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Frisoni GB, Festari C, Massa F, Cotta Ramusino M, Orini S, Aarsland D, Agosta F, Babiloni C, Borroni B, Cappa SF, Frederiksen KS, Froelich L, Garibotto V, Haliassos A, Jessen F, Kamondi A, Kessels RP, Morbelli SD, O'Brien JT, Otto M, Perret-Liaudet A, Pizzini FB, Vandenbulcke M, Vanninen R, Verhey F, Vernooij MW, Yousry T, Boada Rovira M, Dubois B, Georges J, Hansson O, Ritchie CW, Scheltens P, van der Flier WM, Nobili F. European intersocietal recommendations for the biomarker-based diagnosis of neurocognitive disorders. Lancet Neurol 2024; 23:302-312. [PMID: 38365381 DOI: 10.1016/s1474-4422(23)00447-7] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/30/2023] [Accepted: 11/13/2023] [Indexed: 02/18/2024]
Abstract
The recent commercialisation of the first disease-modifying drugs for Alzheimer's disease emphasises the need for consensus recommendations on the rational use of biomarkers to diagnose people with suspected neurocognitive disorders in memory clinics. Most available recommendations and guidelines are either disease-centred or biomarker-centred. A European multidisciplinary taskforce consisting of 22 experts from 11 European scientific societies set out to define the first patient-centred diagnostic workflow that aims to prioritise testing for available biomarkers in individuals attending memory clinics. After an extensive literature review, we used a Delphi consensus procedure to identify 11 clinical syndromes, based on clinical history and examination, neuropsychology, blood tests, structural imaging, and, in some cases, EEG. We recommend first-line and, if needed, second-line testing for biomarkers according to the patient's clinical profile and the results of previous biomarker findings. This diagnostic workflow will promote consistency in the diagnosis of neurocognitive disorders across European countries.
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Affiliation(s)
- Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland; Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland.
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology and Dementia Research Center (DRC), IRCCS Mondino Foundation, Pavia, Italy
| | - Stefania Orini
- Alzheimer's Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Dag Aarsland
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway; UK Dementia Research Institute, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele of Cassino, Cassino, Italy
| | - Barbara Borroni
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Continuity of Care and Frailty, ASST Spedali Civili, Brescia, Italy
| | - Stefano F Cappa
- Centro Ricerca sulle Demenze, IRCCS Mondino Foundation, Pavia, Italy; University Institute for Advanced Studies (IUSS), Pavia, Italy
| | - Kristian S Frederiksen
- Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Geneva University Neurocenter and Faculty of Medicine, University of Geneva, Geneva, Switzerland; Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland; CIBM Center for Biomedical Imaging, Geneva, Switzerland
| | | | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Anita Kamondi
- National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary; Department of Neurology, Semmelweis University, Budapest, Hungary
| | - Roy Pc Kessels
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands; Radboud UMC Alzheimer Center and Department of Medical Psychology, Radboud University Medical Center, Nijmegen, Netherlands; Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Silvia D Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - John T O'Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Markus Otto
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Halle (Saale), Germany
| | | | - Francesca B Pizzini
- Department of Diagnostic and Public Health, Verona University Hospital, Verona University, Verona, Italy
| | - Mathieu Vandenbulcke
- Department of Neurosciences, KU Leuven, Leuven, Belgium; Department of Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven-Kortenberg, Belgium
| | - Ritva Vanninen
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology-Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Meike W Vernooij
- Department of Epidemiology and Department of Radiology and Nuclear Medicine Erasmus MC University Medical Center, Rotterdam, Netherlands
| | - Tarek Yousry
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Mercè Boada Rovira
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain
| | - Bruno Dubois
- Institut de La Mémoire et de La Maladie d'Alzheimer, Neurology Department, Salpêtrière Hospital, Assistance Publique-Hôpital de Paris, Paris, France; Sorbonne University, Paris, France
| | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Craig W Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, Western General Hospital, University of Edinburgh, Edinburgh, UK; Brain Health Scotland, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Amsterdam, Netherlands; Amsterdam Neuroscience-Neurodegeneration, Amsterdam, Netherlands; Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, Netherlands
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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Cotta Ramusino M, Massa F, Festari C, Gandolfo F, Nicolosi V, Orini S, Nobili F, Frisoni GB, Morbelli S, Garibotto V. Diagnostic performance of molecular imaging methods in predicting the progression from mild cognitive impairment to dementia: an updated systematic review. Eur J Nucl Med Mol Imaging 2024:10.1007/s00259-024-06631-y. [PMID: 38355740 DOI: 10.1007/s00259-024-06631-y] [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: 11/13/2023] [Accepted: 01/27/2024] [Indexed: 02/16/2024]
Abstract
PURPOSE Epidemiological and logistical reasons are slowing the clinical validation of the molecular imaging biomarkers in the initial stages of neurocognitive disorders. We provide an updated systematic review of the recent advances (2017-2022), highlighting methodological shortcomings. METHODS Studies reporting the diagnostic accuracy values of the molecular imaging techniques (i.e., amyloid-, tau-, [18F]FDG-PETs, DaT-SPECT, and cardiac [123I]-MIBG scintigraphy) in predicting progression from mild cognitive impairment (MCI) to dementia were selected according to the Preferred Reporting Items for a Systematic Review and Meta-Analysis (PRISMA) method and evaluated with the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Main eligibility criteria were as follows: (1) ≥ 50 subjects with MCI, (2) follow-up ≥ 3 years, (3) gold standard: progression to dementia or diagnosis on pathology, and (4) measures of prospective accuracy. RESULTS Sensitivity (SE) and specificity (SP) in predicting progression to dementia, mainly to Alzheimer's dementia were 43-100% and 63-94% for [18F]FDG-PET and 64-94% and 48-93% for amyloid-PET. Longitudinal studies were lacking for less common disorders (Dementia with Lewy bodies-DLB and Frontotemporal lobe degeneration-FTLD) and for tau-PET, DaT-SPECT, and [123I]-MIBG scintigraphy. Therefore, the accuracy values from cross-sectional studies in a smaller sample of subjects (n > 20, also including mild dementia stage) were chosen as surrogate outcomes. DaT-SPECT showed 47-100% SE and 71-100% SP in differentiating Lewy body disease (LBD) from non-LBD conditions; tau-PET: 88% SE and 100% SP in differentiating DLB from Posterior Cortical Atrophy. [123I]-MIBG scintigraphy differentiated LBD from non-LBD conditions with 47-100% SE and 71-100% SP. CONCLUSION Molecular imaging has a moderate-to-good accuracy in predicting the progression of MCI to Alzheimer's dementia. Longitudinal studies are sparse in non-AD conditions, requiring additional efforts in these settings.
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Affiliation(s)
- Matteo Cotta Ramusino
- Unit of Behavior Neurology and Dementia Research Center, IRCCS Mondino Foundation, via Mondino 2, 27100, Pavia, Italy.
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Federica Gandolfo
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genoa, Italy
| | - Valentina Nicolosi
- UOC Neurologia Ospedale Magalini Di Villafranca Di Verona (VR) ULSS 9, Verona, Italy
| | - Stefania Orini
- Alzheimer's Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Flavio Nobili
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University and University Hospitals, Geneva, Switzerland
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, University Hospitals of Geneva, Geneva, Switzerland
- NIMTLab, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- CIBM Center for Biomedical Imaging, Geneva, Switzerland
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Singh Solorzano C, Cattane N, Mega A, Orini S, Zanetti O, Chattat R, Marizzoni M, Pievani M, Cattaneo A, Festari C. Psychobiological effects of an eHealth psychoeducational intervention to informal caregivers of persons with dementia: a pilot study during the COVID-19 pandemic in Italy. Aging Clin Exp Res 2023; 35:3085-3096. [PMID: 37943404 PMCID: PMC10721699 DOI: 10.1007/s40520-023-02610-9] [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: 07/12/2023] [Accepted: 10/25/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND The workload associated with caring for a person with dementia (PwD) could negatively affect informal caregivers' physical and mental health. According to the recent literature, there is a need for studies testing the implementation of affordable and accessible interventions for improving caregivers' well-being. AIMS This study aimed to explore the feasibility and effectiveness of an 8 week eHealth psychoeducation intervention held during the COVID-19 pandemic in Italy in reducing the psychological burden and neuroendocrine markers of stress in caregivers of PwD. METHODS Forty-one informal caregivers of PwD completed the eHealth psychoeducation intervention. Self-reported (i.e., caregiver burden, anxiety symptoms, depressive symptoms, and caregiver self-efficacy) and cortisol measurements were collected before and after the intervention. RESULTS Following the intervention, the caregivers' self-efficacy regarding the ability to respond to disruptive behaviours improved (t = - 2.817, p = 0.007), anxiety and burden levels decreased (state anxiety: t = 3.170, p = 0.003; trait anxiety: t = 2.327, p = 0.025; caregiver burden: t = 2.290, p = 0.027), while depressive symptoms and cortisol levels did not change significantly. Correlation analyses showed that the increase in self-efficacy was positively associated with the improvement of caregiver burden from pre- to post-intervention (r = 0.386, p = 0.014). The intervention had a low rate of dropout (n = 1, due to the patient's death) and high levels of appreciation. DISCUSSION The positive evidence and participation rate support the feasibility and effectiveness of the proposed eHealth psychoeducational intervention to meet the need for knowledge of disease management and possibly reduce detrimental effects on caregivers' psychological well-being. CONCLUSION Further placebo-controlled trials are needed to test the generalizability and specificity of our results.
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Affiliation(s)
- Claudio Singh Solorzano
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy.
