - Roger Clarnette
- Department of Internal Medicine, University of Western Australia, Crawley, WA, Australia
| | - David Wallon
- Department of Neurology and CNR-MAJ, Normandie Univ, UNIROUEN, INSERM U1245, CHU Rouen, F-76000, Rouen, France
| | - Bruno Dubois
- Sorbonne Université, AP-HP, GRC No. 21, APM, Hôpital de La Pitié-Salpêtrière, Paris, France
- Institut du Cerveau Et de La Moelle Épinière, INSERM U1127, CNRS UMR 7225, Paris, France
- Institut de La Mémoire Et de La Maladie d'Alzheimer, Département de Neurologie, Hôpital de La Pitié-Salpêtrière, Paris, France
| | - Jérémie Pariente
- Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- Toulouse NeuroImaging Centre, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Florence Pasquier
- Univ. Lille, INSERM, CHU Lille, 59000, Lille, France
- CNR-MAJ, Labex DISTALZ, LiCEND, 59000, Lille, France
| | - Raquel Sanchez-Valle
- Alzheimer's Disease and Other Cognitive Disorders Unit, Hospital ClínicInstitut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Fundació Clínic Per a La Recerca Biomèdica, University of Barcelona, Barcelona, Spain
| | | | | | - Ilke Tunali
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | | | | | - Robin Hsiung
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Serge Gauthier
- Douglas Mental Health University Institute, Montreal, QC, Canada
| | - Steve Salloway
- Alpert Medical School of Brown University, Providence, RI, USA
| | - David B Clifford
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Susan Mills
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Eric McDade
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO, USA.
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Xiong C, McCue LM, Buckles V, Grant E, Agboola F, Coble D, Bateman RJ, Fagan AM, Benzinger TL, Hassenstab J, Schindler SE, McDade E, Moulder K, Gordon BA, Cruchaga C, Day GS, Ikeuchi T, Suzuki K, Allegri RF, Vöglein J, Levin J, Morris JC. Cross-sectional and longitudinal comparisons of biomarkers and cognition among asymptomatic middle-aged individuals with a parental history of either autosomal dominant or late-onset Alzheimer's disease. Alzheimers Dement 2023; 19:2923-2932. [PMID: 36640138 PMCID: PMC10345163 DOI: 10.1002/alz.12912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Comparisons of late-onset Alzheimer's disease (LOAD) and autosomal dominant AD (ADAD) are confounded by age. METHODS We compared biomarkers from cerebrospinal fluid (CSF), magnetic resonance imaging, and amyloid imaging with Pittsburgh Compound-B (PiB) across four groups of 387 cognitively normal participants, 42 to 65 years of age, in the Dominantly Inherited Alzheimer Network (DIAN) and the Adult Children Study (ACS) of LOAD: DIAN mutation carriers (MCs) and non-carriers (NON-MCs), and ACS participants with a positive (FH+) and negative (FH-) family history of LOAD. RESULTS At baseline, MCs had the lowest age-adjusted level of CSF Aβ42 and the highest levels of total and phosphorylated tau-181, and PiB uptake. Longitudinally, MC had similar increase in PiB uptake to FH+, but drastically faster decline in hippocampal volume than others, and was the only group showing cognitive decline. DISCUSSION Preclinical ADAD and LOAD share many biomarker signatures, but cross-sectional and longitudinal differences may exist.
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Affiliation(s)
- Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Lena M. McCue
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Virginia Buckles
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Elizabeth Grant
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Folasade Agboola
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Dean Coble
- Division of Biostatistics, Washington University, St. Louis, Missouri, USA
| | - Randall J. Bateman
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Anne M Fagan
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Tammie L.S. Benzinger
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Radiology, Washington University, St. Louis, Missouri, USA
- Department of Neurological Surgery, Washington University, St. Louis, Missouri, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Department of Psychology, Washington University, St. Louis, Missouri, USA
| | - Suzanne E. Schindler
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Eric McDade
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Krista Moulder
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
| | - Brian A. Gordon
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Psychology, Washington University, St. Louis, Missouri, USA
- Department of Radiology, Washington University, St. Louis, Missouri, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- Department of Psychiatry, Washington University, St. Louis, Missouri, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic in Florida, Jacksonville, FL, USA
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Brain Research Institute, Niigata University, Niigata, JAPAN
| | | | | | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University, St. Louis, Missouri, USA
- The Dominantly Inherited Alzheimer Network, Washington University, St. Louis, Missouri, USA
- Department of Neurology, Washington University, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University, St. Louis, Missouri, USA
- Department of Physical Therapy, Washington University, St. Louis, Missouri, USA
- Department of Occupational Therapy, Washington University, St. Louis, Missouri, USA
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Chatterjee P, Vermunt L, Gordon BA, Pedrini S, Boonkamp L, Armstrong NJ, Xiong C, Singh AK, Li Y, Sohrabi HR, Taddei K, Molloy MP, Benzinger TL, Morris JC, Karch CM, Berman SB, Chhatwal J, Cruchaga C, Graff-Radford NR, Day GS, Farlow M, Fox NC, Goate AM, Hassenstab J, Lee JH, Levin J, McDade E, Mori H, Perrin RJ, Sanchez-Valle R, Schofield PR, Levey A, Jucker M, Masters CL, Fagan AM, Bateman RJ, Martins RN, Teunissen CE. Plasma glial fibrillary acidic protein in autosomal dominant Alzheimer's disease: Associations with Aβ-PET, neurodegeneration, and cognition. Alzheimers Dement 2023; 19:2790-2804. [PMID: 36576155 PMCID: PMC10300233 DOI: 10.1002/alz.12879] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 06/29/2022] [Revised: 09/22/2022] [Accepted: 10/21/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Glial fibrillary acidic protein (GFAP) is a promising candidate blood-based biomarker for Alzheimer's disease (AD) diagnosis and prognostication. The timing of its disease-associated changes, its clinical correlates, and biofluid-type dependency will influence its clinical utility. METHODS We evaluated plasma, serum, and cerebrospinal fluid (CSF) GFAP in families with autosomal dominant AD (ADAD), leveraging the predictable age at symptom onset to determine changes by stage of disease. RESULTS Plasma GFAP elevations appear a decade before expected symptom onset, after amyloid beta (Aβ) accumulation and prior to neurodegeneration and cognitive decline. Plasma GFAP distinguished Aβ-positive from Aβ-negative ADAD participants and showed a stronger relationship with Aβ load in asymptomatic than symptomatic ADAD. Higher plasma GFAP was associated with the degree and rate of neurodegeneration and cognitive impairment. Serum GFAP showed similar relationships, but these were less pronounced for CSF GFAP. CONCLUSION Our findings support a role for plasma GFAP as a clinical biomarker of Aβ-related astrocyte reactivity that is associated with cognitive decline and neurodegeneration. HIGHLIGHTS Plasma glial fibrillary acidic protein (GFAP) elevations appear a decade before expected symptom onset in autosomal dominant Alzheimer's disease (ADAD). Plasma GFAP was associated to amyloid positivity in asymptomatic ADAD. Plasma GFAP increased with clinical severity and predicted disease progression. Plasma and serum GFAP carried similar information in ADAD, while cerebrospinal fluid GFAP did not.
