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Fleisher AS, Pontecorvo MJ, Devous MD, Lu M, Arora AK, Truocchio SP, Aldea P, Flitter M, Locascio T, Devine M, Siderowf A, Beach TG, Montine TJ, Serrano GE, Curtis C, Perrin A, Salloway S, Daniel M, Wellman C, Joshi AD, Irwin DJ, Lowe VJ, Seeley WW, Ikonomovic MD, Masdeu JC, Kennedy I, Harris T, Navitsky M, Southekal S, Mintun MA. Positron Emission Tomography Imaging With [18F]flortaucipir and Postmortem Assessment of Alzheimer Disease Neuropathologic Changes. JAMA Neurol 2020; 77:829-839. [PMID: 32338734 PMCID: PMC7186920 DOI: 10.1001/jamaneurol.2020.0528] [Citation(s) in RCA: 216] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/10/2020] [Indexed: 01/05/2023]
Abstract
Importance Positron emission tomography (PET) may increase the diagnostic accuracy and confirm the underlying neuropathologic changes of Alzheimer disease (AD). Objective To determine the accuracy of antemortem [18F]flortaucipir PET images for predicting the presence of AD-type tau pathology at autopsy. Design, Setting, and Participants This diagnostic study (A16 primary cohort) was conducted from October 2015 to June 2018 at 28 study sites (27 in US sites and 1 in Australia). Individuals with a terminal illness who were older than 50 years and had a projected life expectancy of less than 6 months were enrolled. All participants underwent [18F]flortaucipir PET imaging, and scans were interpreted by 5 independent nuclear medicine physicians or radiologists. Supplemental autopsy [18F]flortaucipir images and pathological samples were also collected from 16 historically collected cases. A second study (FR01 validation study) was conducted from March 26 to April 26, 2019, in which 5 new readers assessed the original PET images for comparison to autopsy. Main Outcomes and Measures [18F]flortaucipir PET images were visually assessed and compared with immunohistochemical tau pathology. An AD tau pattern of flortaucipir retention was assessed for correspondence with a postmortem B3-level (Braak stage V or VI) pathological pattern of tau accumulation and to the presence of amyloid-β plaques sufficient to meet the criteria for high levels of AD neuropathological change. Success was defined as having at least 3 of the 5 readers above the lower bounds of the 95% CI for both sensitivity and specificity of 50% or greater. Results A total of 156 patients were enrolled in the A16 study and underwent [18F]flortaucipir PET imaging. Of these, 73 died during the study, and valid autopsies were performed for 67 of these patients. Three autopsies were evaluated as test cases and removed from the primary cohort (n = 64). Of the 64 primary cohort patients, 34 (53%) were women and 62 (97%) were white; mean (SD) age was 82.5 (9.6) years; and 49 (77%) had dementia, 1 (2%) had mild cognitive impairment, and 14 (22%) had normal cognition. Prespecified success criteria were met for the A16 primary cohort. The flortaucipir PET scans predicted a B3 level of tau pathology, with sensitivity ranging from 92.3% (95% CI, 79.7%-97.3%) to 100.0% (95% CI, 91.0%-100.0%) and specificity ranging from 52.0% (95% CI, 33.5%-70.0%) to 92.0% (95% CI, 75.0%-97.8%). A high level of AD neuropathological change was predicted with sensitivity of 94.7% (95% CI, 82.7%-98.5%) to 100.0% (95% CI, 90.8%-100.0%) and specificity of 50.0% (95% CI, 32.1%-67.9%) to 92.3% (95% CI, 75.9%-97.9%). The FR01 validation study also met prespecified success criteria. Addition of the supplemental autopsy data set and 3 test cases, which comprised a total of 82 patients and autopsies for both the A16 and FR01 studies, resulted in improved specificity and comparable overall accuracy. Among the 156 enrolled participants, 14 (9%) experienced at least 1 treatment-emergent adverse event. Conclusions and Relevance This study's findings suggest that PET imaging with [18F]flortaucipir could be used to identify the density and distribution of AD-type tau pathology and the presence of high levels of AD neuropathological change, supporting a neuropathological diagnosis of AD.