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Mega
- UOC Neurologia, ULSS 9 Scaligera-Distretto 4, Verona, Italy
| | - Stefania Orini
- Alzheimer Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Clinical and Experimental Sciences, Università degli Studi di Brescia, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Rabih Chattat
- Department of Psychology, Università di Bologna, Bologna, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Michela Pievani
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
| | - Annamaria Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Via Pilastroni 4, 25125, Brescia, Italy
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Marizzoni M, Mirabelli P, Mombelli E, Coppola L, Festari C, Lopizzo N, Luongo D, Mazzelli M, Naviglio D, Blouin JL, Abramowicz M, Salvatore M, Pievani M, Cattaneo A, Frisoni GB. A peripheral signature of Alzheimer's disease featuring microbiota-gut-brain axis markers. Alzheimers Res Ther 2023; 15:101. [PMID: 37254223 PMCID: PMC10230724 DOI: 10.1186/s13195-023-01218-5] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 03/21/2023] [Indexed: 06/01/2023]
Abstract
BACKGROUND Increasing evidence links the gut microbiota (GM) to Alzheimer's disease (AD) but the mechanisms through which gut bacteria influence the brain are still unclear. This study tests the hypothesis that GM and mediators of the microbiota-gut-brain axis (MGBA) are associated with the amyloid cascade in sporadic AD. METHODS We included 34 patients with cognitive impairment due to AD (CI-AD), 37 patients with cognitive impairment not due to AD (CI-NAD), and 13 cognitively unimpaired persons (CU). We studied the following systems: (1) fecal GM, with 16S rRNA sequencing; (2) a panel of putative MGBA mediators in the blood including immune and endothelial markers as bacterial products (i.e., lipopolysaccharide, LPS), cell adhesion molecules (CAMs) indicative of endothelial dysfunction (VCAM-1, PECAM-1), vascular changes (P-, E-Selectin), and upregulated after infections (NCAM, ICAM-1), as well as pro- (IL1β, IL6, TNFα, IL18) and anti- (IL10) inflammatory cytokines; (3) the amyloid cascade with amyloid PET, plasma phosphorylated tau (pTau-181, for tau pathology), neurofilament light chain (NfL, for neurodegeneration), and global cognition measured using MMSE and ADAScog. We performed 3-group comparisons of markers in the 3 systems and calculated correlation matrices for the pooled group of CI-AD and CU as well as CI-NAD and CU. Patterns of associations based on Spearman's rho were used to validate the study hypothesis. RESULTS CI-AD were characterized by (1) higher abundance of Clostridia_UCG-014 and decreased abundance of Moryella and Blautia (p < .04); (2) elevated levels of LPS (p < .03), upregulation of CAMs, Il1β, IL6, and TNFα, and downregulation of IL10 (p < .05); (3) increased brain amyloid, plasma pTau-181, and NfL (p < 0.004) compared with the other groups. CI-NAD showed (1) higher abundance of [Eubacterium] coprostanoligenes group and Collinsella and decreased abundance of Lachnospiraceae_ND3007_group, [Ruminococcus]_gnavus_group and Oscillibacter (p < .03); (2) upregulation of PECAM-1 and TNFα (p < .03); (4) increased plasma levels of NfL (p < .02) compared with CU. Different GM genera were associated with immune and endothelial markers in both CI-NAD and CI-AD but these mediators were widely related to amyloid cascade markers only in CI-AD. CONCLUSIONS Specific bacterial genera are associated with immune and endothelial MGBA mediators, and these are associated with amyloid cascade markers in sporadic AD. The physiological mechanisms linking the GM to the amyloid cascade should be further investigated to elucidate their potential therapeutic implications.
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Affiliation(s)
- Moira Marizzoni
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy.
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy.
| | | | - Elisa Mombelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | | | - Cristina Festari
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Delia Luongo
- Istituto Di Biostrutture E Bioimmagini (I.B.B.) - CNR, Naples, Italy
| | - Monica Mazzelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Daniele Naviglio
- Dip.to Di Scienze Chimiche, Università Degli Studi Di Napoli - Federico II, Naples, Italy
| | - Jean-Louis Blouin
- Genetic Medicine Division, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Marc Abramowicz
- Genetic Medicine Division, University Hospitals and University of Geneva, Geneva, Switzerland
| | | | - Michela Pievani
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Brescia, Italy
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Giovanni B Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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Festari C, Massa F, Cotta Ramusino M, Gandolfo F, Nicolosi V, Orini S, Aarsland D, Agosta F, Babiloni C, Boada M, Borroni B, Cappa S, Dubois B, Frederiksen KS, Froelich L, Garibotto V, Georges J, Haliassos A, Hansson O, Jessen F, Kamondi A, Kessels RPC, Morbelli S, O'Brien JT, Otto M, Perret-Liaudet A, Pizzini FB, Ritchie CW, Scheltens P, Vandenbulcke M, Vanninen R, Verhey F, Vernooij MW, Yousry T, Van Der Flier WM, Nobili F, Frisoni GB. European consensus for the diagnosis of MCI and mild dementia: Preparatory phase. Alzheimers Dement 2022; 19:1729-1741. [PMID: 36209379 DOI: 10.1002/alz.12798] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 03/02/2022] [Revised: 07/29/2022] [Accepted: 08/09/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION Etiological diagnosis of neurocognitive disorders of middle-old age relies on biomarkers, although evidence for their rational use is incomplete. A European task force is defining a diagnostic workflow where expert experience fills evidence gaps for biomarker validity and prioritization. We report methodology and preliminary results. METHODS Using a Delphi consensus method supported by a systematic literature review, 22 delegates from 11 relevant scientific societies defined workflow assumptions. RESULTS We extracted diagnostic accuracy figures from literature on the use of biomarkers in the diagnosis of main forms of neurocognitive disorders. Supported by this evidence, panelists defined clinical setting (specialist outpatient service), application stage (MCI-mild dementia), and detailed pre-assessment screening (clinical-neuropsychological evaluations, brain imaging, and blood tests). DISCUSSION The Delphi consensus on these assumptions set the stage for the development of the first pan-European workflow for biomarkers' use in the etiological diagnosis of middle-old age neurocognitive disorders at MCI-mild dementia stages. HIGHLIGHTS Rational use of biomarkers in neurocognitive disorders lacks consensus in Europe. A consensus of experts will define a workflow for the rational use of biomarkers. The diagnostic workflow will be patient-centered and based on clinical presentation. The workflow will be updated as new evidence accrues.
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Affiliation(s)
- Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
| | - Matteo Cotta Ramusino
- Unit of Behavioral Neurology, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Federica Gandolfo
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, E.O. Galliera Hospital, Genova, Italy
| | - Valentina Nicolosi
- UOC Neurologia, Ospedale Magalini (ULSS 9 - Veneto), Villafranca di Verona (VR), Italy
| | - Stefania Orini
- Alzheimer's Unit - Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Dipartimento di Scienze Cliniche e Sperimentali, Università degli Studi di Brescia, Brescia, Italy
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Centre for Age-Related Diseases, Stavanger University Hospital, Stavanger, Norway
- European DLB Consortium
| | - Federica Agosta
- Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Vita-Salute San Raffaele University, Milan, Italy
- European Academy of Neurology
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
- Hospital San Raffaele of Cassino, Cassino (FR), Italy
- Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology
| | - Mercè Boada
- Ace Alzheimer Center Barcelona - Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Neurology Unit, Department of Neurological and Vision Sciences, ASST Spedali Civili, Brescia, Italy
- European FTLD network
| | - Stefano Cappa
- Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
- Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy
- Federation of the European Societies of Neuropsychology
| | - Bruno Dubois
- Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A), ICM, Salpetriere Hospital, AP-HP, University Paris 6, Paris, France
| | - Kristian S Frederiksen
- European Academy of Neurology
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lutz Froelich
- Department of Geriatric Psychiatry, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
- European Alzheimer Disease Consortium
| | - Valentina Garibotto
- NIMTLab, Faculty of Medicine, University of Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland
- Center for Biomedical Imaging, CIBM, Geneva, Switzerland
- European Association of Nuclear Medicine
| | | | - Alexander Haliassos
- ESEAP-Proficiency Testing Scheme for Clinical Laboratories, Athens, Greece
- International Federation of Clinical Chemistry
| | - Oskar Hansson
- Department of Clinical Sciences Malmö, Clinical Memory Research Unit, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmo, Sweden
| | - Frank Jessen
- European Alzheimer Disease Consortium
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Anita Kamondi
- Europe, Middle East and Africa Chapter of the International Federation of Clinical Neurophysiology
- Department of Neurology, National Institute of Mental Health, Neurology and Neurosurgery, Budapest, Hungary
| | - Roy P C Kessels
- Federation of the European Societies of Neuropsychology
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, The Netherlands
- Department of Medical Psychology and Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Silvia Morbelli
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Dept of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - John T O'Brien
- European DLB Consortium
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Markus Otto
- European FTLD network
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany
| | - Armand Perret-Liaudet
- International Federation of Clinical Chemistry
- Laboratory of Neurobiology, Department of Biochemistry and Molecular Biology, Hospices civils de Lyon; Research and Resources Memory Centre, Lyon, France
- BioRan Team, Centre de Recherche en Neurosciences de Lyon, CNRS UMR5292, INSERM U1028, Lyon, France
| | - Francesca B Pizzini
- Verona University Hospital, Verona University, Dept. of Diagnostic and Public Health, Verona, Italy
- European Union of Medical Specialists
| | - Craig W Ritchie
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Brain Health Scotland, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mathieu Vandenbulcke
- Neuropsychiatry, Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Geriatric Psychiatry, University Psychiatric Centre KU Leuven, Leuven, Belgium
- European Association of Geriatric Psychiatry
| | - Ritva Vanninen
- European Union of Medical Specialists
- University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Frans Verhey
- European Association of Geriatric Psychiatry
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands
- European Society of Neuroradiology
| | - Tarek Yousry
- European Society of Neuroradiology
- Lysholm Department of Neuroradiology and the Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, UK
| | - Wiesje M Van Der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Flavio Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Geneva Memory Center, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
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6
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Boccardi M, Monsch AU, Ferrari C, Altomare D, Berres M, Bos I, Buchmann A, Cerami C, Didic M, Festari C, Nicolosi V, Sacco L, Aerts L, Albanese E, Annoni JM, Ballhausen N, Chicherio C, Démonet JF, Descloux V, Diener S, Ferreira D, Georges J, Gietl A, Girtler N, Kilimann I, Klöppel S, Kustyniuk N, Mecocci P, Mella N, Pigliautile M, Seeher K, Shirk SD, Toraldo A, Brioschi-Guevara A, Chan KCG, Crane PK, Dodich A, Grazia A, Kochan NA, de Oliveira FF, Nobili F, Kukull W, Peters O, Ramakers I, Sachdev PS, Teipel S, Visser PJ, Wagner M, Weintraub S, Westman E, Froelich L, Brodaty H, Dubois B, Cappa SF, Salmon D, Winblad B, Frisoni GB, Kliegel M. Harmonizing neuropsychological assessment for mild neurocognitive disorders in Europe. Alzheimers Dement 2022; 18:29-42. [PMID: 33984176 PMCID: PMC9642857 DOI: 10.1002/alz.12365] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [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: 07/27/2020] [Revised: 03/11/2021] [Accepted: 04/05/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Harmonized neuropsychological assessment for neurocognitive disorders, an international priority for valid and reliable diagnostic procedures, has been achieved only in specific countries or research contexts. METHODS To harmonize the assessment of mild cognitive impairment in Europe, a workshop (Geneva, May 2018) convened stakeholders, methodologists, academic, and non-academic clinicians and experts from European, US, and Australian harmonization initiatives. RESULTS With formal presentations and thematic working-groups we defined a standard battery consistent with the U.S. Uniform DataSet, version 3, and homogeneous methodology to obtain consistent normative data across tests and languages. Adaptations consist of including two tests specific to typical Alzheimer's disease and behavioral variant frontotemporal dementia. The methodology for harmonized normative data includes consensus definition of cognitively normal controls, classification of confounding factors (age, sex, and education), and calculation of minimum sample sizes. DISCUSSION This expert consensus allows harmonizing the diagnosis of neurocognitive disorders across European countries and possibly beyond.