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Affiliation(s)
- Pratishtha Chatterjee
- Macquarie Medical School, Macquarie University, North Ryde, NSW 2019, Australia; School of Medical Sciences, Edith Cowan University, Sarich Neuroscience Research Institute, Nedlands, WA 6009, Australia
| | - Lisa Vermunt
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, programme Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Brian A. Gordon
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Steve Pedrini
- School of Medical Sciences, Edith Cowan University, Sarich Neuroscience Research Institute, Nedlands, WA 6009, Australia
| | - Lynn Boonkamp
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, programme Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
| | - Nicola J. Armstrong
- Department of Mathematics & Statistics, Curtin University, Bentley, WA, Australia
| | - Chengjie Xiong
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Abhay K. Singh
- Macquarie Business School, Macquarie University, North Ryde, NSW, Australia
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA; Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hamid R. Sohrabi
- Department of Biomedical Sciences, Macquarie University, North Ryde, NSW 2019, Australia; School of Medical Sciences, Edith Cowan University, Sarich Neuroscience Research Institute, Nedlands, WA 6009, Australia; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia; Australian Alzheimer’s Research Foundation, Nedlands, WA, Australia; Centre for Healthy Ageing, Health Future Institute, Murdoch University, Murdoch, WA, Australia
| | - Kevin Taddei
- School of Medical Sciences, Edith Cowan University, Sarich Neuroscience Research Institute, Nedlands, WA 6009, Australia; Australian Alzheimer’s Research Foundation, Nedlands, WA, Australia
| | - Mark P. Molloy
- Bowel Cancer and Biomarker Laboratory, Kolling Institute, The University of Sydney, St Leonards, NSW, Australia; Australian Proteome Analysis Facility, Macquarie University, North Ryde, NSW, Australia
| | - Tammie L.S. Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, USA
| | - John C. Morris
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Celeste M. Karch
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, USA
| | - Sarah B. Berman
- University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jasmeer Chhatwal
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carlos Cruchaga
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Gregory S Day
- Department of Neurology, Mayo Clinic Jacksonville, Jacksonville, FL, USA
| | - Martin Farlow
- Department of Neurology, Indiana University, Indianapolis, IN, USA
| | - Nick C. Fox
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Alison M. Goate
- Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jae-Hong Lee
- Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul05505, Republic of Korea
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hiroshi Mori
- Osaka Metropolitan University, Nagaoka Sutoku University, Osaka, Japan
| | - Richard J. Perrin
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA; Dominantly Inherited Alzheimer Network, Washington University School of Medicine, St. Louis, MO, USA; Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Raquel Sanchez-Valle
- Alzheimer’s Disease and other Cognitive Disorders Unit, Neurology Service, Hospital Clinic, Barcelona, Spain
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia; School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Allan Levey
- Department of Neurology, Emory University, Atlanta, GA, USA
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany. Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Colin L. Masters
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia; University of Melbourne, Melbourne, Victoria, Australia
| | - Anne M. Fagan
- Knight Alzheimer’s Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA; Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Randall J. Bateman
- Dominantly Inherited Alzheimer Network, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Ralph N. Martins
- Macquarie Medical School, Macquarie University, North Ryde, NSW 2019, Australia; School of Medical Sciences, Edith Cowan University, Sarich Neuroscience Research Institute, Nedlands, WA 6009, Australia; The Cooperative Research Centre for Mental Health, Carlton South, Australia; KaRa Institute of Neurological Disease, Sydney, Macquarie Park, Australia; Australian Alzheimer’s Research Foundation, Nedlands, WA, Australia
| | - Charlotte E. Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, programme Neurodegeneration, Amsterdam University Medical Centers, Vrije Universiteit, Amsterdam, The Netherlands
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34
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Horie K, Li Y, Barthélemy NR, Gordon BA, Hassenstab J, Benzinger TL, Fagan AM, Morris JC, Karch CM, Xiong C, Allegri R, Mendez PC, Ikeuchi T, Kasuga K, Noble J, Farlow M, Chhatwal J, Day GS, Schofield PR, Masters CL, Levin J, Jucker M, Lee JH, Hoon Roh J, Sato C, Sachdev P, Koyama A, Reyderman L, Bateman RJ, McDade E. Change in Cerebrospinal Fluid Tau Microtubule Binding Region Detects Symptom Onset, Cognitive Decline, Tangles, and Atrophy in Dominantly Inherited Alzheimer's Disease. Ann Neurol 2023; 93:1158-1172. [PMID: 36843330 PMCID: PMC10238659 DOI: 10.1002/ana.26620] [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: 11/21/2022] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/28/2023]
Abstract
OBJECTIVE Identifying cerebrospinal fluid measures of the microtubule binding region of tau (MTBR-tau) species that reflect tau aggregation could provide fluid biomarkers that track Alzheimer's disease related neurofibrillary tau pathological changes. We examined the cerebrospinal fluid (CSF) MTBR-tau species in dominantly inherited Alzheimer's disease (DIAD) mutation carriers to assess the association with Alzheimer's disease (AD) biomarkers and clinical symptoms. METHODS Cross-sectional and longitudinal CSF from 229 DIAD mutation carriers and 130 mutation non-carriers had sequential characterization of N-terminal/mid-domain phosphorylated tau (p-tau) followed by MTBR-tau species and tau positron emission tomography (tau PET), other soluble tau and amyloid biomarkers, comprehensive clinical and cognitive assessments, and brain magnetic resonance imaging of atrophy. RESULTS CSF MTBR-tau species located within the putative "border" region and one species corresponding to the "core" region of aggregates in neurofibrillary tangles (NFTs) increased during the presymptomatic stage and decreased during the symptomatic stage. The "border" MTBR-tau species were associated with amyloid pathology and CSF p-tau; whereas the "core" MTBR-tau species were associated stronger with tau PET and CSF measures of neurodegeneration. The ratio of the border to the core species provided a continuous measure of increasing amounts that tracked clinical progression and NFTs. INTERPRETATION Changes in CSF soluble MTBR-tau species preceded the onset of dementia, tau tangle increase, and atrophy in DIAD. The ratio of 4R-specific MTBR-tau (border) to the NFT (core) MTBR-tau species corresponds to the pathology of NFTs in DIAD and change with disease progression. The dynamics between different MTBR-tau species in the CSF may serve as a marker of tau-related disease progression and target engagement of anti-tau therapeutics. ANN NEUROL 2023;93:1158-1172.
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Affiliation(s)
- Kanta Horie
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- Eisai Inc., Nutley, NJ, 07110, USA
- The Tracy Family SILQ Center, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Nicolas R. Barthélemy
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- The Tracy Family SILQ Center, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Brian A. Gordon
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Tammie. L.S. Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Anne M. Fagan
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Celeste M. Karch
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Ricardo Allegri
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI) Instituto de Investigaciones Neurológicas Raúl Correa, Buenos Aires, Argentina
| | - Patricio Chrem Mendez
- Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI) Instituto de Investigaciones Neurológicas Raúl Correa, Buenos Aires, Argentina
| | | | | | - James Noble
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, Department of Neurology, Columbia University Irving Medical Center, New York, NY 10032 USA
| | - Martin Farlow
- Department of Neurology, Indiana University, Indianapolis, IN 46202, USA
| | - Jasmeer Chhatwal
- Massachusetts General Hospital, Harvard Medical School Boston, MA 02114, USA
| | - Gregory S. Day
- Department of Neurology, Mayo Clinic in Florida, Jacksonville, FL 32224, USA
| | - Peter R. Schofield
- Neuroscience Research Australia, Sydney, 2031 NSW, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, 2052 NSW, Australia
| | - Colin L. Masters
- The Florey Institute and the University of Melbourne, Parkville, Victoria 3010, Australia
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE) Munich, Marchioninistr 15, D-83177 Munchen, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, Ludwig-Maximilians Universität München, Marchioninistr 15, 83177 Munich, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE) Tübingen; and Hertie-Institute for Clinical Brain Research, University of Tübingen, D-72076 Tübingen, Germany
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, Seoul 05505, Korea
| | - Jee Hoon Roh
- Departments of Biomedical Sciences, Physiology, and Neurology, Korea University College of Medicine, Seoul 02841, Korea
| | - Chihiro Sato
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- The Tracy Family SILQ Center, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | | | | | | | - Randall J. Bateman
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
- The Tracy Family SILQ Center, Washington University School of Medicine, Saint Louis, MO, 63110, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO, 63110, USA
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35