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Affiliation(s)
| | | | | | - Ming Lu
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
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- Houston Methodist Institute for Academic Medicine, Houston, Texas
| | - Ian Kennedy
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
| | - Thomas Harris
- Avid Radiopharmaceuticals, Philadelphia, Pennsylvania
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Pontecorvo MJ, Keene CD, Beach TG, Montine TJ, Arora AK, Devous MD, Navitsky M, Kennedy I, Joshi AD, Lu M, Serrano GE, Sue LI, Intorcia AJ, Rose SE, Wilson A, Hellstern L, Coleman N, Flitter M, Aldea P, Fleisher AS, Mintun MA, Siderowf A. Comparison of regional flortaucipir PET with quantitative tau immunohistochemistry in three subjects with Alzheimer's disease pathology: a clinicopathological study. EJNMMI Res 2020; 10:65. [PMID: 32542468 PMCID: PMC7295920 DOI: 10.1186/s13550-020-00653-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 12/13/2019] [Accepted: 06/03/2020] [Indexed: 01/16/2023] Open
Abstract
Background The objective of this study was to make a quantitative comparison of flortaucipir PET retention with pathological tau and β-amyloid across a range of brain regions at autopsy. Methods Patients with dementia (two with clinical diagnosis of AD, one undetermined), nearing the end of life, underwent 20-min PET, beginning 80 min after an injection of ~370 mBq flortaucipir [18F]. Neocortical, basal ganglia, and limbic tissue samples were obtained bilaterally from 19 regions at autopsy and subject-specific PET regions of interest corresponding to the 19 sampled target tissue regions in each hemisphere were hand drawn on the PET images. SUVr values were calculated for each region using a cerebellar reference region. Abnormally phosphorylated tau (Ptau) and amyloid-β (Aβ) tissue concentrations were measured for each tissue region with an antibody capture assay (Histelide) using AT8 and H31L21 antibodies respectively. Results The imaging-to-autopsy interval ranged from 4–29 days. All three subjects had intermediate to high levels of AD neuropathologic change at autopsy. Mean cortical SUVr averaged across all three subjects correlated significantly with the Ptau immunoassay (Pearson r = 0.81; p < 0.0001). When Ptau and Aβ1-42 were both included in the model, the Ptau correlation with flortaucipir SUVr was preserved but there was no correlation of Aβ1-42 with flortaucipir. There was also a modest correlation between limbic (hippocampal/entorhinal and amygdala) flortaucipir SUVr and Ptau (Pearson r = 0.52; p < 0.080). There was no significant correlation between SUVr and Ptau in basal ganglia. Conclusions The results of this pilot study support a quantitative relationship between cortical flortaucipir SUVr values and quantitative measures of Ptau at autopsy. Additional research including more cases is needed to confirm the generalizability of these results. Trial registration, NIH Clinicaltrials.gov NCT # 02516046. Registered August 27, 2015. https://clinicaltrials.gov/ct2/show/NCT02516046?term=02516046&draw=2&rank=1
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Affiliation(s)
- Michael J Pontecorvo
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.
| | - C Dirk Keene
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Thomas G Beach
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | | | - Anupa K Arora
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Michael D Devous
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Michael Navitsky
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Ian Kennedy
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Abhinay D Joshi
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.,Present Address: Medpace Holdings, Inc., Cincinnati, Ohio, USA
| | - Ming Lu
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Geidy E Serrano
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Lucia I Sue
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Anthony J Intorcia
- Civin Laboratory for Neuropathology, Banner Sun Health Research Institute, Phoenix, AZ, USA
| | - Shannon E Rose
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Angela Wilson
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Leanne Hellstern
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Natalie Coleman
- Department of Pathology, University of Washington, Seattle, WA, USA
| | - Matthew Flitter
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Patricia Aldea
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Adam S Fleisher
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Mark A Mintun
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA
| | - Andrew Siderowf
- Avid Radiopharmaceuticals, 3711 Market St., 7th floor, Philadelphia, PA, 19104, USA.,Present Address: Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
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Brier MR, Gordon B, Friedrichsen K, McCarthy J, Stern A, Christensen J, Owen C, Aldea P, Su Y, Hassenstab J, Cairns NJ, Holtzman DM, Fagan AM, Morris JC, Benzinger TLS, Ances BM. Tau and Aβ imaging, CSF measures, and cognition in Alzheimer's disease. Sci Transl Med 2017; 8:338ra66. [PMID: 27169802 PMCID: PMC5267531 DOI: 10.1126/scitranslmed.aaf2362] [Citation(s) in RCA: 492] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/22/2016] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is characterized by two molecular pathologies: cerebral β-amyloidosis in the form of β-amyloid (Aβ) plaques and tauopathy in the form of neurofibrillary tangles, neuritic plaques, and neuropil threads. Until recently, only Aβ could be studied in humans using positron emission tomography (PET) imaging owing to a lack of tau PET imaging agents. Clinical pathological studies have linked tau pathology closely to the onset and progression of cognitive symptoms in patients with AD. We report PET imaging of tau and Aβ in a cohort of cognitively normal older adults and those with mild AD. Multivariate analyses identified unique disease-related stereotypical spatial patterns (topographies) for deposition of tau and Aβ. These PET imaging tau and Aβ topographies were spatially distinct but correlated with disease progression. Cerebrospinal fluid measures of tau, often used to stage preclinical AD, correlated with tau deposition in the temporal lobe. Tau deposition in the temporal lobe more closely tracked dementia status and was a better predictor of cognitive performance than Aβ deposition in any region of the brain. These data support models of AD where tau pathology closely tracks changes in brain function that are responsible for the onset of early symptoms in AD.
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Affiliation(s)
- Matthew R Brier
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Brian Gordon
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Karl Friedrichsen
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - John McCarthy
- Department of Mathematics, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Ari Stern
- Department of Mathematics, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Jon Christensen
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Christopher Owen
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Patricia Aldea
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Yi Su
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Jason Hassenstab
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Nigel J Cairns
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Department of Pathology, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - David M Holtzman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Anne M Fagan
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - John C Morris
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Department of Pathology, Washington University in St. Louis, St. Louis, MO 63110, USA. Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Department of Neurosurgery, Washington University in St. Louis, St. Louis, MO 63110, USA
| | - Beau M Ances
- Department of Neurology, Washington University in St. Louis, St. Louis, MO 63110, USA. Department of Radiology, Washington University in St. Louis, St. Louis, MO 63110, USA. Knight Alzheimer's Disease Research Center, Washington University in St. Louis, St. Louis, MO 63110, USA. Hope Center for Neurological Disorders, Washington University in St. Louis, St. Louis, MO 63110, USA.