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Affiliation(s)
- Marina Boccardi
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
| | - Andreas U Monsch
- Memory Clinic, University Department of Geriatric Medicine FELIX PLATTER, Faculty of Psychology, University of Basel, Basel, Switzerland
| | - Clarissa Ferrari
- Unit of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Daniele Altomare
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Isabelle Bos
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Chiara Cerami
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Mira Didic
- APHM, Timone, Service de Neurologie et Neuropsychologie, Hôpital Timone Adultes, Marseille, France
- Aix-Marseille Université, Inserm, INS, UMR_S 1106, 13005, Marseille, France
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Valentina Nicolosi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Leonardo Sacco
- Clinic of Neurology, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland
| | - Liesbeth Aerts
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Jean-Marie Annoni
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Nicola Ballhausen
- Department of Developmental Psychology, Tilburg University, Tilburg, The Netherlands
| | | | - Jean-François Démonet
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Virginie Descloux
- Department of Neuroscience and Movement Sciences, University of Geneva and Fribourg Hospital, Geneva, Switzerland
| | - Suzie Diener
- Department of Neurology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Nicola Girtler
- Clinical Psychology and Psychotherapy, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Ingo Kilimann
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Stefan Klöppel
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Nicole Kustyniuk
- Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Patrizia Mecocci
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Nathalie Mella
- Cognitive Aging Lab, University of Geneva, Geneva, Switzerland
| | - Martina Pigliautile
- Department of Medicine and Surgery, Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy
| | - Katrin Seeher
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Steven D Shirk
- VISN 1 New England MIRECC and VISN 1 New England GRECC, Bedford VA Healthcare System, Bedford, Department of Psychiatry and Population and Quantitative Health Sciences, University of Massachusetts Medical School, Massachusetts, USA
| | - Alessio Toraldo
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy, Milan Center for Neuroscience, Milan, Italy
| | - Andrea Brioschi-Guevara
- Leenaards Memory Centre-CHUV, Clinical Neuroscience Department, Cité Hospitalière CHUV, Lausanne, Switzerland
| | - Kwun C G Chan
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Paul K Crane
- Department of Medicine, University of Washington, Seattle, Washington, USA
| | - Alessandra Dodich
- Neuroimaging and Innovative Molecular Tracers Laboratory, and Division of Nuclear Medicine, Diagnostic Departement, University of Geneva, University Hospitals of Geneva, Geneva, Switzerland
- Centre for Mind/Brain Sciences, University of Trento, Rovereto, Italy
| | - Alice Grazia
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - Flavio Nobili
- Neurology Clinic, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dept of Neuroscience (DINOGMI), University of Genoa, Genoa, Italy
| | - Walter Kukull
- National Alzheimer's Coordination Center (NACC), Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Oliver Peters
- Department of Psychiatry and Psychotherapy, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Germany, ZNE, German Center for Neurodegenerative Diseases, Berlin, Germany
| | - Inez Ramakers
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Stefan Teipel
- DZNE - Deutsches Zentrum für Neurodegenerative Erkrankungen, Rostock-Greifswald site, Rostock, Germany
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Michael Wagner
- DZNE, German Center for Neurodegenerative Diseases, Bonn, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern Feinberg School of Medicine, Chicago, Illinois
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lutz Froelich
- University of Heidelberg, Heidelberg, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Bruno Dubois
- Hôpital Pitié-Salpêtrière, AP-HP, Alzheimer Research Institute (IM2A), and Institut du cerveau et la moelle (ICM), Sorbonne Université, Paris, France
| | - Stefano F Cappa
- Institute for Advanced Studies (IUSS-Pavia), Pavia, Italy, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - David Salmon
- Department of Neurosciences, University of California San Diego School of Medicine, San Diego, USA
| | - Bengt Winblad
- Dept NVS, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Center, Geneva University Hospitals, Geneva, Switzerland
| | - Matthias Kliegel
- Cognitive Aging Lab, Department of Psychology, University of Geneva, Geneva, Switzerland
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Boccardi M, Dodich A, Albanese E, Gayet-Ageron A, Festari C, Ashton NJ, Bischof GN, Chiotis K, Leuzy A, Wolters EE, Walter M, Rabinovici GD, Carrillo M, Drzezga A, Hansson O, Nordberg A, Ossenkoppele R, Villemagne VL, Winblad B, Frisoni G, Garibotto V. Correction to: The Strategic Biomarker Roadmap for the validation of Alzheimer's diagnostic biomarkers: methodological update. Eur J Nucl Med Mol Imaging 2021; 48:4525-4531. [PMID: 34546388 DOI: 10.1007/s00259-021-05549-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Marina Boccardi
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany. .,LANVIE, Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
| | - Alessandra Dodich
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy.,NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
| | | | | | - Cristina Festari
- LANE, Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Konstantinos Chiotis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Antoine Leuzy
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Emma E Wolters
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martin Walter
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
| | - Gil D Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, University of California, San Francisco, USA
| | | | - Alexander Drzezga
- University of Cologne, Faculty of Medicine, Cologne, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany.,Institute of Neuroscience and Medicine (INM-2), Molecular Organization of the Brain, Research Center Jülich, Jülich, Germany
| | - Oskar Hansson
- Clinical Memory Rresearch Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Clinical Memory Research, Lund University, Lund, Sweden
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, VIC, Australia.,Department of Medicine, Austin Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Bengt Winblad
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni Frisoni
- LANVIE, Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.,Memory Clinic, University Hospital, Geneva, Switzerland
| | - Valentina Garibotto
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland.,Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
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8
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Bischof GN, Dodich A, Boccardi M, van Eimeren T, Festari C, Barthel H, Hansson O, Nordberg A, Ossenkoppele R, Sabri O, Giovanni BFG, Garibotto V, Drzezga A. Clinical validity of second-generation tau PET tracers as biomarkers for Alzheimer's disease in the context of a structured 5-phase development framework. Eur J Nucl Med Mol Imaging 2021; 48:2110-2120. [PMID: 33590274 PMCID: PMC8175320 DOI: 10.1007/s00259-020-05156-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE In 2017, the Geneva Alzheimer's disease (AD) strategic biomarker roadmap initiative proposed a framework of the systematic validation AD biomarkers to harmonize and accelerate their development and implementation in clinical practice. Here, we use this framework to examine the translatability of the second-generation tau PET tracers into the clinical context. METHODS All available literature was systematically searched based on a set of search terms that related independently to analytic validity (phases 1-2), clinical validity (phase 3-4), and clinical utility (phase 5). The progress on each of the phases was determined based on scientific criteria applied for each phase and coded as fully, partially, preliminary achieved or not achieved at all. RESULTS The validation of the second-generation tau PET tracers has successfully passed the analytical phase 1 of the strategic biomarker roadmap. Assay definition studies showed evidence on the superiority over first-generation tau PET tracers in terms of off-target binding. Studies have partially achieved the primary aim of the analytical validity stage (phase 2), and preliminary evidence has been provided for the assessment of covariates on PET signal retention. Studies investigating of the clinical validity in phases 3, 4, and 5 are still underway. CONCLUSION The current literature provides overall preliminary evidence on the establishment of the second-generation tau PET tracers into the clinical context, thereby successfully addressing some methodological issues from the tau PET tracer of the first generation. Nevertheless, bigger cohort studies, longitudinal follow-up, and examination of diverse disease population are still needed to gauge their clinical validity.
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Affiliation(s)
- Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany.
| | - Alessandra Dodich
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy
| | - Marina Boccardi
- German Center for Neurodegenerative Disorders (DZNE), Rostock/Greifswald, Rostock, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn/Cologne, Germany
| | - Thilo van Eimeren
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
- German Center for Neurodegenerative Disorders (DZNE), Rostock/Greifswald, Rostock, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn/Cologne, Germany
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Henryk Barthel
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - Oskar Hansson
- Memory Clinic, Skåne University Hopsital, Malmö, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Rik Ossenkoppele
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Osama Sabri
- Department of Nuclear Medicine, University of Leipzig, Leipzig, Germany
| | - B Frisoni G Giovanni
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Memory Center - Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Nuclear Medicine and Molecular Imaging Division, Diagnostic Department, Geneva University Hospitals, Genève, Switzerland
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
- German Center for Neurodegenerative Disorders (DZNE), Rostock/Greifswald, Rostock, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn/Cologne, Germany
- Molecular Organization of the Brain, Institute for Neuroscience and Medicine (INM-2), Jülich, Germany
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9
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De Francesco S, Galluzzi S, Vanacore N, Festari C, Rossini PM, Cappa SF, Frisoni GB, Redolfi A. Norms for Automatic Estimation of Hippocampal Atrophy and a Step Forward for Applicability to the Italian Population. Front Neurosci 2021; 15:656808. [PMID: 34262425 PMCID: PMC8273578 DOI: 10.3389/fnins.2021.656808] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 06/03/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Hippocampal volume is one of the main biomarkers of Alzheimer's Dementia (AD). Over the years, advanced tools that performed automatic segmentation of Magnetic Resonance Imaging (MRI) T13D scans have been developed, such as FreeSurfer (FS) and ACM-Adaboost (AA). Hippocampal volume is considered abnormal when it is below the 5th percentile of the normative population. The aim of this study was to set norms, established from the Alzheimer's Disease Neuroimaging Initiative (ADNI) population, for hippocampal volume measured with FS v.6.0 and AA tools in the neuGRID platform (www.neugrid2.eu) and demonstrate their applicability for the Italian population. METHODS Norms were set from a large group of 545 healthy controls belonging to ADNI. For each pipeline, subjects with segmentation errors were discarded, resulting in 532 valid segmentations for FS and 421 for AA (age range 56-90 years). The comparability of ADNI and the Italian Brain Normative Archive (IBNA), representative of the Italian general population, was assessed testing clinical variables, neuropsychological scores and normalized hippocampal volumes. Finally, percentiles were validated using the Italian Alzheimer's disease Repository Without Borders (ARWiBo) as external independent data set to evaluate FS and AA generalizability. RESULTS Hippocampal percentiles were checked with the chi-square goodness of fit test. P-values were not significant, showing that FS and AA algorithm distributions fitted the data well. Clinical, neuropsychological and volumetric features were similar in ADNI and IBNA (p > 0.01). Hippocampal volumes measured with both FS and AA were associated with age (p < 0.001). The 5th percentile thresholds, indicating left/right hippocampal atrophy were respectively: (i) below 3,223/3,456 mm3 at 56 years and 2,506/2,415 mm3 at 90 years for FS; (ii) below 4,583/4,873 mm3 at 56 years and 3,831/3,870 mm3 at 90 years for AA. The average volumes computed on 100 cognitively intact healthy controls (CN) selected from ARWiBo were close to the 50th percentiles, while those for 100 AD patients were close to the abnormal percentiles. DISCUSSION Norms generated from ADNI through the automatic FS and AA segmentation tools may be used as normative references for Italian patients with suspected AD.