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O'Connor A, Rice H, Barnes J, Ryan NS, Liu KY, Allegri RF, Berman S, Ringman JM, Cruchaga C, Farlow MR, Hassenstab J, Lee JH, Perrin RJ, Xiong C, Gordon B, Levey AI, Goate A, Graff-Radford N, Levin J, Jucker M, Benzinger T, McDade E, Mori H, Noble JM, Schofield PR, Martins RN, Salloway S, Chhatwal J, Morris JC, Bateman R, Howard R, Reeves S, Fox NC. First presentation with neuropsychiatric symptoms in autosomal dominant Alzheimer's disease: the Dominantly Inherited Alzheimer's Network Study. J Neurol Neurosurg Psychiatry 2023; 94:403-405. [PMID: 36522155 PMCID: PMC10145026 DOI: 10.1136/jnnp-2022-329843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/31/2022] [Indexed: 12/23/2022]
Affiliation(s)
- Antoinette O'Connor
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK antoinette.o'
- UK Dementia Research Institute at UCL, London, UK
| | - Helen Rice
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Natalie S Ryan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kathy Y Liu
- Division of Psychiatry, University College London, London, UK
| | - Ricardo Francisco Allegri
- Cognitive Neurology, Neurological Research Institute FLENI, Buenos Aires (Argentina), Buenos Aires, Argentina
| | - Sarah Berman
- Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - John M Ringman
- Department of Neurology, Keck School of Medicine of the University of Southern California, Los Angeles, California, USA
| | - Carlos Cruchaga
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Martin R Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jae-Hong Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea (the Republic of)
| | - Richard J Perrin
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University in St Louis MO, St Louis, Missouri, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University in St Louis MO, St Louis, Missouri, USA
| | - Brian Gordon
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine Atlanta, Atlanta, Georgia, USA
| | - Alison Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Neil Graff-Radford
- Department of Neurology, Mayo Clinic Jacksonville, Jacksonville, Florida, USA
| | - Johannes Levin
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology, (SyNergy), Munich, Germany
- Department of Neurology, Ludwig-Maximilians Universität München, Munich, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Tammie Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - James M Noble
- Department of Neurology and Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, New York, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Ralph N Martins
- Sir James McCusker Alzheimer's Disease Research Unit, Edith Cowan University, Perth, Western Australia, Australia
| | - Stephen Salloway
- Department of Neurology, Butler Hospital & Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jasmeer Chhatwal
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Randall Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Rob Howard
- Division of Psychiatry, University College London, London, UK
| | - Suzanne Reeves
- Division of Psychiatry, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
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36
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Novotny BC, Fernandez MV, Wang C, Budde JP, Bergmann K, Eteleeb AM, Bradley J, Webster C, Ebl C, Norton J, Gentsch J, Dube U, Wang F, Morris JC, Bateman RJ, Perrin RJ, McDade E, Xiong C, Chhatwal J, Goate A, Farlow M, Schofield P, Chui H, Karch CM, Cruchaga C, Benitez BA, Harari O. Metabolomic and lipidomic signatures in autosomal dominant and late-onset Alzheimer's disease brains. Alzheimers Dement 2023; 19:1785-1799. [PMID: 36251323 PMCID: PMC10106526 DOI: 10.1002/alz.12800] [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: 01/06/2022] [Revised: 07/21/2022] [Accepted: 08/09/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION The identification of multiple genetic risk factors for Alzheimer's disease (AD) suggests that many pathways contribute to AD onset and progression. However, the metabolomic and lipidomic profiles in carriers of distinct genetic risk factors are not fully understood. The metabolome can provide a direct image of dysregulated pathways in the brain. METHODS We interrogated metabolomic signatures in the AD brain, including carriers of pathogenic variants in APP, PSEN1, and PSEN2 (autosomal dominant AD; ADAD), APOE ɛ4, and TREM2 risk variant carriers, and sporadic AD (sAD). RESULTS We identified 133 unique and shared metabolites associated with ADAD, TREM2, and sAD. We identified a signature of 16 metabolites significantly altered between groups and associated with AD duration. DISCUSSION AD genetic variants show distinct metabolic perturbations. Investigation of these metabolites may provide greater insight into the etiology of AD and its impact on clinical presentation. HIGHLIGHTS APP/PSEN1/PSEN2 and TREM2 variant carriers show distinct metabolic changes. A total of 133 metabolites were differentially abundant in AD genetic groups. β-citrylglutamate is differentially abundant in autosomal dominant, TREM2, and sporadic AD. A 16-metabolite profile shows differences between Alzheimer's disease (AD) genetic groups. The identified metabolic profile is associated with duration of disease.
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Affiliation(s)
- Brenna C. Novotny
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Maria Victoria Fernandez
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Ciyang Wang
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Division of Biology & Biomedical Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - John P. Budde
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Kristy Bergmann
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Abdallah M. Eteleeb
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joseph Bradley
- Division of Biology & Biomedical Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Carol Webster
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Curtis Ebl
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Joanne Norton
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jen Gentsch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Umber Dube
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Fengxian Wang
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - John C. Morris
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Randall J. Bateman
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Richard J. Perrin
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Eric McDade
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chengjie Xiong
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jasmeer Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alzheimer’s Disease Neuroimaging Initiative
- Data used in the preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in the analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf
| | - Alzheimer’s Disease Metabolomics Consortium (ADMC)
- Data used in the preparation of this article were generated by the Alzheimer’s Disease Metabolomics Consortium (ADMC). As such, the investigators within the ADMC provided data but did not participate in the analysis or writing of this report. A complete listing of ADMC investigators can be found at: https://sites.duke.edu/adnimetab/team/
| | - Alison Goate
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Peter Schofield
- Neuroscience Research Australia, Randwick, Sydney, NSW, Australia
| | - Helena Chui
- Neurology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Celeste M. Karch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Bruno A. Benitez
- Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine, St. Louis, Missouri, USA
- NeuroGenomics and Informatics Center, Washington University School of Medicine, St. Louis, Missouri, USA
- The Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
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Ali M, Archer DB, Gorijala P, Western D, Timsina J, Fernández MV, Wang TC, Satizabal CL, Yang Q, Beiser AS, Wang R, Chen G, Gordon B, Benzinger TLS, Xiong C, Morris JC, Bateman RJ, Karch CM, McDade E, Goate A, Seshadri S, Mayeux RP, Sperling RA, Buckley RF, Johnson KA, Won HH, Jung SH, Kim HR, Seo SW, Kim HJ, Mormino E, Laws SM, Fan KH, Kamboh MI, Vemuri P, Ramanan VK, Yang HS, Wenzel A, Rajula HSR, Mishra A, Dufouil C, Debette S, Lopez OL, DeKosky ST, Tao F, Nagle MW, Hohman TJ, Sung YJ, Dumitrescu L, Cruchaga C. Large multi-ethnic genetic analyses of amyloid imaging identify new genes for Alzheimer disease. Acta Neuropathol Commun 2023; 11:68. [PMID: 37101235 PMCID: PMC10134547 DOI: 10.1186/s40478-023-01563-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 01/27/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023] Open
Abstract
Amyloid PET imaging has been crucial for detecting the accumulation of amyloid beta (Aβ) deposits in the brain and to study Alzheimer's disease (AD). We performed a genome-wide association study on the largest collection of amyloid imaging data (N = 13,409) to date, across multiple ethnicities from multicenter cohorts to identify variants associated with brain amyloidosis and AD risk. We found a strong APOE signal on chr19q.13.32 (top SNP: APOE ɛ4; rs429358; β = 0.35, SE = 0.01, P = 6.2 × 10-311, MAF = 0.19), driven by APOE ɛ4, and five additional novel associations (APOE ε2/rs7412; rs73052335/rs5117, rs1081105, rs438811, and rs4420638) independent of APOE ɛ4. APOE ɛ4 and ε2 showed race specific effect with stronger association in Non-Hispanic Whites, with the lowest association in Asians. Besides the APOE, we also identified three other genome-wide loci: ABCA7 (rs12151021/chr19p.13.3; β = 0.07, SE = 0.01, P = 9.2 × 10-09, MAF = 0.32), CR1 (rs6656401/chr1q.32.2; β = 0.1, SE = 0.02, P = 2.4 × 10-10, MAF = 0.18) and FERMT2 locus (rs117834516/chr14q.22.1; β = 0.16, SE = 0.03, P = 1.1 × 10-09, MAF = 0.06) that all colocalized with AD risk. Sex-stratified analyses identified two novel female-specific signals on chr5p.14.1 (rs529007143, β = 0.79, SE = 0.14, P = 1.4 × 10-08, MAF = 0.006, sex-interaction P = 9.8 × 10-07) and chr11p.15.2 (rs192346166, β = 0.94, SE = 0.17, P = 3.7 × 10-08, MAF = 0.004, sex-interaction P = 1.3 × 10-03). We also demonstrated that the overall genetic architecture of brain amyloidosis overlaps with that of AD, Frontotemporal Dementia, stroke, and brain structure-related complex human traits. Overall, our results have important implications when estimating the individual risk to a population level, as race and sex will needed to be taken into account. This may affect participant selection for future clinical trials and therapies.
