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Impact of amyloid and cardiometabolic risk factors on prognostic capacity of plasma neurofilament light chain for neurodegeneration 淀粉样蛋白和心脏代谢风险因素对神经退行性疾病血浆神经丝蛋白轻链预后能力的影响
IF 9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-12 DOI: 10.1186/s13195-024-01564-y
Keun You Kim, Eosu Kim, Jun-Young Lee
Plasma neurofilament light chain (NfL) is a blood biomarker of neurodegeneration, including Alzheimer’s disease. However, its usefulness may be influenced by common conditions in older adults, including amyloid-β (Aβ) deposition and cardiometabolic risk factors like hypertension, diabetes mellitus (DM), impaired kidney function, and obesity. This longitudinal observational study using the Alzheimer’s Disease Neuroimaging Initiative cohort investigated how these conditions influence the prognostic capacity of plasma NfL. Non-demented participants (cognitively unimpaired or mild cognitive impairment) underwent repeated assessments including the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores, hippocampal volumes, and white matter hyperintensity (WMH) volumes at 6- or 12-month intervals. Linear mixed-effect models were employed to examine the interaction between plasma NfL and various variables of interest, such as Aβ (evaluated using Florbetapir positron emission tomography), hypertension, DM, impaired kidney function, or obesity. Over a mean follow-up period of 62.5 months, participants with a mean age of 72.1 years (n = 720, 48.8% female) at baseline were observed. Higher plasma NfL levels at baseline were associated with steeper increases in ADAS-Cog scores and WMH volumes, and steeper decreases in hippocampal volumes over time (all p-values < 0.001). Notably, Aβ at baseline significantly enhanced the association between plasma NfL and longitudinal changes in ADAS-Cog scores (p-value 0.005) and hippocampal volumes (p-value 0.004). Regarding ADAS-Cog score and WMH volume, the impact of Aβ was more prominent in cognitively unimpaired than in mild cognitive impairment. Hypertension significantly heightened the association between plasma NfL and longitudinal changes in ADAS-Cog scores, hippocampal volumes, and WMH volumes (all p-values < 0.001). DM influenced the association between plasma NfL and changes in ADAS-Cog scores (p-value < 0.001) without affecting hippocampal and WMH volumes. Impaired kidney function did not significantly alter the association between plasma NfL and longitudinal changes in any outcome variables. Obesity heightened the association between plasma NfL and changes in hippocampal volumes only (p-value 0.026). This study suggests that the prognostic capacity of plasma NfL may be amplified in individuals with Aβ or hypertension. This finding emphasizes the importance of considering these factors in the NfL-based prognostic model for neurodegeneration in non-demented older adults.
血浆神经丝蛋白轻链(NfL)是神经变性(包括阿尔茨海默病)的血液生物标志物。然而,它的作用可能会受到老年人常见疾病的影响,包括淀粉样蛋白-β(Aβ)沉积以及高血压、糖尿病(DM)、肾功能受损和肥胖等心脏代谢风险因素。这项纵向观察研究利用阿尔茨海默病神经影像学倡议队列调查了这些情况如何影响血浆NfL的预后能力。非痴呆参与者(认知功能未受损或轻度认知功能受损)接受了重复评估,包括阿尔茨海默病评估量表-认知子量表(ADAS-Cog)评分、海马体积和白质高密度(WMH)体积,评估间隔为 6 个月或 12 个月。研究人员采用线性混合效应模型来检验血浆NfL与Aβ(通过氟贝他匹正电子发射断层扫描评估)、高血压、糖尿病、肾功能受损或肥胖等各种相关变量之间的相互作用。在平均 62.5 个月的随访期间,对平均年龄为 72.1 岁(n = 720,48.8% 为女性)的基线参与者进行了观察。随着时间的推移,基线时较高的血浆NfL水平与ADAS-Cog评分和WMH体积的急剧增加以及海马体积的急剧减少相关(所有P值均小于0.001)。值得注意的是,基线时的 Aβ 能显著增强血浆 NfL 与 ADAS-Cog 评分(p 值 0.005)和海马体积(p 值 0.004)纵向变化之间的关联。关于ADAS-Cog评分和WMH体积,Aβ对认知功能未受损者的影响比对轻度认知功能受损者的影响更为显著。高血压明显增强了血浆NfL与ADAS-Cog评分、海马体积和WMH体积纵向变化之间的关联(所有P值均小于0.001)。糖尿病会影响血浆NfL与ADAS-Cog评分变化之间的关系(p值<0.001),但不会影响海马体积和WMH体积。肾功能受损不会明显改变血浆NfL与任何结果变量的纵向变化之间的关系。肥胖仅增强了血浆NfL与海马体积变化之间的关联(p值为0.026)。这项研究表明,血浆 NfL 的预后能力可能会在患有 Aβ 或高血压的个体中放大。这一发现强调了在基于 NfL 的非痴呆老年人神经变性预后模型中考虑这些因素的重要性。
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引用次数: 0
TRanscranial AlterNating current stimulation FOR patients with mild Alzheimer’s Disease (TRANSFORM-AD): a randomized controlled clinical trial 轻度阿尔茨海默病患者的颅内改变电流刺激(TRANSFORM-AD):随机对照临床试验
IF 9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-12 DOI: 10.1186/s13195-024-01570-0