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Affiliation(s)
- Silvia De Francesco
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology - LANE, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
| | - Cristina Festari
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology - LANE, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Paolo Maria Rossini
- Department of Neuroscience and Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy
| | - Stefano F. Cappa
- IRCCS Mondino Foundation, Pavia, Italy
- IUSS Cognitive Neuroscience (ICoN) Center, University School for Advanced Studies, Pavia, Italy
| | - Giovanni B. Frisoni
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology - LANE, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Alberto Redolfi
- Laboratory of Neuroinformatics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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10
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Marizzoni M, Cattaneo A, Mirabelli P, Festari C, Lopizzo N, Nicolosi V, Mombelli E, Mazzelli M, Luongo D, Naviglio D, Coppola L, Salvatore M, Frisoni GB. Short-Chain Fatty Acids and Lipopolysaccharide as Mediators Between Gut Dysbiosis and Amyloid Pathology in Alzheimer's Disease. J Alzheimers Dis 2021; 78:683-697. [PMID: 33074224 DOI: 10.3233/jad-200306] [Citation(s) in RCA: 159] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Metagenomic data support an association between certain bacterial strains and Alzheimer's disease (AD), but their functional dynamics remain elusive. OBJECTIVE To investigate the association between amyloid pathology, bacterial products such as lipopolysaccharide (LPS) and short chain fatty acids (SCFAs: acetate, valerate, butyrate), inflammatory mediators, and markers of endothelial dysfunction in AD. METHODS Eighty-nine older persons with cognitive performance from normal to dementia underwent florbetapir amyloid PET and blood collection. Brain amyloidosis was measured with standardized uptake value ratio versus cerebellum. Blood levels of LPS were measured by ELISA, SCFAs by mass spectrometry, cytokines by using real-time PCR, and biomarkers of endothelial dysfunction by flow cytometry. We investigated the association between the variables listed above with Spearman's rank test. RESULTS Amyloid SUVR uptake was positively associated with blood LPS (rho≥0.32, p≤0.006), acetate and valerate (rho≥0.45, p < 0.001), pro-inflammatory cytokines (rho≥0.25, p≤0.012), and biomarkers of endothelial dysfunction (rho≥0.25, p≤0.042). In contrast, it was negatively correlated with butyrate (rho≤-0.42, p≤0.020) and the anti-inflammatory cytokine IL10 (rho≤-0.26, p≤0.009). Endothelial dysfunction was positively associated with pro-inflammatory cytokines, acetate and valerate (rho≥0.25, p≤0.045) and negatively with butyrate and IL10 levels (rho≤-0.25, p≤0.038). CONCLUSION We report a novel association between gut microbiota-related products and systemic inflammation with brain amyloidosis via endothelial dysfunction, suggesting that SCFAs and LPS represent candidate pathophysiologic links between the gut microbiota and AD pathology.
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Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Cristina Festari
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Valentina Nicolosi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Mombelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Monica Mazzelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Daniele Naviglio
- Department of Chemical Sciences, University of Naples Federico II, Via Cintia 4, Naples, Italy
| | | | | | - Giovanni B Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
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11
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Boccardi M, Dodich A, Albanese E, Gayet-Ageron A, Festari C, Ashton NJ, Bischof GN, Chiotis K, Leuzy A, Wolters EE, Walter MA, Rabinovici GD, Carrillo M, Drzezga A, Hansson O, Nordberg A, Ossenkoppele R, Villemagne VL, Winblad B, Frisoni GB, Garibotto V. The strategic biomarker roadmap for the validation of Alzheimer's diagnostic biomarkers: methodological update. Eur J Nucl Med Mol Imaging 2021; 48:2070-2085. [PMID: 33688996 PMCID: PMC8175304 DOI: 10.1007/s00259-020-05120-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 09/25/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
Background The 2017 Alzheimer’s disease (AD) Strategic Biomarker Roadmap (SBR) structured the validation of AD diagnostic biomarkers into 5 phases, systematically assessing analytical validity (Phases 1–2), clinical validity (Phases 3–4), and clinical utility (Phase 5) through primary and secondary Aims. This framework allows to map knowledge gaps and research priorities, accelerating the route towards clinical implementation. Within an initiative aimed to assess the development of biomarkers of tau pathology, we revised this methodology consistently with progress in AD research. Methods We critically appraised the adequacy of the 2017 Biomarker Roadmap within current diagnostic frameworks, discussed updates at a workshop convening the Alzheimer’s Association and 8 leading AD biomarker research groups, and detailed the methods to allow consistent assessment of aims achievement for tau and other AD diagnostic biomarkers. Results The 2020 update applies to all AD diagnostic biomarkers. In Phases 2–3, we admitted a greater variety of study designs (e.g., cross-sectional in addition to longitudinal) and reference standards (e.g., biomarker confirmation in addition to clinical progression) based on construct (in addition to criterion) validity. We structured a systematic data extraction to enable transparent and formal evidence assessment procedures. Finally, we have clarified issues that need to be addressed to generate data eligible to evidence-to-decision procedures. Discussion This revision allows for more versatile and precise assessment of existing evidence, keeps up with theoretical developments, and helps clinical researchers in producing evidence suitable for evidence-to-decision procedures. Compliance with this methodology is essential to implement AD biomarkers efficiently in clinical research and diagnostics.
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Affiliation(s)
- Marina Boccardi
- German Center for Neurodegenerative Diseases DZNE-Standort Rostock/Greifswald, Gehlsheimer Str. 20, 18147, Rostock, Germany.
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland.
| | - Alessandra Dodich
- Center for Neurocognitive Rehabilitation (CeRiN), CIMeC, University of Trento, Trento, Italy
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
| | - Emiliano Albanese
- USI - Università della Svizzera Italiana, Institute of Public Health (IPH), Lugano, Switzerland
| | - Angèle Gayet-Ageron
- Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Nicholas J Ashton
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, The Sahlgrenska Academy at The University of Gothenburg, Molndal, Sweden
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, London, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Gérard N Bischof
- Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany
| | - Konstantinos Chiotis
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Antoine Leuzy
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Emma E Wolters
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martin A Walter
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
| | - Gil D Rabinovici
- Departments of Neurology, Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | | | - Alexander Drzezga
- Faculty of Medicine, University of Cologne, Cologne, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn/Cologne, Germany
- Molecular Organization of the Brain, Research Center Jülich, Institute of Neuroscience and Medicine (INM-2), Julich, Germany
| | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Malmo, Sweden
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Department of Clinical Memory Research, Lund University, Lund, Sweden
| | - Victor L Villemagne
- Department of Molecular Imaging & Therapy, Austin Health, Melbourne, VIC, Australia
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsilvania, USA
| | - Bengt Winblad
- Karolinska University Hospital, Theme Aging, Geriatric Clinic, Huddinge, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Giovanni B Frisoni
- LANVIE - Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland
- Memory Clinic, University Hospital, Geneva, Switzerland
| | - Valentina Garibotto
- NIMTlab - Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
- Nuclear Medicine and Molecular Division, Geneva Medical Hospital, Geneva, Switzerland
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12
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Marizzoni M, Gurry T, Provasi S, Greub G, Lopizzo N, Ribaldi F, Festari C, Mazzelli M, Mombelli E, Salvatore M, Mirabelli P, Franzese M, Soricelli A, Frisoni GB, Cattaneo A. Comparison of Bioinformatics Pipelines and Operating Systems for the Analyses of 16S rRNA Gene Amplicon Sequences in Human Fecal Samples. Front Microbiol 2020; 11:1262. [PMID: 32636817 PMCID: PMC7318847 DOI: 10.3389/fmicb.2020.01262] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 05/18/2020] [Indexed: 01/03/2023] Open
Abstract
Amplicon high-throughput sequencing of 16S ribosomal RNA (rRNA) gene is currently the most widely used technique to investigate complex gut microbial communities. Microbial identification might be influenced by several factors, including the choice of bioinformatic pipelines, making comparisons across studies difficult. Here, we compared four commonly used pipelines (QIIME2, Bioconductor, UPARSE and mothur) run on two operating systems (OS) (Linux and Mac), to evaluate the impact of bioinformatic pipeline and OS on the taxonomic classification of 40 human stool samples. We applied the SILVA 132 reference database for all the pipelines. We compared phyla and genera identification and relative abundances across the four pipelines using the Friedman rank sum test. QIIME2 and Bioconductor provided identical outputs on Linux and Mac OS, while UPARSE and mothur reported only minimal differences between OS. Taxa assignments were consistent at both phylum and genus level across all the pipelines. However, a difference in terms of relative abundance was identified for all phyla (p < 0.013) and for the majority of the most abundant genera (p < 0.028), such as Bacteroides (QIIME2: 24.5%, Bioconductor: 24.6%, UPARSE-linux: 23.6%, UPARSE-mac: 20.6%, mothur-linux: 22.2%, mothur-mac: 21.6%, p < 0.001). The use of different bioinformatic pipelines affects the estimation of the relative abundance of gut microbial community, indicating that studies using different pipelines cannot be directly compared. A harmonization procedure is needed to move the field forward.