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Affiliation(s)
- Muhammad Ali
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Derek B Archer
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Priyanka Gorijala
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Daniel Western
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Jigyasha Timsina
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Maria V Fernández
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Ting-Chen Wang
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, UT Health, San Antonio, TX, 78229, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | - Qiong Yang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
| | | | - Gengsheng Chen
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, USA
| | - Brian Gordon
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, USA
| | - Tammie L S Benzinger
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University, St Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
| | - John C Morris
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
- Department of Neurology, Washington University, St Louis, MO, USA
| | - Randall J Bateman
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA
- Department of Neurology, Washington University, St Louis, MO, USA
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Celeste M Karch
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
| | - Eric McDade
- Department of Neurology, Washington University, St Louis, MO, USA
| | - Alison Goate
- Department of Neuroscience, Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sudha Seshadri
- Framingham Heart Study, Framingham, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Richard P Mayeux
- The Department of Neurology, Columbia University, New York, NY, USA
| | - Reisa A Sperling
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Brigham and Women's Hospital and Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Brigham and Women's Hospital and Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
| | - Keith A Johnson
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hong-Hee Won
- Department of Digital Health, Samsung Medical Center, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Sang-Hyuk Jung
- Department of Digital Health, Samsung Medical Center, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hang-Rai Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang, Republic of Korea
| | - Sang Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hee Jin Kim
- Department of Digital Health, Samsung Medical Center, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Elizabeth Mormino
- Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Simon M Laws
- Centre for Precision Health, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA, 6027, Australia
| | - Kang-Hsien Fan
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - M Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, PA, USA
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Vijay K Ramanan
- Department of Neurology, Mayo Clinic-Minnesota, Rochester, MN, 55905, USA
| | - Hyun-Sik Yang
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Broad Institute of Harvard and MIT, Cambridge, USA
| | - Allen Wenzel
- Wisconsin Alzheimer's Institute, Madison, WI, USA
| | - Hema Sekhar Reddy Rajula
- UMR 1219, University of Bordeaux, INSERM, Bordeaux Population Health Research Centre, Team ELEANOR, 33000, Bordeaux, France
| | - Aniket Mishra
- UMR 1219, University of Bordeaux, INSERM, Bordeaux Population Health Research Centre, Team ELEANOR, 33000, Bordeaux, France
| | - Carole Dufouil
- UMR 1219, University of Bordeaux, INSERM, Bordeaux Population Health Research Centre, Team ELEANOR, 33000, Bordeaux, France
| | - Stephanie Debette
- UMR 1219, University of Bordeaux, INSERM, Bordeaux Population Health Research Centre, Team ELEANOR, 33000, Bordeaux, France
- Department of Neurology, Boston University School of Medicine, Boston, MA, 2115, USA
- Department of Neurology, CHU de Bordeaux, 33000, Bordeaux, France
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Feifei Tao
- Neurogenomics, Genetics-Guided Dementia Discovery, Eisai, Inc, Cambridge, MA, USA
| | - Michael W Nagle
- Neurogenomics, Genetics-Guided Dementia Discovery, Eisai, Inc, Cambridge, MA, USA
| | - Timothy J Hohman
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yun Ju Sung
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA
| | - Logan Dumitrescu
- Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Carlos Cruchaga
- Department of Psychiatry, Washington University, St. Louis, MO, 63110, USA.
- NeuroGenomics and Informatics, Washington University, St. Louis, MO, 63110, USA.
- Knight Alzheimer's Disease Research Center, Washington University, St Louis, MO, USA.
- Hope Center for Neurologic Diseases, Washington University, St. Louis, MO, 63110, USA.
- Department of Genetics, Washington University School of Medicine, St Louis, MO, 63110, USA.
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Brase L, You SF, D'Oliveira Albanus R, Del-Aguila JL, Dai Y, Novotny BC, Soriano-Tarraga C, Dykstra T, Fernandez MV, Budde JP, Bergmann K, Morris JC, Bateman RJ, Perrin RJ, McDade E, Xiong C, Goate AM, Farlow M, Sutherland GT, Kipnis J, Karch CM, Benitez BA, Harari O. Single-nucleus RNA-sequencing of autosomal dominant Alzheimer disease and risk variant carriers. Nat Commun 2023; 14:2314. [PMID: 37085492 PMCID: PMC10121712 DOI: 10.1038/s41467-023-37437-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [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: 10/04/2022] [Accepted: 03/15/2023] [Indexed: 04/23/2023] Open
Abstract
Genetic studies of Alzheimer disease (AD) have prioritized variants in genes related to the amyloid cascade, lipid metabolism, and neuroimmune modulation. However, the cell-specific effect of variants in these genes is not fully understood. Here, we perform single-nucleus RNA-sequencing (snRNA-seq) on nearly 300,000 nuclei from the parietal cortex of AD autosomal dominant (APP and PSEN1) and risk-modifying variant (APOE, TREM2 and MS4A) carriers. Within individual cell types, we capture genes commonly dysregulated across variant groups. However, specific transcriptional states are more prevalent within variant carriers. TREM2 oligodendrocytes show a dysregulated autophagy-lysosomal pathway, MS4A microglia have dysregulated complement cascade genes, and APOEε4 inhibitory neurons display signs of ferroptosis. All cell types have enriched states in autosomal dominant carriers. We leverage differential expression and single-nucleus ATAC-seq to map GWAS signals to effector cell types including the NCK2 signal to neurons in addition to the initially proposed microglia. Overall, our results provide insights into the transcriptional diversity resulting from AD genetic architecture and cellular heterogeneity. The data can be explored on the online browser ( http://web.hararilab.org/SNARE/ ).
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Affiliation(s)
- Logan Brase
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Shih-Feng You
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Ricardo D'Oliveira Albanus
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | | | - Yaoyi Dai
- Baylor College of Medicine, Houston, TX, USA
| | - Brenna C Novotny
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Carolina Soriano-Tarraga
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Taitea Dykstra
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center for Brain Immunology and Glia (BIG), Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Maria Victoria Fernandez
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - John P Budde
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Kristy Bergmann
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - John C Morris
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Randall J Bateman
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Richard J Perrin
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Eric McDade
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Alison M Goate
- Ronald M. Loeb Center for Alzheimer's Disease, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Greg T Sutherland
- School of Medical Sciences and Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jonathan Kipnis
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Center for Brain Immunology and Glia (BIG), Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Celeste M Karch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Bruno A Benitez
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Oscar Harari
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
- Hope Center for Neurological Disorders, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
- NeuroGenomics and Informatics, Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, USA.
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Liu J, Lin S, Dang J, Wang S, Cheng W, Ran Z, Zhu H, Deng H, Xiong C, Xu W, Huang Z, Xu P, Xu H. Anticancer and bone-enhanced nano-hydroxyapatite/gelatin/polylactic acid fibrous membrane with dual drug delivery and sequential release for osteosarcoma. Int J Biol Macromol 2023; 240:124406. [PMID: 37060976 DOI: 10.1016/j.ijbiomac.2023.124406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 03/30/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
Surgical resection of osteosarcoma is always accompanied by residual metastasis of tumor cells and bone tissue defects. In this work, a novel kind of gelatin/polylactic acid (PLA) coaxial fiber membrane with a shell layer containing doxorubicin-loaded hydroxyapatite (DOX@nHAp) nanoparticles and a core layer containing Icariin (ICA) was developed for antitumor and bone enhancement at the defect site. Physical evaluation displayed that the composite membrane provided moderate hydrophilicity, enhanced tensile strength (Dry: 2-3 MPa, wet: 1-2 MPa) and elasticity (70-100 %), as well as increased specific surface area and pore volume (19.39 m2/g and 0.16 cm3/g). In SBF, DOX@nHAp in the fibers promoted biomineralization on the fiber surface. In in vitro evaluation, approximately 80 % of DOX had a short-term release during the first 8 days, followed by long-term release behavior of ICA for up to 40 days. CCK-8 results confirmed that the membrane could actively support MC3T3-E1 cells proliferation and was conductive to high alkaline phosphatase expression, while the viability of MG-63 cells was effectively inhibited to 50 %. Thus, the dual-loaded fibrous membrane with a coaxial structure and nHAp is a promising system for anticancer and defects reconstruction after osteosarcoma surgery.
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Affiliation(s)
- Jiaming Liu
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Sihui Lin
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Jiarui Dang
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Sining Wang
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Wanting Cheng
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Zhihui Ran
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Hong Zhu
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Huan Deng
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Chengjie Xiong
- Orthopedic Department, General Hospital of Central Theater Command of PLA, #627 Wuluo Road, Wuchang District, Wuhan 430070, China.
| | - Wenjin Xu
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Zhijun Huang
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China
| | - Peihu Xu
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China.
| | - Haixing Xu
- Department of Chemistry, Chemical and Life Sciences, Wuhan University of Technology, Wuhan 430070, China.
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Hartz SM, Mozersky J, Schindler SE, Linnenbringer E, Wang J, Gordon BA, Raji CA, Moulder KL, West T, Benzinger TL, Cruchaga C, Hassenstab JJ, Bierut LJ, Xiong C, Morris JC. A flexible modeling approach for biomarker-based computation of absolute risk of Alzheimer's disease dementia. Alzheimers Dement 2023; 19:1452-1465. [PMID: 36178120 PMCID: PMC10060442 DOI: 10.1002/alz.12781] [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: 11/19/2021] [Revised: 06/15/2022] [Accepted: 07/21/2022] [Indexed: 01/19/2023]
Abstract
INTRODUCTION As Alzheimer's disease (AD) biomarkers rapidly develop, tools are needed that accurately and effectively communicate risk of AD dementia. METHODS We analyzed longitudinal data from >10,000 cognitively unimpaired older adults. Five-year risk of AD dementia was modeled using survival analysis. RESULTS A demographic model was developed and validated on independent data with area under the receiver operating characteristic curve (AUC) for 5-year prediction of AD dementia of 0.79. Clinical and cognitive variables (AUC = 0.79), and apolipoprotein E genotype (AUC = 0.76) were added to the demographic model. We then incorporated the risk computed from the demographic model with hazard ratios computed from independent data for amyloid positron emission tomography status and magnetic resonance imaging hippocampal volume (AUC = 0.84), and for plasma amyloid beta (Aβ)42/Aβ40 (AUC = 0.82). DISCUSSION An adaptive tool was developed and validated to compute absolute risks of AD dementia. This approach allows for improved accuracy and communication of AD risk among cognitively unimpaired older adults.