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Berríos P, Fuentes JA, Salas D, Carreño A, Aldea P, Fernández F, Trombert AN. Inhibitory effect of biofilm-forming Lactobacillus kunkeei strains against virulent Pseudomonas aeruginosa in vitro and in honeycomb moth (Galleria mellonella) infection model. Benef Microbes 2017; 9:257-268. [PMID: 29124967 DOI: 10.3920/bm2017.0048] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 12/19/2022]
Abstract
Biofilms correspond to complex communities of microorganisms embedded in an extracellular polymeric matrix. Biofilm lifestyle predominates in Pseudomonas aeruginosa, an opportunistic Gram negative pathogen responsible for a wide spectrum of infections in humans, plants and animals. In this context, anti-biofilm can be considered a key strategy to control P. aeruginosa infections, thereby more research in the field is required. On the other hand, Lactobacillus species have been described as beneficial due to their anti-biofilm properties and their consequent effect against a wide spectrum of pathogens. In fact, biofilm-forming Lactobacilli seem to be more efficient than their planktonic counterpart to antagonise pathogenic bacteria. In this work, we demonstrated that Lactobacillus kunkeei, a novel Lactobacillus species isolated from honeybee guts, can form biofilms in vitro. In addition, the L. kunkeei biofilm can, in turn, inhibit the formation of P. aeruginosa biofilms. Finally, we found that L. kunkeei strains attenuate infection of P. aeruginosa in the Galleria mellonella model, presumably by affecting P. aeruginosa biofilm formation and/or their stability. Since L. kunkeei presents characteristics of a probiotic, this work provides evidence arguing that the use of this Lactobacillus species in both animals (including insects) and humans could contribute to impair P. aeruginosa biofilm formation.
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Affiliation(s)
- P Berríos
- 1 Escuela de Biotecnología, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Santiago 8580745, Chile
| | - J A Fuentes
- 2 Laboratorio de Genética y Patogénesis Bacteriana, Facultad de Ciencias Biológicas, Universidad Andrés Bello, Av. República 217, Santiago 8370146, Chile
| | - D Salas
- 3 Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Santiago 8580745, Chile
| | - A Carreño
- 4 Center of Applied Nanosciences (CANS), Universidad Andres Bello, Ave. República 275, Santiago 8370146, Chile.,5 Núcleo Milenio de Ingeniería Molecular para Catálisis y Biosensores (MECB), ICM, Av. República 275, Santiago 8370146, Chile
| | - P Aldea
- 6 CEAPI Mayor, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Santiago 8580745, Chile
| | - F Fernández
- 3 Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Santiago 8580745, Chile
| | - A N Trombert
- 3 Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor, Camino La Pirámide 5750, Huechuraba, Santiago 8580745, Chile
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Wang L, Benzinger TL, Su Y, Christensen J, Friedrichsen K, Aldea P, McConathy J, Cairns NJ, Fagan AM, Morris JC, Ances BM. Evaluation of Tau Imaging in Staging Alzheimer Disease and Revealing Interactions Between β-Amyloid and Tauopathy. JAMA Neurol 2017; 73:1070-7. [PMID: 27454922 DOI: 10.1001/jamaneurol.2016.2078] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
IMPORTANCE In vivo tau imaging may become a diagnostic marker for Alzheimer disease (AD) and provides insights into the pathophysiology of AD. OBJECTIVE To evaluate the usefulness of [18F]-AV-1451 positron emission tomography (PET) imaging to stage AD and assess the associations among β-amyloid (Aβ), tau, and volume loss. DESIGN, SETTING, AND PARTICIPANTS An imaging study conducted at Knight Alzheimer Disease Research Center at Washington University in St Louis, Missouri. A total of 59 participants who were cognitively normal (CN) (Clinical Dementia Rating [CDR] score, 0) or had AD dementia (CDR score, >0) were included. MAIN OUTCOMES AND MEASURES Standardized uptake value ratio (SUVR) of [18F]-AV-1451 in the hippocampus and a priori-defined AD cortical signature regions, cerebrospinal fluid Aβ42, hippocampal volume, and AD signature cortical thickness. RESULTS Of the 59 participants, 38 (64%) were male; mean (SD) age was 74 (6) years. The [18F]-AV-1451 SUVR in the hippocampus and AD cortical signature regions distinguished AD from CN participants (area under the receiver operating characteristic curve range [95% CI], 0.89 [0.73-1.00] to 0.98 [0.92-1.00]). An [18F]-AV-1451 SUVR cutoff value of 1.19 (sensitivity, 100%; specificity, 86%) from AD cortical signature regions best separated cerebrospinal fluid Aβ42-positive (Aβ+) AD from cerebrospinal fluid Aβ42-negative (Aβ-) CN participants. This same cutoff also divided Aβ+ CN participants into low vs high tau groups. Moreover, the presence of Aβ+ was associated with an elevated [18F]-AV-1451 SUVR in AD cortical signature regions (Aβ+ participants: mean [SD], 1.3 [0.3]; Aβ- participants: 1.1 [0.1]; F = 4.3, P = .04) but not in the hippocampus. The presence of Aβ+ alone was not related to hippocampal volume or AD signature cortical thickness. An elevated [18F]-AV-1451 SUVR was associated with volumetric loss in both the hippocampus and AD cortical signature regions. The observed [18F]-AV-1451 SUVR volumetric association was modified by Aβ status in the hippocampus but not in AD cortical signature regions. An inverse association between hippocampal [18F]-AV-1451 SUVR and volume was seen in Aβ+ participants (R2 = 0.55; P < .001) but not Aβ- (R2 = 0; P = .97) participants. CONCLUSIONS AND RELEVANCE Use of [18F]-AV-1451 has a potential for staging of the preclinical and clinical phases of AD. β-Amyloid interacts with hippocampal and cortical tauopathy to affect neurodegeneration. In the absence of Aβ, hippocampal tau deposition may be insufficient for the neurodegenerative process that leads to AD.