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Affiliation(s)
- Moira Marizzoni
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Thomas Gurry
- Pharmaceutical Biochemistry Group, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
| | - Stefania Provasi
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Gilbert Greub
- Institut de Microbiologie de l'Université de Lausanne, Lausanne, Switzerland
| | - Nicola Lopizzo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Federica Ribaldi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Cristina Festari
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Monica Mazzelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Mombelli
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | | | - Giovanni B Frisoni
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Annamaria Cattaneo
- Laboratory of Biological Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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13
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Boccardi M, Nicolosi V, Festari C, Bianchetti A, Cappa S, Chiasserini D, Falini A, Guerra UP, Nobili F, Padovani A, Sancesario G, Morbelli S, Parnetti L, Tiraboschi P, Muscio C, Perani D, Pizzini FB, Beltramello A, Salvini Porro G, Ciaccio M, Schillaci O, Trabucchi M, Tagliavini F, Frisoni GB. Italian consensus recommendations for a biomarker-based aetiological diagnosis in mild cognitive impairment patients. Eur J Neurol 2019; 27:475-483. [PMID: 31692118 DOI: 10.1111/ene.14117] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 02/25/2019] [Accepted: 11/04/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Biomarkers support the aetiological diagnosis of neurocognitive disorders in vivo. Incomplete evidence is available to drive clinical decisions; available diagnostic algorithms are generic and not very helpful in clinical practice. The aim was to develop a biomarker-based diagnostic algorithm for mild cognitive impairment patients, leveraging on knowledge from recognized national experts. METHODS With a Delphi procedure, experienced clinicians making variable use of biomarkers in clinical practice and representing five Italian scientific societies (neurology - Società Italiana di Neurologia per le Demenze; neuroradiology - Associazione Italiana di Neuroradiologia; biochemistry - Società Italiana di Biochimica Clinica; psychogeriatrics - Associazione Italiana di Psicogeriatria; nuclear medicine - Associazione Italiana di Medicina Nucleare) defined the theoretical framework, relevant literature, the diagnostic issues to be addressed and the diagnostic algorithm. An N-1 majority defined consensus achievement. RESULTS The panellists chose the 2011 National Institute on Aging and Alzheimer's Association diagnostic criteria as the reference theoretical framework and defined the algorithm in seven Delphi rounds. The algorithm includes baseline clinical and cognitive assessment, blood examination, and magnetic resonance imaging with exclusionary and inclusionary roles; dopamine transporter single-photon emission computed tomography (if no/unclear parkinsonism) or metaiodobenzylguanidine cardiac scintigraphy for suspected dementia with Lewy bodies with clear parkinsonism (round VII, votes (yes-no-abstained): 3-1-1); 18 F-fluorodeoxyglucose positron emission tomography for suspected frontotemporal lobar degeneration and low diagnostic confidence of Alzheimer's disease (round VII, 4-0-1); cerebrospinal fluid for suspected Alzheimer's disease (round IV, 4-1-0); and amyloid positron emission tomography if cerebrospinal fluid was not possible/accepted (round V, 4-1-0) or inconclusive (round VI, 5-0-0). CONCLUSIONS These consensus recommendations can guide clinicians in the biomarker-based aetiological diagnosis of mild cognitive impairment, whilst guidelines cannot be defined with evidence-to-decision procedures due to incomplete evidence.
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Affiliation(s)
- M Boccardi
- IRCCS Istituto Centro S.Giovanni di Dio-Fatebenefratelli, Brescia, Italy.,University of Geneva, Geneva, Switzerland
| | - V Nicolosi
- IRCCS Istituto Centro S.Giovanni di Dio-Fatebenefratelli, Brescia, Italy
| | - C Festari
- IRCCS Istituto Centro S.Giovanni di Dio-Fatebenefratelli, Brescia, Italy.,University of Brescia, Brescia, Italy
| | - A Bianchetti
- Istituto Clinico S. Anna, Brescia, Italy.,Italian Psychogeriatric Association (AIP), Brescia, Italy
| | - S Cappa
- IRCCS Istituto Centro S.Giovanni di Dio-Fatebenefratelli, Brescia, Italy.,University Institute of Higher Studies, Pavia, Italy.,Italian Society of Neurology for the Study of the Dementias (SINdem), Milan, Italy
| | - D Chiasserini
- University of Perugia, Perugia, Italy.,Italian Society of Clinical Biochemistry and Clinical Molecular Biology - Laboratory Medicine (SIBioC), Rimini, Italy
| | - A Falini
- IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy.,Italian Association of Neuroradiology (AINR), Milan, Italy
| | - U P Guerra
- Poliambulanza Foundation, Brescia, Italy.,Italian Association of Nuclear Medicine (AIMN), Bari, Italy
| | - F Nobili
- Italian Association of Nuclear Medicine (AIMN), Bari, Italy.,University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - A Padovani
- Italian Society of Neurology for the Study of the Dementias (SINdem), Milan, Italy.,Brescia University Hospital, Brescia, Italy
| | - G Sancesario
- Italian Society of Clinical Biochemistry and Clinical Molecular Biology - Laboratory Medicine (SIBioC), Rimini, Italy.,IRCCS Santa Lucia Foundation, Neuroimmunology Unit Via Ardeatina 354, Rome, Italy
| | - S Morbelli
- University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - L Parnetti
- Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy
| | | | - C Muscio
- IRCCS 'Carlo Besta', Milan, Italy
| | - D Perani
- IRCCS San Raffaele Scientific Institute, Milan, Italy.,Vita-Salute San Raffaele University, Milan, Italy
| | | | - A Beltramello
- Verona University Hospital, Verona, Italy.,IRCCS 'Sacro Cuore-Don Calabria', Negrar, Verona, Italy
| | | | - M Ciaccio
- Italian Society of Clinical Biochemistry and Clinical Molecular Biology - Laboratory Medicine (SIBioC), Rimini, Italy.,University of Palermo, Palermo, Italy
| | - O Schillaci
- University Tor Vergata, Rome, Italy.,IRCCS-Neuromed, Pozzilli, Italy
| | - M Trabucchi
- Italian Psychogeriatric Association (AIP), Brescia, Italy.,University Tor Vergata, Rome, Italy
| | | | - G B Frisoni
- IRCCS Istituto Centro S.Giovanni di Dio-Fatebenefratelli, Brescia, Italy.,University of Geneva, Geneva, Switzerland
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14
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Ribaldi F, Festari C, Andryszak P, Assal F, Mendes A, Zekry D, Chicherio C, Scheffler M, Lovblad KO, Dodich A, Marizzoni M, Garibotto V, Frisoni GB. O4-04-03: THE BIOLOGICAL BASIS OF COGNITIVE IMPAIRMENT DUE TO SUSPECTED NON-ALZHEIMER'S PATHOLOGY (SNAP): STUDY DESIGN AND BASELINE COHORT FEATURES. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Federica Ribaldi
- University of Geneva; Geneva Switzerland
- University of Brescia; Brescia Italy
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | - Cristina Festari
- University of Brescia; Brescia Italy
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | | | | | | | - Dina Zekry
- Geneva University Hospitals; Geneva Switzerland
| | | | | | | | | | - Moira Marizzoni
- IRCCS Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
| | | | - Giovanni B. Frisoni
- University of Geneva; Geneva Switzerland
- Geneva University Hospitals; Geneva Switzerland
- Lab Alzheimer's Neuroimaging & Epidemiology; IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli; Brescia Italy
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15
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Boccardi M, Nicolosi V, Festari C, Bianchetti A, Cappa SF, Chiasserini D, Falini A, Guerra UP, Nobili F, Padovani A, Sancesario GM, Morbelli S, Parnetti L, Tiraboschi P, Muscio C, Perani D, Pizzini FB, Beltramello A, Porro GS, Ciaccio M, Schillaci O, Trabucchi M, Tagliavini F, Frisoni GB. P1-238: ITALIAN CONSENSUS RECOMMENDATIONS FOR THE ETIOLOGICAL DIAGNOSIS IN MEMORY CLINICS. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Paghera B, Altomare D, Peli A, Morbelli S, Buschiazzo A, Bauckneht M, Giubbini R, Rodella C, Camoni L, Boccardi M, Festari C, Muscio C, Padovani A, Frisoni GB, Guerra UP. Comparison of visual criteria for amyloid-PET reading: could criteria merging reduce inter-rater variability? Q J Nucl Med Mol Imaging 2019; 64:414-421. [PMID: 31089074 DOI: 10.23736/s1824-4785.19.03124-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Three different amyloid tracers labeled with 18-flourine have been introduced into clinical use. The leaflets of tracers indicate different visual criteria for PET reporting. In clinical practice, it is not yet ascertained whether these criteria are equivalent in terms of diagnostic accuracy or if anyone is better than another. We aimed to evaluate the inter and intra-rater variability of visual assessment of 18F-Florbetapir PET/CT images among six independent readers with different clinical experience. METHODS We analyzed 252 PET/CT scans, visually assessed by each reader three times, applying independently the three different reading criteria proposed. Each reader evaluated the regional uptake specifying for each cortical region a numeric value of grading of positivity in order to assign a final score. At the end of each reading a level of confidence was determined by assigning a score from 0 (negative) to 4 (positive). After first reading, those cases in which the evaluations by two experienced readers did not match (discordant cases) were independently reevaluated merging all the three different visual interpretation criteria. RESULTS Good agreement was observed for visual interpretation among the six readers' confidence-level using independently the three visual reading criteria: ICC=0.83 (0.80-0.86) for 18F-florbetapir, ICC=0.84 (0.81-0.87) for 18F-florbetaben, and ICC=0.86 (0.83-0.88) for 18F-flutemetamol reading. A good inter-rater agreement was observed for final-score too: ICC=0.74 (0.70-0.78) for 18F-florbetapir; ICC=0.82 (0.79-0.85) for 18F-florbetaben; ICC=0.84 (0.81-0.87) for 18F-flutemetamol. Intra-rater agreement was good for final-score (from 0.76 to 0.90; P<0.001) and confidence-level (Spearman's rho from 0.89 to 1.00; P<0.001). Disagreement between the two experienced readers was observed in 22 of 252 cases (9%). The agreement converged over a second round of independent reading in 12 of 22 cases (54%), by merging all the criteria. CONCLUSIONS All the criteria proposed are useful to determine the grading of positivity or negativity of amyloid deposition and their merging improves the diagnostic confidence and provides a better agreement.