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Affiliation(s)
- Sarah M. Hartz
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jessica Mozersky
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | - Junwei Wang
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Brian A. Gordon
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Cyrus A. Raji
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Tim West
- C2N Diagnostics, St. Louis, Missouri USA
| | | | - Carlos Cruchaga
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | - Laura J. Bierut
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Washington University School of Medicine, St. Louis, Missouri, USA
| | - John C. Morris
- Washington University School of Medicine, St. Louis, Missouri, USA
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Barthélemy NR, Saef B, Li Y, Gordon BA, He Y, Horie K, Stomrud E, Salvadó G, Janelidze S, Sato C, Ovod V, Henson RL, Fagan AM, Benzinger TLS, Xiong C, Morris JC, Hansson O, Bateman RJ, Schindler SE. CSF tau phosphorylation occupancies at T217 and T205 represent improved biomarkers of amyloid and tau pathology in Alzheimer's disease. Nat Aging 2023; 3:391-401. [PMID: 37117788 PMCID: PMC10154225 DOI: 10.1038/s43587-023-00380-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/03/2023] [Indexed: 04/30/2023]
Abstract
Cerebrospinal fluid (CSF) amyloid-β peptide (Aβ)42/Aβ40 and the concentration of tau phosphorylated at site 181 (p-tau181) are well-established biomarkers of Alzheimer's disease (AD). The present study used mass spectrometry to measure concentrations of nine phosphorylated and five nonphosphorylated tau species and phosphorylation occupancies (percentage phosphorylated/nonphosphorylated) at ten sites. In the present study we show that, in 750 individuals with a median age of 71.2 years, CSF pT217/T217 predicted the presence of brain amyloid by positron emission tomography (PET) slightly better than Aβ42/Aβ40 (P = 0.02). Furthermore, for individuals with positive brain amyloid by PET (n = 263), CSF pT217/T217 was more strongly correlated with the amount of amyloid (Spearman's ρ = 0.69) than Aβ42/Aβ40 (ρ = -0.42, P < 0.0001). In two independent cohorts of participants with symptoms of AD dementia (n = 55 and n = 90), CSF pT217/T217 and pT205/T205 were better correlated with tau PET measures than CSF p-tau181 concentration. These findings suggest that CSF pT217/T217 and pT205/T205 represent improved CSF biomarkers of amyloid and tau pathology in AD.
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Affiliation(s)
- Nicolas R Barthélemy
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA.
| | - Benjamin Saef
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yan Li
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Brian A Gordon
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Yingxin He
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA
| | - Kanta Horie
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA
| | - Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Gemma Salvadó
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Shorena Janelidze
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Chihiro Sato
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA
| | - Vitaliy Ovod
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA
| | - Rachel L Henson
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
- Tracy Family SILQ Center for Neurodegenerative Biology, St. Louis, MO, USA
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Suzanne E Schindler
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA.
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Li T, He H, Zhang T, Li X, Xie W, Huang B, Xu F, Xiong C. Comprehensive comparison of three techniques for the treatment of adjacent segment degeneration after lumbar fusion. Front Surg 2023; 10:1096483. [PMID: 37066013 PMCID: PMC10097961 DOI: 10.3389/fsurg.2023.1096483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/07/2023] [Indexed: 04/01/2023] Open
Abstract
PurposeAdjacent segment degeneration (ASD) following lumbar fusion is technically challenging for spine surgeons. Posterolateral open fusion surgery with pedicle screw fixation is an effective way to treat symptomatic ASD with favorable clinical outcomes; however, it is associated with an increased morbidity rate. Therefore, minimally invasive spine surgery is advocated. This study was designed to compare clinical outcomes among patients with symptomatic ASD who underwent percutaneous transforaminal endoscopic discectomy (PTED) with the transforaminal approach, posterior lumbar interbody fusion (PLIF) with cortical bone trajectory screw fixation (CBT-PLIF), and PLIF with traditional trajectory screw fixation (TT-PLIF).MethodsA retrospective study was conductedon 46 patients (26 men and 20 women; average age 60.8 ± 6.78 years) with symptomatic ASD. The patients were treated with three approaches. The operation time, incision length, time to return to work, complications, and the like were compared among three groups. Intervertebral disc (IVD) space height, angular motion, and vertebral slippage were obtained to assess spine biomechanical stability following surgery. The visual analog scale (VAS) score and Oswestry disability index were evaluated at preoperation and 1-week, 3-month, and the latest follow-ups. Clinical global outcomes were also estimated using modified MacNab criteria.ResultsThe operation time, incision length, intraoperative blood loss, and time to return to work for the PTED group were significantly decreased compared with those for the other two groups (P < 0.05). The radiological indicators in the CBT-PLIF group and TT-PLIF group had better biomechanical stability compared with those in the PTED groups at the latest follow-up (P < 0.05). The back pain VAS score in the CBT-PLIF group was significantly decreased compared with those in the other two groups at the latest follow-up (P < 0.05). The good-to-excellent rate was 82.35% in the PTED group, 88.89% in the CBT-PLIF group, and 85.00% in the TT-PLIF group. No serious complications were encountered. Two patients experienced dysesthesia in the PTED group; screw malposition was found in one patient in the CBT-PLIF group. One case with a dural matter tear was observed in the TT-PLIF group.ConclusionAll three approaches can treat patients with symptomatic ASD efficiently and safely. Functional recovery was more accelerated in the PTED group compared with the other approaches in the short term; CBT-PLIF and TT-PLIF can provide superior biomechanical stability to the lumbosacral spine following decompression compared with PTED; however, compared with TT-PLIF, CBT-PLIF can significantly reduce back pain caused by iatrogenic muscle injury and improve functional recovery. Therefore, superior clinical outcomes were achieved in the CBT-PLIF group compared with the PTED and TT-PLIF groups in the long term.
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Affiliation(s)
- Tao Li
- Department of Orthopaedics, Affiliated Hospital of Wuhan Sports University, Wuhan, China
| | - Hang He
- Department of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Tonghui Zhang
- Department of Orthopaedics, Affiliated Hospital of Wuhan Sports University, Wuhan, China
| | - Xugui Li
- Department of Orthopaedics, Affiliated Hospital of Wuhan Sports University, Wuhan, China
| | - Wei Xie
- Department of Orthopaedics, Affiliated Hospital of Wuhan Sports University, Wuhan, China
| | - Biwang Huang
- Department of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Feng Xu
- Department of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- Correspondence: Feng Xu Chengjie Xiong
| | - Chengjie Xiong
- Department of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
- Correspondence: Feng Xu Chengjie Xiong
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Vermunt L, Sutphen C, Dicks E, de Leeuw DM, Allegri R, Berman SB, Cash DM, Chhatwal JP, Cruchaga C, Day G, Ewers M, Farlow M, Fox NC, Ghetti B, Graff-Radford N, Hassenstab J, Jucker M, Karch CM, Kuhle J, Laske C, Levin J, Masters CL, McDade E, Mori H, Morris JC, Perrin RJ, Preische O, Schofield PR, Suárez-Calvet M, Xiong C, Scheltens P, Teunissen CE, Visser PJ, Bateman RJ, Benzinger TLS, Fagan AM, Gordon BA, Tijms BM. Axonal damage and astrocytosis are biological correlates of grey matter network integrity loss: a cohort study in autosomal dominant Alzheimer disease. medRxiv 2023:2023.03.21.23287468. [PMID: 37016671 PMCID: PMC10071836 DOI: 10.1101/2023.03.21.23287468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Brain development and maturation leads to grey matter networks that can be measured using magnetic resonance imaging. Network integrity is an indicator of information processing capacity which declines in neurodegenerative disorders such as Alzheimer disease (AD). The biological mechanisms causing this loss of network integrity remain unknown. Cerebrospinal fluid (CSF) protein biomarkers are available for studying diverse pathological mechanisms in humans and can provide insight into decline. We investigated the relationships between 10 CSF proteins and network integrity in mutation carriers (N=219) and noncarriers (N=136) of the Dominantly Inherited Alzheimer Network Observational study. Abnormalities in Aβ, Tau, synaptic (SNAP-25, neurogranin) and neuronal calcium-sensor protein (VILIP-1) preceded grey matter network disruptions by several years, while inflammation related (YKL-40) and axonal injury (NfL) abnormalities co-occurred and correlated with network integrity. This suggests that axonal loss and inflammation play a role in structural grey matter network changes. Key points Abnormal levels of fluid markers for neuronal damage and inflammatory processes in CSF are associated with grey matter network disruptions.The strongest association was with NfL, suggesting that axonal loss may contribute to disrupted network organization as observed in AD.Tracking biomarker trajectories over the disease course, changes in CSF biomarkers generally precede changes in brain networks by several years.