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Affiliation(s)
- Liang Wang
- Department of Neurology, Washington University, St Louis, Missouri2The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri
| | - Tammie L Benzinger
- The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri3Department of Radiology, Washington University, St Louis, Missouri
| | - Yi Su
- Department of Radiology, Washington University, St Louis, Missouri
| | - Jon Christensen
- Department of Radiology, Washington University, St Louis, Missouri
| | | | - Patricia Aldea
- Department of Radiology, Washington University, St Louis, Missouri
| | | | - Nigel J Cairns
- Department of Neurology, Washington University, St Louis, Missouri2The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri
| | - Anne M Fagan
- Department of Neurology, Washington University, St Louis, Missouri2The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri5The Hope Center for Neurological Disorders at Washington University, St Louis, Missouri
| | - John C Morris
- Department of Neurology, Washington University, St Louis, Missouri2The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri5The Hope Center for Neurological Disorders at Washington University, St Louis, Missouri
| | - Beau M Ances
- Department of Neurology, Washington University, St Louis, Missouri2The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University, St Louis, Missouri3Department of Radiology, Washington University, St Louis, Missouri5The Hope Center for Neurological Disorders at Washington University, St Louis, Missouri
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Gordon BA, Friedrichsen K, Brier M, Blazey T, Su Y, Christensen J, Aldea P, McConathy J, Holtzman DM, Cairns NJ, Morris JC, Fagan AM, Ances BM, Benzinger TLS. The relationship between cerebrospinal fluid markers of Alzheimer pathology and positron emission tomography tau imaging. Brain 2016; 139:2249-60. [PMID: 27286736 PMCID: PMC4958902 DOI: 10.1093/brain/aww139] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/25/2016] [Accepted: 04/26/2016] [Indexed: 12/20/2022] Open
Abstract
The two primary molecular pathologies in Alzheimer's disease are amyloid-β plaques and tau-immunoreactive neurofibrillary tangles. Investigations into these pathologies have been restricted to cerebrospinal fluid assays, and positron emission tomography tracers that can image amyloid-β plaques. Tau tracers have recently been introduced into the field, although the utility of the tracer and its relationship to other Alzheimer biomarkers are still unknown. Here we examined tau deposition in 41 cognitively normal and 11 cognitively impaired older adults using the radioactive tau ligand (18)F-AV-1451 (previously known as T807) who also underwent a lumbar puncture to assess cerebrospinal fluid levels of total tau (t-tau), phosphorylated tau181 (p-tau181) and amyloid-β42 Voxel-wise statistical analyses examined spatial patterns of tau deposition associated with cognitive impairment. We then related the amount of tau tracer uptake to levels of cerebrospinal fluid biomarkers. All analyses controlled for age and gender and, when appropriate, the time between imaging and lumbar puncture assessments. Symptomatic individuals (Clinical Dementia Rating > 0) demonstrated markedly increased levels of tau tracer uptake. This elevation was most prominent in the temporal lobe and temporoparietal junction, but extended more broadly into parietal and frontal cortices. In the entire cohort, there were significant relationships among all cerebrospinal fluid biomarkers and tracer uptake, notably for tau-related cerebrospinal fluid markers. After controlling for levels of amyloid-β42, the correlations with tau uptake were r = 0.490 (P < 0.001) for t-tau and r = 0.492 (P < 0.001) for p-tau181 Within the cognitively normal cohort, levels of amyloid-β42, but not t-tau or p-tau181, were associated with elevated tracer binding that was confined primarily to the medial temporal lobe and adjacent neocortical regions. AV-1451 tau binding in the medial temporal, parietal, and frontal cortices is correlated with tau-related cerebrospinal fluid measures. In preclinical Alzheimer's disease, there is focal tauopathy in the medial temporal lobes and adjacent cortices.