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Affiliation(s)
- Barbara Paghera
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy -
| | - Daniele Altomare
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), San Giovanni di Dio Clinical Research Center, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Alessia Peli
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Silvia Morbelli
- Department of Nuclear Medicine, San Martino University Hospital and IRCCS, Genoa, Italy
| | - Ambra Buschiazzo
- Department of Nuclear Medicine, San Martino University Hospital and IRCCS, Genoa, Italy
| | - Matteo Bauckneht
- Department of Nuclear Medicine, San Martino University Hospital and IRCCS, Genoa, Italy
| | - Raffaele Giubbini
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Carlo Rodella
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Luca Camoni
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Marina Boccardi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), San Giovanni di Dio Clinical Research Center, Brescia, Italy.,Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), San Giovanni di Dio Clinical Research Center, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cristina Muscio
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), San Giovanni di Dio Clinical Research Center, Brescia, Italy.,Division of Neurology V - Neuropathology, Carlo Besta Institute of Neurology Foundation and IRCCS, Milan, Italy
| | - Alessandro Padovani
- Unit of Neurology, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), San Giovanni di Dio Clinical Research Center, Brescia, Italy.,Department of Nuclear Medicine, San Martino University Hospital and IRCCS, Genoa, Italy.,Memory Clinic, University Hospital of Geneva, Geneva, Switzerland
| | - Ugo P Guerra
- Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy
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17
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Chiappiniello A, Tarducci R, Muscio C, Frisoni G, Bruzzone M, Bozzali M, Perani D, Tiraboschi P, Nigri A, Ambrosi C, Caulo M, Chipi E, Chiti S, Fainardi E, Ferraro S, Festari C, Gasparotti R, Ginestroni A, Giulietti G, Mascaro L, Navarra R, Nicolosi V, Parnetti L, Rosazza C, Serra L, Tagliavini F, Jovicich J. 22. Multicentric test-retest reproducibility of human hippocampal volumes with FreeSurfer 6.0: A comparison between standard and longitudinal hippocampal subfields segmentation streams applied to 3D T1, 3D FLAIR and high-resolution 2D T2 neuroimaging. Phys Med 2018. [DOI: 10.1016/j.ejmp.2018.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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18
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Ramusino MC, Altomare D, Costa A, Festari C, Frisoni GB, Boccardi M. P2‐408: MEDIAL TEMPORAL LOBE ATROPHY SCALE: NORMATIVE VALUES FOR ITALIAN POPULATION. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Matteo Cotta Ramusino
- Center for Cognitive and Behavioral DisordersC. Mondino National Neurological InstitutePaviaItaly
| | | | - Alfredo Costa
- Center for Cognitive and Behavioral DisordersC. Mondino National Neurological InstitutePaviaItaly
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19
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Ramusino MC, Altomare D, Costa A, Festari C, Frisoni GB, Boccardi M. IC‐P‐120: MEDIAL TEMPORAL LOBE ATROPHY SCALE: NORMATIVE VALUES FOR ITALIAN POPULATION. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Matteo Cotta Ramusino
- Center for Cognitive and Behavioral DisordersC. Mondino National Neurological InstitutePaviaItaly
| | - Daniele Altomare
- Istituto di Ricovero e Cura a Carattere ScientificoCentro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Alfredo Costa
- Center for Cognitive and Behavioral DisordersC. Mondino National Neurological InstitutePaviaItaly
| | | | - Giovanni B. Frisoni
- Istituto di Ricovero e Cura a Carattere ScientificoCentro San Giovanni di Dio FatebenefratelliBresciaItaly
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Walker Z, Gandolfo F, Orini S, Garibotto V, Agosta F, Arbizu J, Bouwman F, Drzezga A, Nestor P, Boccardi M, Altomare D, Festari C, Nobili F. Clinical utility of FDG PET in Parkinson's disease and atypical parkinsonism associated with dementia. Eur J Nucl Med Mol Imaging 2018; 45:1534-1545. [PMID: 29779045 PMCID: PMC6061481 DOI: 10.1007/s00259-018-4031-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
Purpose There are no comprehensive guidelines for the use of FDG PET in the following three clinical scenarios: (1) diagnostic work-up of patients with idiopathic Parkinson’s disease (PD) at risk of future cognitive decline, (2) discriminating idiopathic PD from progressive supranuclear palsy, and (3) identifying the underlying neuropathology in corticobasal syndrome. Methods We therefore performed three literature searches and evaluated the selected studies for quality of design, risk of bias, inconsistency, imprecision, indirectness and effect size. Critical outcomes were the sensitivity, specificity, accuracy, positive/negative predictive value, area under the receiving operating characteristic curve, and positive/negative likelihood ratio of FDG PET in detecting the target condition. Using the Delphi method, a panel of seven experts voted for or against the use of FDG PET based on published evidence and expert opinion. Results Of 91 studies selected from the three literature searches, only four included an adequate quantitative assessment of the performance of FDG PET. The majority of studies lacked robust methodology due to lack of critical outcomes, inadequate gold standard and no head-to-head comparison with an appropriate reference standard. The panel recommended the use of FDG PET for all three clinical scenarios based on nonquantitative evidence of clinical utility. Conclusion Despite widespread use of FDG PET in clinical practice and extensive research, there is still very limited good quality evidence for the use of FDG PET. However, in the opinion of the majority of the panellists, FDG PET is a clinically useful imaging biomarker for idiopathic PD and atypical parkinsonism associated with dementia.
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Affiliation(s)
- Zuzana Walker
- Division of Psychiatry, University College London, London, UK. .,St Margaret's Hospital, Essex Partnership University NHS Foundation Trust, Epping, CM16 6TN, UK.
| | - Federica Gandolfo
- Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Stefania Orini
- Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Department of Medical Imaging, University Hospitals of Geneva, Geneva University, Geneva, Switzerland
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Javier Arbizu
- Department of Nuclear Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Femke Bouwman
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, University of Cologne and German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany
| | - Peter Nestor
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Queensland Brain Institute, University of Queensland and the Mater Hospital, Brisbane, Australia
| | - Marina Boccardi
- LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, University of Geneva, Geneva, Switzerland.,LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Daniele Altomare
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa & Clinical Neurology Polyclinic IRCCS San Martino-IST, Genoa, Italy.
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Nobili F, Festari C, Altomare D, Agosta F, Orini S, Van Laere K, Arbizu J, Bouwman F, Drzezga A, Nestor P, Walker Z, Boccardi M. Automated assessment of FDG-PET for differential diagnosis in patients with neurodegenerative disorders. Eur J Nucl Med Mol Imaging 2018; 45:1557-1566. [PMID: 29721650 DOI: 10.1007/s00259-018-4030-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [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: 04/12/2018] [Accepted: 04/16/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE To review literature until November 2015 and reach a consensus on whether automatic semi-quantification of brain FDG-PET is useful in the clinical setting for neurodegenerative disorders. METHODS A literature search was conducted in Medline, Embase, and Google Scholar. Papers were selected with a lower limit of 30 patients (no limits with autopsy confirmation). Consensus recommendations were developed through a Delphi procedure, based on the expertise of panelists, who were also informed about the availability and quality of evidence, assessed by an independent methodology team. RESULTS Critical outcomes were available in nine among the 17 papers initially selected. Only three papers performed a direct comparison between visual and automated assessment and quantified the incremental value provided by the latter. Sensitivity between visual and automatic analysis is similar but automatic assessment generally improves specificity and marginally accuracy. Also, automated assessment increases diagnostic confidence. As expected, performance of visual analysis is reported to depend on the expertise of readers. CONCLUSIONS Tools for semi-quantitative evaluation are recommended to assist the nuclear medicine physician in reporting brain FDG-PET pattern in neurodegenerative conditions. However, heterogeneity, complexity, and drawbacks of these tools should be known by users to avoid misinterpretation. Head-to-head comparisons and an effort to harmonize procedures are encouraged.
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Affiliation(s)
- Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa and Polyclinic San Martino Hospital, Genoa, Italy.
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Daniele Altomare
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.,Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Stefania Orini
- Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Koen Van Laere
- Division of Nuclear Medicine, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Javier Arbizu
- Department of Nuclear Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Femke Bouwman
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, University of Cologne and German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany
| | - Peter Nestor
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.,Queensland Brain Institute, University of Queensland and Mater Hospital, Brisbane, Australia
| | - Zuzana Walker
- Division of Psychiatry & Essex Partnership University, University College London, London, UK
| | - Marina Boccardi
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy. .,LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, University of Geneva, Chemin du Petit-Bel-Air, 2, 1225, Chene-Bourg, Geneva, Switzerland.
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Agosta F, Altomare D, Festari C, Orini S, Gandolfo F, Boccardi M, Arbizu J, Bouwman F, Drzezga A, Nestor P, Nobili F, Walker Z, Pagani M. Clinical utility of FDG-PET in amyotrophic lateral sclerosis and Huntington's disease. Eur J Nucl Med Mol Imaging 2018; 45:1546-1556. [PMID: 29717332 DOI: 10.1007/s00259-018-4033-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
AIM To evaluate the incremental value of FDG-PET over clinical tests in: (i) diagnosis of amyotrophic lateral sclerosis (ALS); (ii) picking early signs of neurodegeneration in patients with a genetic risk of Huntington's disease (HD); and detecting metabolic changes related to cognitive impairment in (iii) ALS and (iv) HD patients. METHODS Four comprehensive literature searches were conducted using the PICO model to extract evidence from relevant studies. An expert panel then voted using the Delphi method on these four diagnostic scenarios. RESULTS The availability of evidence was good for FDG-PET utility to support the diagnosis of ALS, poor for identifying presymptomatic subjects carrying HD mutation who will convert to HD, and lacking for identifying cognitive-related metabolic changes in both ALS and HD. After the Delphi consensual procedure, the panel did not support the clinical use of FDG-PET for any of the four scenarios. CONCLUSION Relative to other neurodegenerative diseases, the clinical use of FDG-PET in ALS and HD is still in its infancy. Once validated by disease-control studies, FDG-PET might represent a potentially useful biomarker for ALS diagnosis. FDG-PET is presently not justified as a routine investigation to predict conversion to HD, nor to detect evidence of brain dysfunction justifying cognitive decline in ALS and HD.
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Affiliation(s)
- Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Daniele Altomare
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Cristina Festari
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefania Orini
- Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Federica Gandolfo
- Alzheimer Operative Unit, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Marina Boccardi
- LANE - Laboratory of Alzheimer's Neuroimaging & Epidemiology, IRCCS S. Giovanni di Dio, Fatebenefratelli, Brescia, Italy.
- LANVIE (Laboratoire de Neuroimagerie du Vieillissement), Department of Psychiatry, University of Geneva, Geneva, Switzerland.
| | - Javier Arbizu
- Department of Nuclear Medicine, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain
| | - Femke Bouwman
- Department of Neurology & Alzheimer Center, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, University of Cologne and German Center for Neurodegenerative Diseases (DZNE), Cologne, Germany
| | - Peter Nestor
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Queensland Brain Institute, University of Queensland and at the Mater Hospital Brisbane, Brisbane, Australia
| | - Flavio Nobili
- Department of Neuroscience (DINOGMI), University of Genoa and Polyclinic San Martino Hospital, Genoa, Italy
| | - Zuzana Walker
- Division of Psychiatry & Essex Partnership University NHS Foundation Trust, University College London, London, UK
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
- Department of Nuclear Medicine, Karolinska Hospital Stockholm, Stockholm, Sweden
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Boccardi M, Festari C, Altomare D, Gandolfo F, Orini S, Nobili F, Frisoni GB. Assessing FDG-PET diagnostic accuracy studies to develop recommendations for clinical use in dementia. Eur J Nucl Med Mol Imaging 2018; 45:1470-1486. [DOI: 10.1007/s00259-018-4024-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 04/13/2018] [Indexed: 12/14/2022]
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Altomare D, Ferrari C, Festari C, Guerra UP, Muscio C, Padovani A, Frisoni GB, Boccardi M. Quantitative appraisal of the Amyloid Imaging Taskforce appropriate use criteria for amyloid-PET. Alzheimers Dement 2018; 14:1088-1098. [PMID: 29679576 DOI: 10.1016/j.jalz.2018.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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: 07/28/2017] [Revised: 01/27/2018] [Accepted: 02/22/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION We test the hypothesis that amyloid-positron emission tomography prescriptions, considered appropriate based on the Amyloid Imaging Taskforce (AIT) criteria, lead to greater clinical utility than AIT-inappropriate prescriptions. METHODS We compared the clinical utility between patients who underwent amyloid-positron emission tomography appropriately or inappropriately and among the subgroups of patients defined by the AIT criteria. Finally, we performed logistic regressions to identify variables associated with clinical utility. RESULTS We identified 171 AIT-appropriate and 67 AIT-inappropriate patients. AIT-appropriate and AIT-inappropriate cases did not differ in any outcomes of clinical utility (P > .05). Subgroup analysis denoted both expected and unexpected results. The logistic regressions outlined the primary role of clinical picture and clinical or neuropsychological profile in identifying patients benefitting from amyloid-positron emission tomography. DISCUSSION Contrary to our hypothesis, also AIT-inappropriate prescriptions were associated with clinical utility. Clinical or neuropsychological variables, not taken into account by the AIT criteria, may help further refine criteria for appropriateness.