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Sun C, Xiong C, Xu F. Musculoskeletal Injuries at the Chinese Peacekeeping Level II Hospital in Wau, South Sudan, 2018-2022. Mil Med 2023; 188:usad032. [PMID: 36806664 DOI: 10.1093/milmed/usad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/14/2022] [Accepted: 01/26/2023] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION Musculoskeletal injuries (MSIs) are common among U.N. military personnel and cause a substantial toll, but little is known about the actual risks and changes of MSIs. The Chinese level II hospital (CHN L2H) was the highest-level hospital in the Western Sector of the U.N. Mission in South Sudan (UNMISS). This study reviewed and analyzed the MSIs managed by the CHN L2H in UNMISS. METHODS Medical records of MSIs in CHN L2H from September 2018 to July 2022 were identified. We analyzed all the MSIs and treatment procedures. RESULTS A total of 857 patients from more than 40 countries were included (86.8% men, average age of 37.83 years), consisting of 457 troop-contributing country, 231 U.N. local, and 169 U.N. international personnel. The most common injury was lumbar muscle strain (14.2%). Sports-related mechanism (29.2%) was the most frequent cause of MSIs. The most significant proportions of anatomical regions were the lumbar spine (22.52%), hand (13.77%), and foot (10.97%). No-steroid anti-inflammatory drugs (43.99%), physical therapy (20.54%), and immobilization (11.32%) were the most used treatments. CONCLUSIONS MSIs are common diseases in the CHN L2H in the Western Sector of UNMISS. The universality and complexity of MSIs demonstrate the urgent need to improve prevention, treatment, and rehabilitation.
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Affiliation(s)
- Chao Sun
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan 430074, China
| | - Chengjie Xiong
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan 430074, China
| | - Feng Xu
- Department of Orthopedics, General Hospital of Central Theatre Command of PLA, Wuhan 430074, China
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Goyal MS, Blazey T, Metcalf NV, McAvoy MP, Strain JF, Rahmani M, Durbin TJ, Xiong C, Benzinger TLS, Morris JC, Raichle ME, Vlassenko AG. Brain aerobic glycolysis and resilience in Alzheimer disease. Proc Natl Acad Sci U S A 2023; 120:e2212256120. [PMID: 36745794 PMCID: PMC9963219 DOI: 10.1073/pnas.2212256120] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 01/04/2023] [Indexed: 02/08/2023] Open
Abstract
The distribution of brain aerobic glycolysis (AG) in normal young adults correlates spatially with amyloid-beta (Aβ) deposition in individuals with symptomatic and preclinical Alzheimer disease (AD). Brain AG decreases with age, but the functional significance of this decrease with regard to the development of AD symptomatology is poorly understood. Using PET measurements of regional blood flow, oxygen consumption, and glucose utilization-from which we derive AG-we find that cognitive impairment is strongly associated with loss of the typical youthful pattern of AG. In contrast, amyloid positivity without cognitive impairment was associated with preservation of youthful brain AG, which was even higher than that seen in cognitively unimpaired, amyloid negative adults. Similar findings were not seen for blood flow nor oxygen consumption. Finally, in cognitively unimpaired adults, white matter hyperintensity burden was found to be specifically associated with decreased youthful brain AG. Our results suggest that AG may have a role in the resilience and/or response to early stages of amyloid pathology and that age-related white matter disease may impair this process.
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Affiliation(s)
- Manu S. Goyal
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Department of Neurology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO63110
| | - Tyler Blazey
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
| | - Nicholas V. Metcalf
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
| | - Mark P. McAvoy
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
- Program in Occupational Therapy, Washington University School of Medicine, St. Louis, MO63108
| | - Jeremy F. Strain
- Department of Neurology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
| | - Maryam Rahmani
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
| | - Tony J. Durbin
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
| | - Chengjie Xiong
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
| | - Tammie L.-S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, St. Louis, MO63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
| | - Marcus E. Raichle
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Department of Neurology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
- Department of Neuroscience, Washington University School of Medicine, St. Louis, MO63110
- Department of Biomedical Engineering, Washington University School of Medicine, St. Louis, MO63130
- Department of Psychology & Brain Science, Washington University School of Medicine, St. Louis, MO63130
| | - Andrei G. Vlassenko
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO63110
- Neuroimaging Labs Research Center, Washington University School of Medicine, St. Louis, MO63110
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO63108
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Vöglein J, Franzmeier N, Morris JC, Dieterich M, McDade E, Simons M, Preische O, Hofmann A, Hassenstab J, Benzinger TL, Fagan A, Noble JM, Berman SB, Graff-Radford NR, Ghetti B, Farlow MR, Chhatwal JP, Salloway S, Xiong C, Karch CM, Cairns N, Perrin RJ, Day G, Martins R, Sanchez-Valle R, Mori H, Shimada H, Ikeuchi T, Suzuki K, Schofield PR, Masters CL, Goate A, Buckles V, Fox NC, Chrem P, Allegri R, Ringman JM, Yakushev I, Laske C, Jucker M, Höglinger G, Bateman RJ, Danek A, Levin J. Pattern and implications of neurological examination findings in autosomal dominant Alzheimer disease. Alzheimers Dement 2023; 19:632-645. [PMID: 35609137 PMCID: PMC9684350 DOI: 10.1002/alz.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION As knowledge about neurological examination findings in autosomal dominant Alzheimer disease (ADAD) is incomplete, we aimed to determine the frequency and significance of neurological examination findings in ADAD. METHODS Frequencies of neurological examination findings were compared between symptomatic mutation carriers and non mutation carriers from the Dominantly Inherited Alzheimer Network (DIAN) to define AD neurological examination findings. AD neurological examination findings were analyzed regarding frequency, association with and predictive value regarding cognitive decline, and association with brain atrophy in symptomatic mutation carriers. RESULTS AD neurological examination findings included abnormal deep tendon reflexes, gait disturbance, pathological cranial nerve examination findings, tremor, abnormal finger to nose and heel to shin testing, and compromised motor strength. The frequency of AD neurological examination findings was 65.1%. Cross-sectionally, mutation carriers with AD neurological examination findings showed a more than two-fold faster cognitive decline and had greater parieto-temporal atrophy, including hippocampal atrophy. Longitudinally, AD neurological examination findings predicted a significantly greater decline over time. DISCUSSION ADAD features a distinct pattern of neurological examination findings that is useful to estimate prognosis and may inform clinical care and therapeutic trial designs.