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Affiliation(s)
- Brian A Gordon
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA
| | - Karl Friedrichsen
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Matthew Brier
- 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Tyler Blazey
- 4 Division of Biology and Biomedical Sciences, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Yi Su
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Jon Christensen
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Patricia Aldea
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Jonathan McConathy
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - David M Holtzman
- 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 4 Division of Biology and Biomedical Sciences, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 5 The Hope Center for Neurological Disorders, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Nigel J Cairns
- 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 5 The Hope Center for Neurological Disorders, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - John C Morris
- 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Anne M Fagan
- 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 5 The Hope Center for Neurological Disorders, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Beau M Ances
- 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 3 Department of Neurology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 5 The Hope Center for Neurological Disorders, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA
| | - Tammie L S Benzinger
- 1 Department of Radiology, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63110, USA 2 Knight Alzheimer's Disease Research Center, Washington University in St. Louis, 4488 Forest Park Avenue, St. Louis, Missouri 63110, USA 6 Department of Neurological Surgery, Washington University in St. Louis, 660 South Euclid Avenue, St. Louis, Missouri 63108, USA
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Benzinger TL, Gordon BA, Friedrichsen KA, Su Y, Christensen J, Hornbeck RC, Mishra S, Aldea P, Cash L, Ances B, McConathy J, Koeppe RA, McDade E, Cairns NJ, Morris JC, Bateman R, Buckles V. O5‐01‐06: TAU Pet Imaging with AV‐1451 in Autosomal Dominant Alzheimer's Disease: Update from the Dominantly Inherited Alzheimer Network (DIAN). Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.709] [Citation(s) in RCA: 2] [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: 11/16/2022]
Affiliation(s)
- Tammie L.S. Benzinger
- Knight Alzheimer's Disease Research CenterSt. LouisMO USA
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | - Brian Andrew Gordon
- Knight Alzheimer's Disease Research CenterSt. LouisMO USA
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | | | - Yi Su
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | - Jon Christensen
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | | | - Shruti Mishra
- Washington University School of MedicineSt. LouisMO USA
| | | | - Lisa Cash
- Washington University School of MedicineSaint LouisMO USA
| | - Beau Ances
- Knight Alzheimer's Disease Research CenterSt. LouisMO USA
- Washington University in St. LouisSt. LouisMO USA
| | | | | | - Eric McDade
- Washington University at St. LouisSt. LouisMO USA
| | | | - John C. Morris
- Knight Alzheimer's Disease Research CenterSt. LouisMO USA
- Washington University in St. LouisSt. LouisMO USA
| | - Randall Bateman
- Knight Alzheimer's Disease Research CenterSt. LouisMO USA
- Washington University School of MedicineSt. LouisMO USA
- Hope Center for Neurological DisordersSt. LouisMO USA
| | - Virginia Buckles
- Knight Alzheimer Disease Research Center, Washington University School of MedicineSt. LouisMO USA
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Friedrichsen KA, Ghoshal N, Joseph-Mathurin N, Mishra S, Su Y, Christensen J, Aldea P, McConathy J, Gordon BA, Ances B, Cairns NJ, Morris JC, Benzinger TLS. P3‐234: Similarities and Differences in Patterns of [F18]‐AV‐1451 and [F18]‐FDG in Frontotemporal Dementia. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1896] [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)
| | - Nupur Ghoshal
- Washington University School of MedicineSt. LouisMO USA
| | | | - Shruti Mishra
- Washington University School of MedicineSt. LouisMO USA
| | - Yi Su
- Washington University School of MedicineSt. LouisMO USA
| | | | | | | | | | - Beau Ances
- Washington University School of MedicineSt. LouisMO USA
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Ances B, Brier MR, Gordon BA, Friedrichsen KA, McCarthy JE, Stern A, Christensen J, Owen CJ, Aldea P, Su Y, Hassenstab J, Cairns NJ, Holtzman DM, Fagan AM, Morris JC, Lee Smith Benzinger T. IC‐P‐179: TAU Imaging Relationships With Amyloid B Imaging, CSF TAU/AB
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, and Cognition in Alzheimer’s Disease. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.210] [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: 11/30/2022]
Affiliation(s)
- Beau Ances
- Washington University School of MedicineSt. LouisMO USA
| | | | | | | | | | - Ari Stern
- Washington University in St. LouisSaint LouisMO USA
| | - Jon Christensen
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | | | | | - Yi Su
- Washington University in St. Louis School of MedicineSt. LouisMO USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research CenterSt. LouisMO USA
- Washington University School of MedicineSt LouisMO USA
| | | | | | - Anne M. Fagan
- Washington University School of MedicineSt. LouisMO USA
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Friedrichsen KA, Mishra S, Gordon BA, Ghoshal N, Su Y, Joseph-Mathurin N, Christensen J, Aldea P, McConathy J, Ances B, Cairns NJ, Morris JC, Benzinger TLS. P1‐254: Principal Component Analysis of [18F]‐Av‐1451 TAU Pet in Alzheimer’S Disease and Frontotemporal Dementia. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1003] [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)
| | - Shruti Mishra
- Washington University School of MedicineSt. LouisMO USA
| | | | - Nupur Ghoshal
- Washington University School of MedicineSt. LouisMO USA
| | - Yi Su
- Washington University School of MedicineSt. LouisMO USA
| | | | | | | | | | - Beau Ances
- Washington University School of MedicineSt. LouisMO USA
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11