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Affiliation(s)
- Daniele Altomare
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, Saint John of God Clinical Research Centre, Brescia, Italy
| | - Cristina Festari
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy; Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ugo Paolo Guerra
- Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy
| | - Cristina Muscio
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy; Division of Neurology V-Neuropathology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandro Padovani
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland; Memory Clinic, University Hospital of Geneva, Geneva, Switzerland
| | - Marina Boccardi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy; Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland.
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Boccardi M, Altomare D, Festari C, Drzezga A, Frisoni GB, Nobili F. [P2–421]: DIAGNOSTIC UTILITY OF FDG‐PET IN DETECTING EARLY SIGNS OF NEURODEGENERATION IN ASYMPTOMATIC SUBJECTS WITH FAMILIAL FORMS OF AD. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Marina Boccardi
- IRCCS S Giovanni di Dio FatebenefratelliBresciaItaly
- LANVIE ‐ Laboratory of Neuroimaging of AgingUniversity of GenevaGenevaSwitzerland
| | - Daniele Altomare
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | - Cristina Festari
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | - Giovanni B. Frisoni
- Lab Alzheimer's Neuroimaging & Epidemiology, IRCCS FatebenefratelliBresciaItaly
- Memory Clinic and LANVIE ‐ Laboratory of Neuroimaging of AgingUniversity Hospitals and University of GenevaGenevaSwitzerland
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Boccardi M, Altomare D, Festari C, Rivolta J, Gandolfo F, Orini S, Bouwman FH, Frisoni GB, Nobili F. [IC‐P‐068]: DIAGNOSTIC UTILITY OF FDG‐PET IN DIFFERENTIATING ALZHEIMER's DISEASE FROM FRONTOTEMPORAL LOBAR DEGENERATION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Marina Boccardi
- LANVIE ‐ Laboratory of Neuroimaging of AgingUniversity of GenevaGenevaSwitzerland
- IRCCS S. Giovanni di Dio FatebenefratelliBresciaItaly
| | - Daniele Altomare
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | - Cristina Festari
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | | | | | - Femke H. Bouwman
- Alzheimer Center and Department of NeurologyVU University Medical Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Giovanni B. Frisoni
- Memory Clinic and LANVIE ‐ Laboratory of Neuroimaging of AgingUniversity Hospitals and University of GenevaGenevaSwitzerland
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Altomare D, Orini S, Agosta F, Sarasso E, Festari C, Filippi M, Boccardi M. [IC‐P‐067]: DIAGNOSTIC UTILITY OF FDG‐PET TO CONFIRM A CLINICAL SUSPICION OF AMYOTROPHIC LATERAL SCLEROSIS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.2340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Daniele Altomare
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | | | | | - Cristina Festari
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | - Marina Boccardi
- IRCCS FatebenefratelliBresciaItaly
- University of GenevaGenevaSwitzerland
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Festari C, Altomare D, Walker Z, Nobili F, Boccardi M. [P2–327]: DIAGNOSTIC UTILITY OF FDG‐PET IN DIFFERENTIATING BETWEEN LEWY BODY DEMENTIA AND FRONTO‐TEMPORAL LOBAR DEGENERATION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Festari
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Daniele Altomare
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Zuzana Walker
- North Essex Partnership University NHS Foundation TrustChelmsfordUnited Kingdom
- University College LondonLondonUnited Kingdom
| | | | - Marina Boccardi
- IRCCS FatebenefratelliBresciaItaly
- University of GenevaGenevaSwitzerland
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Festari C, Ferrari C, Nicolosi V, Rossi R, Altomare D, Galluzzi S, Wahlund L, Boccardi M, Frisoni GB. [P1–427]: AGE‐RELATED WHITE MATTER CHANGES SCALE: NORMATIVE DATA ON 1,439 PERSONS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Cristina Festari
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | | | | | - Daniele Altomare
- University of BresciaBresciaItaly
- IRCCS FatebenefratelliBresciaItaly
| | | | | | - Marina Boccardi
- IRCCS FatebenefratelliBresciaItaly
- University of GenevaGenevaSwitzerland
| | - Giovanni B. Frisoni
- University of GenevaGenevaSwitzerland
- University HospitalsGenevaSwitzerland
- Lab Alzheimer's Neuroimaging & Epidemiology, IRCCS FatebenefratelliBresciaItaly
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Boccardi M, Altomare D, Ferrari C, Festari C, Guerra UP, Paghera B, Pizzocaro C, Lussignoli G, Geroldi C, Zanetti O, Cotelli MS, Turla M, Borroni B, Rozzini L, Mirabile D, Defanti C, Gennuso M, Prelle A, Gentile S, Morandi A, Vollaro S, Volta GD, Bianchetti A, Conti MZ, Cappuccio M, Carbone P, Bellandi D, Abruzzi L, Bettoni L, Villani D, Raimondi MC, Lanari A, Ciccone A, Facchi E, Di Fazio I, Rozzini R, Boffelli S, Manzoni L, Salvi GP, Cavaliere S, Belotti G, Avanzi S, Pasqualetti P, Muscio C, Padovani A, Frisoni GB. Assessment of the Incremental Diagnostic Value of Florbetapir F 18 Imaging in Patients With Cognitive Impairment. JAMA Neurol 2016; 73:1417-1424. [DOI: 10.1001/jamaneurol.2016.3751] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Marina Boccardi
- LANVIE–Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland2Laboratory of Alzheimer’s Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Daniele Altomare
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy3Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Clarissa Ferrari
- Unit of Statistics, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Festari
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy3Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Ugo Paolo Guerra
- Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy
| | - Barbara Paghera
- Department of Nuclear Medicine, University of Brescia, Brescia, Italy
| | - Claudio Pizzocaro
- Department of Nuclear Medicine, Poliambulanza Foundation, Brescia, Italy
| | - Giulia Lussignoli
- Alzheimer’s Unit, Memory Clinic, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Geroldi
- Alzheimer’s Unit, Memory Clinic, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer’s Unit, Memory Clinic, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Marinella Turla
- Neurology Unit, Ospedale di Vallecamonica Esine, Brescia, Italy
| | - Barbara Borroni
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Luca Rozzini
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Dario Mirabile
- European Foundation Biomedical Research, Center of Excellence Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy
| | - Carlo Defanti
- European Foundation Biomedical Research, Center of Excellence Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy
| | | | | | - Simona Gentile
- Department of Rehabilitation, Fondazione Teresa Camplani, Casa di cura Ancelle della Carità, Cremona, Italy
| | - Alessandro Morandi
- Department of Rehabilitation, Fondazione Teresa Camplani, Casa di cura Ancelle della Carità, Cremona, Italy
| | - Stefano Vollaro
- Neurology Unit, Istituto Clinico Città di Brescia, Brescia, Italy
| | | | - Angelo Bianchetti
- Department of Medicine and Rehabilitation, Istituto Clinico Sant’Anna, Brescia, Italy
| | - Marta Zaffira Conti
- Hospice, Istituto Polifunzionale Sociosanitario Foundation Cardinal Giorgio Gusmini, Vertova, Bergamo, Italy
| | - Melania Cappuccio
- Hospice, Istituto Polifunzionale Sociosanitario Foundation Cardinal Giorgio Gusmini, Vertova, Bergamo, Italy
| | - Pasqualina Carbone
- Alzheimer Evaluation Unit, Istituto Ospedaliero di Sospiro Non-Profit Organization of Social Utility Foundation, Sospiro, Cremona, Italy
| | - Daniele Bellandi
- Alzheimer Evaluation Unit, Istituto Ospedaliero di Sospiro Non-Profit Organization of Social Utility Foundation, Sospiro, Cremona, Italy
| | - Luciano Abruzzi
- Neurology Unit, Istituti Ospedalieri di Cremona, Cremona, Italy
| | - Luigi Bettoni
- Neurology Unit, Istituti Ospedalieri di Cremona, Cremona, Italy
| | - Daniele Villani
- Alzheimer Evaluation Unit, Casa di Cura Figlie di S. Camillo, Cremona, Italy
| | | | | | | | - Emanuela Facchi
- Geriatric General Rehabilitation, Fondazione Richiedei, Palazzolo sull'Oglio, Brescia, Italy
| | - Ignazio Di Fazio
- Geriatric General Rehabilitation, Fondazione Richiedei, Palazzolo sull'Oglio, Brescia, Italy
| | - Renzo Rozzini
- Neurology Unit, Poliambulanza Foundation, Brescia, Italy
| | | | - Laura Manzoni
- Neuromotor and Cognitive Rehabilitation Center, Clinic Quarenghi, San Pellegrino Terme, Bergamo, Italy
| | - Giovanni Pietro Salvi
- Neuromotor and Cognitive Rehabilitation Center, Clinic Quarenghi, San Pellegrino Terme, Bergamo, Italy
| | - Sabina Cavaliere
- Alzheimer Evaluation Unit, Hospice Santa Maria Ausiliatrice Onlus Foundation, Bergamo, Italy
| | - Gloria Belotti
- Alzheimer Evaluation Unit, Hospice Santa Maria Ausiliatrice Onlus Foundation, Bergamo, Italy
| | - Stefano Avanzi
- Neuromotor Rehabilitation Medicine, Salvatore Maugeri Foundation Clinic of Work and Rehabilitation, Istituto di Ricovero e Cura a Carattere Scientifico, Castel Goffredo, Mantova, Italy
| | - Patrizio Pasqualetti
- Service of Medical Statistics and Information Technology, Fatebenefratelli Foundation for Health Research and Education, Rome, Italy
| | - Cristina Muscio
- Laboratory of Alzheimer’s Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy26Division of Neurology V–Neuropathology, Fondazione, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alessandro Padovani
- Centre for Aging Brain and Neurodegenerative Disorders, Neurology Unit, University of Brescia, Brescia, Italy
| | - Giovanni B. Frisoni
- LANVIE–Laboratory of Neuroimaging of Aging, University of Geneva, Geneva, Switzerland2Laboratory of Alzheimer’s Neuroimaging and Epidemiology, Istituto di Ricovero e Cura a Carattere Scientifico Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy27Memory Clinic, University Hospital of Geneva, Geneva, Switzerland
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Cattaneo A, Cattane N, Galluzzi S, Provasi S, Lopizzo N, Festari C, Ferrari C, Guerra UP, Paghera B, Muscio C, Bianchetti A, Volta GD, Turla M, Cotelli MS, Gennuso M, Prelle A, Zanetti O, Lussignoli G, Mirabile D, Bellandi D, Gentile S, Belotti G, Villani D, Harach T, Bolmont T, Padovani A, Boccardi M, Frisoni GB. Association of brain amyloidosis with pro-inflammatory gut bacterial taxa and peripheral inflammation markers in cognitively impaired elderly. Neurobiol Aging 2016; 49:60-68. [PMID: 27776263 DOI: 10.1016/j.neurobiolaging.2016.08.019] [Citation(s) in RCA: 755] [Impact Index Per Article: 94.4] [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: 12/28/2015] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 12/14/2022]