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Affiliation(s)
- Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Nicolai Franzmeier
- Institute for Stroke and Dementia Research, Ludwig-Maximilians-Universität München, Germany
| | - John C. Morris
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Marianne Dieterich
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- German Center for Vertigo and Balance Disorders, Ludwig-Maximilians-Universität München, Germany
| | - Eric McDade
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Mikael Simons
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Anna Hofmann
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Jason Hassenstab
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Tammie L. Benzinger
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Anne Fagan
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - James M. Noble
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, and Gertrude H. Sergievsky Center, Columbia University Irving Medical Center, 710 West 168 Street Box 176, New York, NY 10032, USA
| | - Sarah B. Berman
- University of Pittsburgh, 3471 Fifth Ave #900, Pittsburgh, PA 15213, USA
| | | | | | - Martin R. Farlow
- Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Jasmeer P. Chhatwal
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Stephen Salloway
- Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Celeste M. Karch
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Nigel Cairns
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
- Medical School and Living Systems Institute, University of Exeter, Stocker Road, Exeter, EX4 4QD, United Kingdom
| | - Richard J. Perrin
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Gregory Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, USA
| | - Ralph Martins
- Edith Cowan University, 270 Joondalup Drive, Joondalup WA 6027, Australia
| | - Raquel Sanchez-Valle
- Alzheimer’s disease and other cognitive disorders group. Service of Neurology, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Hiroshi Mori
- Osaka City University Medical School, Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Hiroyuki Shimada
- Osaka City University Medical School, Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Takeshi Ikeuchi
- Brain Research Institute, Niigata University, 1-757 Asahimachi, Niigata 951-8585, Japan
| | | | - Peter R. Schofield
- Neuroscience Research Australia, Sydney 2031 Australia
- School of Medical Sciences, University of New South Wales, Sydney 2052 Australia
| | - Colin L. Masters
- Florey Institute, University of Melbourne, Level 5, Kenneth Myer Building, 30 Royal Parade, Parkville, Victoria, 3010, Australia
| | - Alison Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, 1425 Madison Ave, B1065, New York, NY 10029,USA
| | - Virginia Buckles
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Nick C. Fox
- Dementia Research Centre, Institute of Neurology, University College London, Queen Square, London WC1 3BG United Kingdom
| | | | | | - John M. Ringman
- Keck School of Medicine of University of Southern California, Center for the Health Professionals, 1540 Alcazar Street, Suite 209F, Los Angeles, CA 90089, USA
| | - Igor Yakushev
- Department of Nuclear Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
| | - Mathias Jucker
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Günter Höglinger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Department of Neurology, Medizinische Hochschule Hannover, Hannover, Germany
| | - Randall J. Bateman
- Washington University School of Medicine, 660 South Euclid, Saint Louis, MO 63110, USA
| | - Adrian Danek
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
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He H, Ma J, Xiong C, Wei T, Tang A, Chen Y, Xu F. Development and Validation of a Nomogram to Predict the Risk of Lumbar Disk Reherniation within 2 Years After Percutaneous Endoscopic Lumbar Discectomy. World Neurosurg 2023; 172:e349-e356. [PMID: 36640832 DOI: 10.1016/j.wneu.2023.01.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 01/06/2023] [Accepted: 01/06/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To develop and validate a nomogram for predicting recurrent lumbar disk herniation (LDH) within 2 years after percutaneous endoscopic lumbar discectomy. METHODS Information on patients' LDH was collected from 1 medical center between January 2015 and September 2020. The LASSO (least absolute shrinkage and selection operator) method was applied to select the most significant risk factors. A multivariate logistic regression analysis was used to develop a predictive model incorporating the possible factors selected by the LASSO regression model. The discriminant, corrected, and clinically useful prediction models were evaluated using consistency index (C-index), receiver operating characteristic curve, calibration curves, and decision curve analysis. Internal validation of clinical predictive power was also assessed by bootstrap validation. RESULTS A total of 690 patients with LDH were included in this study. Sixty-three patients experienced recurrence within 2 years whereas 627 experienced no recurrence. The nomogram predictors included age, body mass index, Modic change, Pfirrmann grade, and sagittal range of motion. The model had good discrimination power, with a reliable C-index of 0.868 (95% confidence interval, 0.822-0.913) and interval validation confirmed a higher C-index value of 0.846. The area under the receiver operating characteristic curve was 0.868, indicating a good predictive value. The decision curve analysis indicated that it was clinically feasible to use the predictive recurrence nomogram model. CONCLUSIONS We developed and validated a new accurate and effective nomogram for predicting recurrent LDH within 2 years after percutaneous endoscopic lumbar discectomy. Age, body mass index, Modic change, Pfirrmann grade, and sagittal range of motion were significant features for predicting rLDH.
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Affiliation(s)
- Hang He
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Jun Ma
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Chengjie Xiong
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Tanjun Wei
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Aolin Tang
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Yongkang Chen
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China
| | - Feng Xu
- Departments of Orthopaedics, General Hospital of Central Theater Command of PLA, Wuhan, China.
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48
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Li QF, Song LJ, Yang YY, Dong PP, Mei CJ, Li YX, Zhang JF, Xiong C, Yu CX, Yang K. [Recombinant Schistosoma japonicum egg ribonuclease SjCP1412 inhibits the activation of LX-2 hepatic stellate cells in vitro]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 34:566-579. [PMID: 36642896 DOI: 10.16250/j.32.1374.2022163] [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] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To investigate the effect of recombinant Schistosoma japonicum egg ribonuclease SjCP1412 (rSjCP1412) on proliferation, cell cycle, apoptosis and activation of human hepatic stellate cells LX-2 in vitro, and explore the underlying mechanisms. METHODS The rSjCP1412 protein was expressed in Escherichia coli BL21 by prokaryotic expression, and the highly purified soluble rSjCP1412 protein was prepared by Ni NTA affinity chromatography and urea gradient refolding dialysis. Yeast RNA was digested using 12.5, 25.0, 50.0 µg rSjCP1412 proteins at 37 °C for 2, 3, 4 h, and the enzymatic products were electrophoresed on 1.5% agarose gel to observe the RNAase activity of rSjCP1412 protein. The proliferation of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was measured using CCK-8 assay, and the apoptosis of LX-2 cells stimulated by different doses of rSjCP1412 protein for 48 hours was detected using the Annexin V-FITC/PI double staining, while the percentage of LX-2 cells at G0/G1, S and G2/M phases of cell cycle following stimulation with different doses of rSjCP1412 protein for 48 h was detected by DAPI staining. The type I collagen, type III collagen and α-smooth muscle actin (α-SMA) mRNA expression was quantified using quantitative florescent real-time PCR (qPCR) assay and Western blotting at transcriptional and translational levels in LX-2 cells following stimulation with different doses of rSjCP1412 protein for 48 h, while soluble egg antigen (SEA) served a positive control and PBS without rSjCP1412 protein as a normal control in the above experiments. The expression of collagen I, α-SMA and Smad4 protein was determined using Western blotting in LX-2 cells following stimulation with rSjCP1412 protein, transforming growth factor-β1 (TGF-β1) alone or in combination, to examine the signaling for the effect of rSjCP1412 protein on LX-2 cells. RESULTS The rSjCP1412 protein was successfully expressed and the highly purified soluble rSjCP1412 protein was prepared, which had a RNase activity. Compared with the normal group, the survival rates of LX-2 cells significantly decreased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein and SEA for 48 h (F = 22.417 and 20.448, both P values < 0.05). The apoptotic rates of LX-2 cells significantly increased post-treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h (F = 11.350, P < 0.05), and treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h resulted in arrest of LX-2 cells in G0/G1 phase (F = 20.710, P < 0.05). Treatment with 12.5, 25.0, 50.0 µg/mL rSjCP1412 protein for 48 h caused a significant reduction in relative expression levels of collagen I (F = 11.340, P < 0.05), collagen III (F = 456.600, P < 0.05) and α-SMA mRNA (F = 23.100, P < 0.05) in LX-2 cells, and both rSjCP1412 protein and SEA treatment caused a significant reduction in collagen I (F = 1 302.000, P < 0.05), α-SMA (F = 49.750, P < 0.05) and Smad4 protein expression (F = 52.420, P < 0.05) in LX-2 cells. In addition, rSjCP1412 protein treatment inhibited collagen I (F = 66.290, P < 0.05), α-SMA (F = 31.300, P < 0.05) and Smad4 protein expression (F = 27.010, P < 0.05) in LX-2 cells activated by TGF-β1. CONCLUSIONS rSjCP1412 protein may induce apoptosis of LX-2 cells and inhibit proliferation, cell cycle and activation of LX-2 cells through down-regulating Smad4 signaling molecules.