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Asenjo F, Olmos A, Henríquez-Piskulich P, Polanco V, Aldea P, Ugalde JA, Trombert AN. Genome sequencing and analysis of the first complete genome of Lactobacillus kunkeei strain MP2, an Apis mellifera gut isolate. PeerJ 2016; 4:e1950. [PMID: 27114887 PMCID: PMC4841242 DOI: 10.7717/peerj.1950] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [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: 10/19/2015] [Accepted: 03/29/2016] [Indexed: 01/23/2023] Open
Abstract
Background. The honey bee (Apis mellifera) is the most important pollinator in agriculture worldwide. However, the number of honey bees has fallen significantly since 2006, becoming a huge ecological problem nowadays. The principal cause is CCD, or Colony Collapse Disorder, characterized by the seemingly spontaneous abandonment of hives by their workers. One of the characteristics of CCD in honey bees is the alteration of the bacterial communities in their gastrointestinal tract, mainly due to the decrease of Firmicutes populations, such as the Lactobacilli. At this time, the causes of these alterations remain unknown. We recently isolated a strain of Lactobacillus kunkeei (L. kunkeei strain MP2) from the gut of Chilean honey bees. L. kunkeei, is one of the most commonly isolated bacterium from the honey bee gut and is highly versatile in different ecological niches. In this study, we aimed to elucidate in detail, the L. kunkeei genetic background and perform a comparative genome analysis with other Lactobacillus species. Methods. L. kunkeei MP2 was originally isolated from the guts of Chilean A. mellifera individuals. Genome sequencing was done using Pacific Biosciences single-molecule real-time sequencing technology. De novo assembly was performed using Celera assembler. The genome was annotated using Prokka, and functional information was added using the EggNOG 3.1 database. In addition, genomic islands were predicted using IslandViewer, and pro-phage sequences using PHAST. Comparisons between L. kunkeei MP2 with other L. kunkeei, and Lactobacillus strains were done using Roary. Results. The complete genome of L. kunkeei MP2 comprises one circular chromosome of 1,614,522 nt. with a GC content of 36,9%. Pangenome analysis with 16 L. kunkeei strains, identified 113 unique genes, most of them related to phage insertions. A large and unique region of L. kunkeei MP2 genome contains several genes that encode for phage structural protein and replication components. Comparative analysis of MP2 with other Lactobacillus species, identified several unique genes of L. kunkeei MP2 related with metabolism, biofilm generation, survival under stress conditions, and mobile genetic elements (MGEs). Discussion. The presence of multiple mobile genetic elements, including phage sequences, suggest a high degree of genetic variability in L. kunkeei. Its versatility and ability to survive in different ecological niches (bee guts, flowers, fruits among others) could be given by its genetic capacity to change and adapt to different environments. L. kunkeei could be a new source of Lactobacillus with beneficial properties. Indeed, L. kunkeei MP2 could play an important role in honey bee nutrition through the synthesis of components as isoprenoids.
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Affiliation(s)
- Freddy Asenjo
- Centro de Genética y Genómica, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo , Santiago , Chile
| | - Alejandro Olmos
- Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor , Santiago , Chile
| | | | - Victor Polanco
- Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor, Santiago, Chile; Centro de Estudios Apícolas CEAPI Mayor, Facultad de Ciencias, Universidad Mayor, Santiago, Chile
| | - Patricia Aldea
- Centro de Estudios Apícolas CEAPI Mayor, Facultad de Ciencias, Universidad Mayor , Santiago , Chile
| | - Juan A Ugalde
- Centro de Genética y Genómica, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo , Santiago , Chile
| | - Annette N Trombert
- Centro de Genómica y Bioinformática, Facultad de Ciencias, Universidad Mayor , Santiago , Chile
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Su Y, Blazey TM, Snyder AZ, Raichle ME, Hornbeck RC, Aldea P, Morris JC, Benzinger TLS. Quantitative amyloid imaging using image-derived arterial input function. PLoS One 2015; 10:e0122920. [PMID: 25849581 PMCID: PMC4388540 DOI: 10.1371/journal.pone.0122920] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 02/24/2015] [Indexed: 11/19/2022] Open
Abstract
Amyloid PET imaging is an indispensable tool widely used in the investigation, diagnosis and monitoring of Alzheimer’s disease (AD). Currently, a reference region based approach is used as the mainstream quantification technique for amyloid imaging. This approach assumes the reference region is amyloid free and has the same tracer influx and washout kinetics as the regions of interest. However, this assumption may not always be valid. The goal of this work is to evaluate an amyloid imaging quantification technique that uses arterial region of interest as the reference to avoid potential bias caused by specific binding in the reference region. 21 participants, age 58 and up, underwent Pittsburgh compound B (PiB) PET imaging and MR imaging including a time-of-flight (TOF) MR angiography (MRA) scan and a structural scan. FreeSurfer based regional analysis was performed to quantify PiB PET data. Arterial input function was estimated based on coregistered TOF MRA using a modeling based technique. Regional distribution volume (VT) was calculated using Logan graphical analysis with estimated arterial input function. Kinetic modeling was also performed using the estimated arterial input function as a way to evaluate PiB binding (DVRkinetic) without a reference region. As a comparison, Logan graphical analysis was also performed with cerebellar cortex as reference to obtain DVRREF. Excellent agreement was observed between the two distribution volume ratio measurements (r>0.89, ICC>0.80). The estimated cerebellum VT was in line with literature reported values and the variability of cerebellum VT in the control group was comparable to reported variability using arterial sampling data. This study suggests that image-based arterial input function is a viable approach to quantify amyloid imaging data, without the need of arterial sampling or a reference region. This technique can be a valuable tool for amyloid imaging, particularly in population where reference normalization may not be accurate.