Abstract
The pathway leading from amyloid-β deposition to cognitive impairment is believed to be a cornerstone of the pathogenesis of Alzheimer's disease (AD). However, what drives amyloid buildup in sporadic nongenetic cases of AD is still unknown. AD brains feature an inflammatory reaction around amyloid plaques, and a specific subset of the gut microbiota (GMB) may promote brain inflammation. We investigated the possible role of the GMB in AD pathogenesis by studying the association of brain amyloidosis with (1) GMB taxa with pro- and anti-inflammatory activity; and (2) peripheral inflammation in cognitively impaired patients. We measured the stool abundance of selected bacterial GMB taxa (Escherichia/Shigella, Pseudomonas aeruginosa, Eubacterium rectale, Eubacterium hallii, Faecalibacterium prausnitzii, and Bacteroides fragilis) and the blood expression levels of cytokines (pro-inflammatory cytokines: CXCL2, CXCL10, interleukin [IL]-1β, IL-6, IL-18, IL-8, inflammasome complex (NLRP3), tumor necrosis factor-alpha [TNF-α]; anti-inflammatory cytokines: IL-4, IL-10, IL-13) in cognitively impaired patients with (n = 40, Amy+) and with no brain amyloidosis (n = 33, Amy-) and also in a group of controls (n = 10, no brain amyloidosis and no cognitive impairment). Amy+ patients showed higher levels of pro-inflammatory cytokines (IL-6, CXCL2, NLRP3, and IL-1β) compared with both controls and with Amy- patients. A reduction of the anti-inflammatory cytokine IL-10 was observed in Amy+ versus Amy-. Amy+ showed lower abundance of E. rectale and higher abundance of Escherichia/Shigella compared with both healthy controls (fold change, FC = -9.6, p < 0.001 and FC = +12.8, p < 0.001, respectively) and to Amy- (FC = -7.7, p < 0.001 and FC = +7.4, p = 0.003). A positive correlation was observed between pro-inflammatory cytokines IL-1β, NLRP3, and CXCL2 with abundance of the inflammatory bacteria taxon Escherichia/Shigella (rho = 0.60, p < 0.001; rho = 0.57, p < 0.001; and rho = 0.30, p = 0.007, respectively) and a negative correlation with the anti-inflammatory E. rectale (rho = -0.48, p < 0.001; rho = -0.25, p = 0.024; rho = -0.49, p < 0.001). Our data indicate that an increase in the abundance of a pro-inflammatory GMB taxon, Escherichia/Shigella, and a reduction in the abundance of an anti-inflammatory taxon, E. rectale, are possibly associated with a peripheral inflammatory state in patients with cognitive impairment and brain amyloidosis. A possible causal relation between GMB-related inflammation and amyloidosis deserves further investigation.
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Affiliation(s)
- Annamaria Cattaneo
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy; King's College London, Institute of Psychiatry, London, UK.
| | - Nadia Cattane
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Samantha Galluzzi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Stefania Provasi
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Nicola Lopizzo
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Cristina Festari
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Ugo Paolo Guerra
- Nuclear Medicine, Poliambulanza Foundation, Istituto Ospedaliero, Brescia, Italy
| | - Barbara Paghera
- Nuclear Medicine, University of Brescia and Spedali Civili di Brescia, Brescia, Italy
| | - Cristina Muscio
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy; European Foundation Biomedical Research (FERB), Center of Excellence Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy
| | - Angelo Bianchetti
- Department of Medicine and Rehabilitation, Istituto Clinico Sant'Anna, Brescia, Italy
| | | | - Marinella Turla
- Neurology Unit, Ospedale di Vallecamonica Esine, Brescia, Italy
| | | | | | | | - Orazio Zanetti
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Giulia Lussignoli
- Biological Psychiatry Laboratory, IRCCS Fatebenefratelli, Brescia, Italy
| | - Dario Mirabile
- European Foundation Biomedical Research (FERB), Center of Excellence Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy
| | - Daniele Bellandi
- Alzheimer Evaluation Unit, Istituto Ospedaliero di Sospiro ONLUS Foundation, Cremona, Italy
| | - Simona Gentile
- Department of Rehabilitation, Casa di Cura Ancelle della Carità, Cremona, Italy
| | - Gloria Belotti
- Alzheimer Evaluation Unit, Hospice Santa Maria Ausiliatrice ONLUS Foundation, Bergamo, Italy
| | - Daniele Villani
- Alzheimer Evaluation Unit, Casa di Cura Figlie di S. Camillo, Cremona, Italy
| | - Taoufiq Harach
- Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
| | | | - Alessandro Padovani
- Neurology Unit, Department of Medical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Marina Boccardi
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging and Alzheimer's Epidemiology, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals, Geneva, Switzerland; Memory Clinic, University Hospitals and University of Geneva, Geneva, Switzerland
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Altomare D, Festari C, Ferrari C, Muscio C, Padovani A, Frisoni GB, Boccardi M. IC‐P‐007: Brain Amyloidosis and Cognitive Decline in MCI: 12‐Month Follow‐Up. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Daniele Altomare
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Cristina Festari
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | | | - Cristina Muscio
- IRCCS FatebenefratelliBresciaItaly
- Fondazione IRCCS Istituto NeurologicoMilanoItaly
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Altomare D, Ferrari C, Festari C, Muscio C, Zanetti O, Turla M, Defanti C, Prelle A, Gentile S, Volta GD, Padovani A, Frisoni GB, Boccardi M. IC‐P‐005: Does Clinical Use of Amyloid‐Pet Affect Physicians’ Beliefs on The Pathogenetic Role of Amyloid‐β and The Clinical Usage of Amyloid‐Pet? Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Daniele Altomare
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | | | - Cristina Festari
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Cristina Muscio
- IRCCS FatebenefratelliBresciaItaly
- Fondazione IRCCS Istituto NeurologicoMilanoItaly
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Altomare D, Festari C, Muscio C, Padovani A, Frisoni GB, Boccardi M. P3‐302: Brain Amyloidosis and Cognitive Decline in MCI: 12‐Month Follow‐Up. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Daniele Altomare
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Cristina Festari
- IRCCS FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
| | - Cristina Muscio
- IRCCS FatebenefratelliBresciaItaly
- Fondazione IRCCS Istituto NeurologicoMilanoItaly
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Festari C, Altomare D, Bocchetta M, Muscio C, Padovani A, Frisoni GB, Boccardi M, Boccardi M. O2‐08‐04: Is the Incremental Diagnostic Value of Amyloid‐Pet Affected by Information on Other Core Biomarkers? Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Cristina Festari
- IRCCS Fatebenefratelli BresciaItaly
- University of BresciaBresciaItaly
| | - Daniele Altomare
- IRCCS Fatebenefratelli BresciaItaly
- University of BresciaBresciaItaly
| | - Martina Bocchetta
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Cristina Muscio
- IRCCS Fatebenefratelli BresciaItaly
- Fondazione IRCCS Istituto Neurologico MilanoItaly
| | | | - Giovanni B. Frisoni
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
- University of GenevaGenevaSwitzerland
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of GenevaGenevaSwitzerland
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Boccardi M, Altomare D, Ferrari C, Festari C, Antelmi L, Tarallo A, Pasqualetti P, Muscio C, Guerra U, Paghera B, Padovani A, Frisoni G. The incremental diagnostic value of 18F-Florbetapir imaging in naturalistic patients with cognitive impairment: final results from the india-FBP study. Neurobiol Aging 2016. [DOI: 10.1016/j.neurobiolaging.2016.01.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Boccardi M, Altomare D, Ferrari C, Festari C, Antelmi L, Pievani M, Tarallo A, Muscio C, Guerra UP, Paghera B, Padovani A, Frisoni GB. Do Beliefs about the Pathogenetic Role of Amyloid Affect the Interpretation of Amyloid PET in the Clinic? NEURODEGENER DIS 2015; 16:111-7. [DOI: 10.1159/000439255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 08/07/2015] [Indexed: 11/19/2022] Open
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Boccardi M, Altomare D, Guerra UP, Pievani M, Albanese E, Festari C, Pasqualetti P, Muscio C, Nobili F, Padovani A, Frisoni GB. P4‐250: Appraisal of the utility of the amyloid imaging taskforce recommendations for amyloid‐PET prescription. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.08.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | | | | | | | | | - Cristina Muscio
- IRCCS Saint John of God FatebenefratelliBresciaItaly
- Ospedale Briolini of GazzanigaBergamoItaly
| | | | | | - Giovanni Battista Frisoni
- IRCCS Saint John of God FatebenefratelliBresciaItaly
- University of GenevaGenevaSwitzerland
- University HospitalsGenevaSwitzerland
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Boccardi M, Altomare D, Festari C, Tarallo A, Guerra UP, Paghera B, Pizzocaro C, Muscio C, Pievani M, Padovani A, Frisoni GB. P2‐158: The incremental diagnostic value of 18F‐florbetapir imaging in naturalistic patients with cognitive impairment: The India‐FBP study. Alzheimers Dement 2015. [DOI: 10.1016/j.jalz.2015.06.697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Marina Boccardi
- IRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | | | | | - Anna Tarallo
- IRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | | | - Barbara Paghera
- University of BresciaBresciaItaly
- Spedali Civili di BresciaBresciaItaly
| | | | - Cristina Muscio
- IRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
- Ospedale Briolini of GazzanigaBergamoItaly
| | - Michela Pievani
- IRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | | | - Giovanni Battista Frisoni
- IRCCS Centro San Giovanni di Dio FatebenefratelliBresciaItaly
- University of BresciaBresciaItaly
- University Hospitals and University of GenevaGenevaSwitzerland
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