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Affiliation(s)
- Q F Li
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,Co-first authors
| | - L J Song
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China.,Co-first authors
| | - Y Y Yang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - P P Dong
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - C J Mei
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - Y X Li
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - J F Zhang
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - C Xiong
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - C X Yu
- National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
| | - K Yang
- School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.,National Health Commission Key Laboratory of Parasitic Disease Control and Prevention, Jiangsu Provincial Key Laboratory on Parasite and Vector Control Technology, Jiangsu Institute of Parasitic Diseases, Wuxi, Jiangsu 214064, China
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49
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Boerwinkle AH, Gordon BA, Wisch J, Flores S, Henson RL, Butt OH, McKay N, Chen CD, Benzinger TLS, Fagan AM, Handen BL, Christian BT, Head E, Mapstone M, Rafii MS, O'Bryant S, Lai F, Rosas HD, Lee JH, Silverman W, Brickman AM, Chhatwal JP, Cruchaga C, Perrin RJ, Xiong C, Hassenstab J, McDade E, Bateman RJ, Ances BM. Comparison of amyloid burden in individuals with Down syndrome versus autosomal dominant Alzheimer's disease: a cross-sectional study. Lancet Neurol 2023; 22:55-65. [PMID: 36517172 PMCID: PMC9979840 DOI: 10.1016/s1474-4422(22)00408-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/14/2022] [Accepted: 09/27/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Important insights into the early pathogenesis of Alzheimer's disease can be provided by studies of autosomal dominant Alzheimer's disease and Down syndrome. However, it is unclear whether the timing and spatial distribution of amyloid accumulation differs between people with autosomal dominant Alzheimer's disease and those with Down syndrome. We aimed to directly compare amyloid changes between these two groups of people. METHODS In this cross-sectional study, we included participants (aged ≥25 years) with Down syndrome and sibling controls who had MRI and amyloid PET scans in the first data release (January, 2020) of the Alzheimer's Biomarker Consortium-Down Syndrome (ABC-DS) study. We also included carriers of autosomal dominant Alzheimer's disease genetic mutations and non-carrier familial controls who were within a similar age range to ABC-DS participants (25-73 years) and had MRI and amyloid PET scans at the time of a data freeze (December, 2020) of the Dominantly Inherited Alzheimer Network (DIAN) study. Controls from the two studies were combined into a single group. All DIAN study participants had genetic testing to determine PSEN1, PSEN2, or APP mutation status. APOE genotype was determined from blood samples. CSF samples were collected in a subset of ABC-DS and DIAN participants and the ratio of amyloid β42 (Aβ42) to Aβ40 (Aβ42/40) was measured to evaluate its Spearman's correlation with amyloid PET. Global PET amyloid burden was compared with regards to cognitive status, APOE ɛ4 status, sex, age, and estimated years to symptom onset. We further analysed amyloid PET deposition by autosomal dominant mutation type. We also assessed regional patterns of amyloid accumulation by estimated number of years to symptom onset. Within a subset of participants the relationship between amyloid PET and CSF Aβ42/40 was evaluated. FINDINGS 192 individuals with Down syndrome and 33 sibling controls from the ABC-DS study and 265 carriers of autosomal dominant Alzheimer's disease mutations and 169 non-carrier familial controls from the DIAN study were included in our analyses. PET amyloid centiloid and CSF Aβ42/40 were negatively correlated in carriers of autosomal dominant Alzheimer's disease mutations (n=216; r=-0·565; p<0·0001) and in people with Down syndrome (n=32; r=-0·801; p<0·0001). There was no difference in global PET amyloid burden between asymptomatic people with Down syndrome (mean 18·80 centiloids [SD 28·33]) versus asymptomatic mutation carriers (24·61 centiloids [30·27]; p=0·11) and between symptomatic people with Down syndrome (77·25 centiloids [41·76]) versus symptomatic mutation carriers (69·15 centiloids [51·10]; p=0·34). APOE ɛ4 status and sex had no effect on global amyloid PET deposition. Amyloid deposition was elevated significantly earlier in mutation carriers than in participants with Down syndrome (estimated years to symptom onset -23·0 vs -17·5; p=0·0002). PSEN1 mutations primarily drove this difference. Early amyloid accumulation occurred in striatal and cortical regions for both mutation carriers (n=265) and people with Down syndrome (n=128). Although mutation carriers had widespread amyloid accumulation in all cortical regions, the medial occipital regions were spared in people with Down syndrome. INTERPRETATION Despite minor differences, amyloid PET changes were similar between people with autosomal dominant Alzheimer's disease versus Down syndrome and strongly supported early amyloid dysregulation in individuals with Down syndrome. Individuals with Down syndrome aged at least 35 years might benefit from early intervention and warrant future inclusion in clinical trials, particularly given the relatively high incidence of Down syndrome. FUNDING The National Institute on Aging, Riney and Brennan Funds, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the German Center for Neurodegenerative Diseases, and the Japan Agency for Medical Research and Development.
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Affiliation(s)
- Anna H Boerwinkle
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Brian A Gordon
- Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA; Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Julie Wisch
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Shaney Flores
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Rachel L Henson
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Omar H Butt
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Nicole McKay
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Charles D Chen
- Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Tammie L S Benzinger
- Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA; Department of Radiology, Washington University in St Louis, St Louis, MO, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Benjamin L Handen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Bradley T Christian
- Department of Medical Physics and Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, University of California Irvine School of Medicine, University of California, Irvine, CA, USA
| | - Mark Mapstone
- Department of Neurology, University of California Irvine School of Medicine, University of California, Irvine, CA, USA
| | - Michael S Rafii
- Alzheimer's Therapeutic Research Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Sid O'Bryant
- Institute for Translational Research, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Florence Lai
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA, USA
| | - H Diana Rosas
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA, USA
| | - Joseph H Lee
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wayne Silverman
- Department of Pediatrics, University of California Irvine School of Medicine, University of California, Irvine, CA, USA
| | - Adam M Brickman
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA; G H Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jasmeer P Chhatwal
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital and Brigham and Women's Hospital, Boston, MA, USA
| | - Carlos Cruchaga
- Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA; Department of Psychiatry, Washington University in St Louis, St Louis, MO, USA
| | - Richard J Perrin
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA; Department of Pathology and Immunology, Washington University in St Louis, St Louis, MO, USA
| | - Chengjie Xiong
- Division of Biostatistics, Washington University School of Medicine, Washington University in St Louis, St Louis, MO, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Eric McDade
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA
| | - Randall J Bateman
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St Louis, St Louis, MO, USA; Hope Center for Neurological Disorders, Washington University in St Louis, St Louis, MO, USA; Department of Radiology, Washington University in St Louis, St Louis, MO, USA.
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50
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Luckett PH, Chen C, Gordon BA, Wisch J, Berman SB, Chhatwal JP, Cruchaga C, Fagan AM, Farlow MR, Fox NC, Jucker M, Levin J, Masters CL, Mori H, Noble JM, Salloway S, Schofield PR, Brickman AM, Brooks WS, Cash DM, Fulham MJ, Ghetti B, Jack CR, Vöglein J, Klunk WE, Koeppe R, Su Y, Weiner M, Wang Q, Marcus D, Koudelis D, Mathurin NJ, Cash L, Hornbeck R, Xiong C, Perrin RJ, Karch CM, Hassenstab J, McDade E, Morris JC, Benzinger TL, Bateman RJ, Ances BM. Biomarker clustering in autosomal dominant Alzheimer's disease. Alzheimers Dement 2023; 19:274-284. [PMID: 35362200 PMCID: PMC9525451 DOI: 10.1002/alz.12661] [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: 11/02/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION As the number of biomarkers used to study Alzheimer's disease (AD) continues to increase, it is important to understand the utility of any given biomarker, as well as what additional information a biomarker provides when compared to others. METHODS We used hierarchical clustering to group 19 cross-sectional biomarkers in autosomal dominant AD. Feature selection identified biomarkers that were the strongest predictors of mutation status and estimated years from symptom onset (EYO). Biomarkers identified included clinical assessments, neuroimaging, cerebrospinal fluid amyloid, and tau, and emerging biomarkers of neuronal integrity and inflammation. RESULTS Three primary clusters were identified: neurodegeneration, amyloid/tau, and emerging biomarkers. Feature selection identified amyloid and tau measures as the primary predictors of mutation status and EYO. Emerging biomarkers of neuronal integrity and inflammation were relatively weak predictors. DISCUSSION These results provide novel insight into our understanding of the relationships among biomarkers and the staging of biomarkers based on disease progression.
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Affiliation(s)
| | - Charlie Chen
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Brian A. Gordon
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Julie Wisch
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Jasmeer P. Chhatwal
- Brigham and Women’s Hospital, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Carlos Cruchaga
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Anne M. Fagan
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | - Nick C. Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Mathias Jucker
- German Center for Neurodegenerative Disease, Tübingen, Germany
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes Levin
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Colin L. Masters
- Florey Institute, The University of Melbourne, Parkville, Victoria, Australia
| | - Hiroshi Mori
- Osaka City University Medical School, Nagaoka Sutoku University, Abenoku, Osaka, Japan
| | - James M. Noble
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, G.H. Sergievsky Center, and Department of Neurology, Columbia University Irving Medical Center, New York, New York, USA
| | - Stephen Salloway
- Butler Hospital and Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Peter R. Schofield
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Adam M. Brickman
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - William S. Brooks
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - David M. Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Michael J. Fulham
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | | | | | - Yi Su
- Banner Alzheimer Institute, Phoenix, Arizona, USA
| | - Michael Weiner
- University of California San Francisco, San Francisco, California, USA
- San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Qing Wang
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Daniel Marcus
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | | | - Lisa Cash
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Russ Hornbeck
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Chengjie Xiong
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | | | | | - Eric McDade
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - John C. Morris
- Washington University in St. Louis, St. Louis, Missouri, USA
| | | | | | - Beau M. Ances
- Washington University in St. Louis, St. Louis, Missouri, USA
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