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Affiliation(s)
- Yi Su
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Knight Alzheimer’s Disease Research Center (ADRC), Washington University School of Medicine, Saint Louis, Missouri, United States of America
- * E-mail:
| | - Tyler M. Blazey
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Abraham Z. Snyder
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Marcus E. Raichle
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Russ C. Hornbeck
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Knight Alzheimer’s Disease Research Center (ADRC), Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Patricia Aldea
- Knight Alzheimer’s Disease Research Center (ADRC), Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - John C. Morris
- Department of Neurology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Knight Alzheimer’s Disease Research Center (ADRC), Washington University School of Medicine, Saint Louis, Missouri, United States of America
| | - Tammie L. S. Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Knight Alzheimer’s Disease Research Center (ADRC), Washington University School of Medicine, Saint Louis, Missouri, United States of America
- Department of Neurosurgery, Washington University School of Medicine, Saint Louis, Missouri, United States of America
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13
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Su Y, Blazey TM, Snyder AZ, Raichle ME, Marcus DS, Ances BM, Bateman RJ, Cairns NJ, Aldea P, Cash L, Christensen JJ, Friedrichsen K, Hornbeck RC, Farrar AM, Owen CJ, Mayeux R, Brickman AM, Klunk W, Price JC, Thompson PM, Ghetti B, Saykin AJ, Sperling RA, Johnson KA, Schofield PR, Buckles V, Morris JC, Benzinger TLS. Partial volume correction in quantitative amyloid imaging. Neuroimage 2014; 107:55-64. [PMID: 25485714 DOI: 10.1016/j.neuroimage.2014.11.058] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [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: 06/17/2014] [Revised: 11/26/2014] [Accepted: 11/30/2014] [Indexed: 12/16/2022] Open
Abstract
Amyloid imaging is a valuable tool for research and diagnosis in dementing disorders. As positron emission tomography (PET) scanners have limited spatial resolution, measured signals are distorted by partial volume effects. Various techniques have been proposed for correcting partial volume effects, but there is no consensus as to whether these techniques are necessary in amyloid imaging, and, if so, how they should be implemented. We evaluated a two-component partial volume correction technique and a regional spread function technique using both simulated and human Pittsburgh compound B (PiB) PET imaging data. Both correction techniques compensated for partial volume effects and yielded improved detection of subtle changes in PiB retention. However, the regional spread function technique was more accurate in application to simulated data. Because PiB retention estimates depend on the correction technique, standardization is necessary to compare results across groups. Partial volume correction has sometimes been avoided because it increases the sensitivity to inaccuracy in image registration and segmentation. However, our results indicate that appropriate PVC may enhance our ability to detect changes in amyloid deposition.
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Affiliation(s)
- Yi Su
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA.
| | - Tyler M Blazey
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Abraham Z Snyder
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Marcus E Raichle
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Beau M Ances
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Randall J Bateman
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Nigel J Cairns
- Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Patricia Aldea
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Lisa Cash
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Jon J Christensen
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Karl Friedrichsen
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Russ C Hornbeck
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Angela M Farrar
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Christopher J Owen
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Richard Mayeux
- Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA
| | - Adam M Brickman
- Department of Neurology, Columbia University Medical Center, New York, NY 10032, USA
| | - William Klunk
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Julie C Price
- Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
| | - Paul M Thompson
- Imaging Genetics Center, Institute for Neuroimaging and Informatics, University of Southern California, Los Angeles, CA 90032, USA; Department of Neurology, University of Southern California, Los Angeles, CA 90032, USA; Department of Psychiatry, University of Southern California, Los Angeles, CA 90032, USA; Department of Engineering, University of Southern California, Los Angeles, CA 90032, USA; Department of Radiology, University of Southern California, Los Angeles, CA 90032, USA; Department of Pediatrics, University of Southern California, Los Angeles, CA 90032, USA; Department of Ophthalmology, University of Southern California, Los Angeles, CA 90032, USA
| | - Bernadino Ghetti
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Science, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Keith A Johnson
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW 2031, Australia; School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia
| | - Virginia Buckles
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - John C Morris
- Department of Neurology, Washington University School of Medicine, Saint Louis, MO 63110, USA
| | - Tammie L S Benzinger
- Department of Radiology, Washington University School of Medicine, Saint Louis, MO 63110, USA
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Ances BM, Benzinger TL, Christensen JJ, Thomas J, Venkat R, Teshome M, Aldea P, Fagan AM, Holtzman DM, Morris JC, Clifford DB. 11C-PiB imaging of human immunodeficiency virus-associated neurocognitive disorder. ACTA ACUST UNITED AC 2012; 69:72-7. [PMID: 22232345 DOI: 10.1001/archneurol.2011.761] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To evaluate whether the amyloid-binding agent carbon 11-labeled Pittsburgh Compound B ((11)C-PiB) could differentiate Alzheimer disease (AD) from human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) in middle-aged HIV-positive participants. DESIGN (11)C-PiB scanning, clinical assessment, and cerebrospinal fluid (CSF) analysis were performed. Both χ(2) and t tests assessed differences in clinical and demographic variables between HIV-positive participants and community-living individuals observed at the Knight Alzheimer's Disease Research Center (ADRC). Analysis of variance assessed for regional differences in amyloid-β protein 1-42 (Aβ42) using (11)C-PiB. SETTING An ADRC and HIV clinic. PARTICIPANTS Sixteen HIV-positive participants (11 cognitively normal and 5 with HAND) and 19 ADRC participants (8 cognitively normal and 11 with symptomatic AD). MAIN OUTCOME MEASURES Mean and regional (11)C-PiB binding potentials. RESULTS Participants with symptomatic AD were older (P < .001), had lower CSF Aβ42 levels (P < .001), and had higher CSF tau levels (P < .001) than other groups. Regardless of degree of impairment, HIV-positive participants did not have increased (11)C-PiB levels. Mean and regional binding potentials were elevated for symptomatic AD participants (P < .001). CONCLUSIONS Middle-aged HIV-positive participants, even with HAND, do not exhibit increased (11)C-PiB levels, whereas symptomatic AD individuals have increased fibrillar Aβ42 deposition in cortical and subcortical regions. Observed dissimilarities between HAND and AD may reflect differences in Aβ42 metabolism. (11)C-PiB may provide a diagnostic biomarker for distinguishing symptomatic AD from HAND in middle-aged HIV-positive participants. Future cross-sectional and longitudinal studies are required to assess the utility of (11)C-PiB in older individuals with HAND.
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Affiliation(s)
- Beau M Ances
- Department of Neurology, Washington University in St. Louis, Campus Box 8111, 660 S Euclid Ave, St Louis, MO 63110, USA.
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15
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Ances BM, Christensen JJ, Teshome M, Taylor J, Xiong C, Aldea P, Fagan AM, Holtzman DM, Morris JC, Mintun MA, Clifford DB. Cognitively unimpaired HIV-positive subjects do not have increased 11C-PiB: a case-control study. Neurology 2010; 75:111-5. [PMID: 20534887 DOI: 10.1212/wnl.0b013e3181e7b66e] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Diagnostic challenges exist for differentiating HIV dementia from Alzheimer disease (AD) in older HIV-infected (HIV+) individuals. Similar abnormalities in brain amyloid-beta42 (Alphabeta42) metabolism may be involved in HIV-associated neuropathology and AD. We evaluated the amyloid-binding agent (11)C-Pittsburgh compound B ((11)C-PiB), a biomarker for Alphabeta42 deposition, in cognitively unimpaired HIV+ (n = 10) participants and matched community controls without dementia (n = 20). METHODS In this case-control study, all participants had an (11)C-PiB scan within 2 years of concomitant CSF studies and neuropsychometric testing. Statistical differences between HIV+ and community controls for demographic and clinical values were assessed by chi(2) tests. Participants were further divided into either low (<500 pg/mL) or normal (>or=500 pg/mL) CSF Alphabeta42 groups with Student t tests performed to determine if regional differences in fibrillar amyloid plaque deposition varied with CSF Alphabeta42. RESULTS Regardless of CSF Alphabeta42 level, none of the HIV+ participants had fibrillar amyloid plaques as assessed by increased (11)C-PiB mean cortical binding potential (MCBP) or binding potential within 4 cortical regions. In contrast, some community controls with low CSF Alphabeta42 (<500 pg/mL) had high (11)C-PiB MCBP with elevated binding potentials (>0.18 arbitrary units) within cortical regions. CONCLUSIONS Cognitively unimpaired HIV+ participants, even with low CSF Alphabeta42 (<500 pg/mL), do not have (11)C-PiB parameters suggesting brain fibrillar amyloid deposition. The dissimilarity between unimpaired HIV+ and preclinical AD may reflect differences in Abeta42 production and/or formation of diffuse plaques. Future longitudinal studies of HIV+ participants with low CSF Abeta42 and normal (11)C-PiB are required.
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Affiliation(s)
- B M Ances
- Department of Neurology, Washington University, St Louis, MO 63110, USA.
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Fagan AM, Mintun MA, Shah AR, Aldea P, Roe CM, Mach RH, Marcus D, Morris JC, Holtzman DM. Cerebrospinal fluid tau and ptau(181) increase with cortical amyloid deposition in cognitively normal individuals: implications for future clinical trials of Alzheimer's disease. EMBO Mol Med 2010; 1:371-80. [PMID: 20049742 PMCID: PMC2806678 DOI: 10.1002/emmm.200900048] [Citation(s) in RCA: 256] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Alzheimer's disease (AD) pathology is estimated to develop many years before detectable cognitive decline. Fluid and imaging biomarkers may identify people in early symptomatic and even preclinical stages, possibly when potential treatments can best preserve cognitive function. We previously reported that cerebrospinal fluid (CSF) levels of amyloid-beta(42) (Abeta(42)) serve as an excellent marker for brain amyloid as detected by the amyloid tracer, Pittsburgh compound B (PIB). Using data from 189 cognitively normal participants, we now report a positive linear relationship between CSF tau/ptau(181) (primary constituents of neurofibrillary tangles) with the amount of cortical amyloid. We observe a strong inverse relationship of cortical PIB binding with CSF Abeta(42) but not for plasma Abeta species. Some individuals have low CSF Abeta(42) but no cortical PIB binding. Together, these data suggest that changes in brain Abeta(42) metabolism and amyloid formation are early pathogenic events in AD, and that significant disruptions in CSF tau metabolism likely occur after Abeta(42) initially aggregates and increases as amyloid accumulates. These findings have important implications for preclinical AD diagnosis and treatment.
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Affiliation(s)
- Anne M Fagan
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA.
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