Yi Tang, Yi Xing, Liwei Sun, Zhibin Wang, Changming Wang, Kun Yang, Wei Zhu, Xinrui Shi, Beijia Xie, Yunsi Yin, Yingxin Mi, Tao Wei, Renjie Tong, Yuchen Qiao, Shaozhen Yan, Penghu Wei, Yanfeng Yang, Yongzhi Shan, Xu Zhang, Jianping Jia, Stefan J. Teipel, Robert Howard, Jie Lu, Chunlin Li, Guoguang Zhao
The mechanistic effects of gamma transcranial alternating current stimulation (tACS) on hippocampal gamma oscillation activity in Alzheimer’s Disease (AD) remains unclear. This study aimed to clarify beneficial effects of gamma tACS on cognitive functioning in AD and to elucidate effects on hippocampal gamma oscillation activity. This is a double-blind, randomized controlled single-center trial. Participants with mild AD were randomized to tACS group or sham group, and underwent 30 one-hour sessions of either 40 Hz tACS or sham stimulation over consecutive 15 days. Cognitive functioning, structural magnetic resonance imaging (MRI), and simultaneous electroencephalography–functional MRI (EEG-fMRI) were evaluated at baseline, the end of the intervention and at 3-month follow-up from the randomization. A total of 46 patients were enrolled (23 in the tACS group, 23 in the sham group). There were no group differences in the change of the primary outcome, 11-item cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-Cog) score after intervention (group*time, p = 0.449). For secondary outcomes, compared to the control group, the intervention group showed significant improvement in MMSE (group*time, p = 0.041) and MoCA scores (non-parametric test, p = 0.025), which were not sustained at 3-month follow-up. We found an enhancement of theta-gamma coupling in the hippocampus, which was positively correlated with improvements of MMSE score and delayed recall. Additionally, fMRI revealed increase of the local neural activity in the hippocampus. Effects on the enhancement of theta-gamma coupling and neural activity within the hippocampus suggest mechanistic models for potential therapeutic mechanisms of tACS. ClinicalTrials.gov, NCT 03920826; Registration Date: 2019-04-19.
伽马经颅交变电流刺激(tACS)对阿尔茨海默病(AD)海马伽马振荡活动的机理影响仍不清楚。本研究旨在明确伽马经颅交流电刺激对阿尔茨海默病认知功能的有益影响,并阐明其对海马伽马振荡活动的影响。这是一项双盲、随机对照的单中心试验。轻度注意力缺失症患者被随机分配到tACS组或假刺激组,在连续15天内接受30次每次一小时的40赫兹tACS或假刺激。在基线、干预结束和随机化后3个月的随访中,对认知功能、结构磁共振成像(MRI)和同步脑电图-功能磁共振成像(EEG-FMRI)进行评估。共有 46 名患者接受了干预(tACS 组 23 人,假干预组 23 人)。干预后,主要结果--阿尔茨海默病评估量表(ADAS-Cog)11项认知分量表得分的变化没有组间差异(组间*时间,P = 0.449)。在次要结果方面,与对照组相比,干预组在 MMSE(组*时间,p = 0.041)和 MoCA 评分(非参数检验,p = 0.025)方面有显著改善,但在 3 个月的随访中并未持续。我们发现海马的θ-γ耦合增强,这与MMSE评分和延迟回忆的改善呈正相关。此外,fMRI 显示海马区的局部神经活动有所增加。对海马内θ-γ耦合和神经活动增强的影响为tACS的潜在治疗机制提供了机理模型。ClinicalTrials.gov, NCT 03920826;注册日期:2019-04-19。
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引用次数: 0
Clinical, neuropathological, and molecular characteristics of rapidly progressive dementia with Lewy bodies: a distinct clinicopathological entity? 快速进展性路易体痴呆症的临床、神经病理学和分子特征:一个独特的临床病理学实体?
IF 9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-10 DOI: 10.1186/s13195-024-01565-x
Giuseppe Mario Bentivenga, Simone Baiardi, Andrea Mastrangelo, Edoardo Ruggeri, Angela Mammana, Alice Ticca, Marcello Rossi, Sabina Capellari, Piero Parchi
The term rapidly progressive dementia (RPD) with Lewy bodies (rpDLB) is used for DLB patients who develop a rapidly progressive neurological syndrome and have reduced survival. Here, we characterise the clinical, neuropathological, and molecular characteristics of a large rpDLB neuropathological series. We included all RPD patients with a disease duration < 4 years submitted to our prion disease referral centre between 2003 and 2022 who showed Lewy body pathology (LBP) in limbic or neocortical stages as primary neuropathological diagnosis, had no systemic condition justifying the rapid deterioration and were previously neurologically unimpaired. Clinical features were retrieved and compared with Creutzfeldt-Jakob disease (CJD) and rapidly progressive Alzheimer’s disease (rpAD) cohorts. Neuropathological and genetic (whole exome sequencing, APOE genotyping, and C9orf72 repeat expansion analysis) characteristics of rpDLB patients were systematically investigated. We scored semi-quantitatively the LBP load and performed a α-synuclein (αSyn) RT-QuIC seeding amplification assay (SAA) on cerebrospinal fluid (CSF) and tenfold serially diluted brain homogenates from different brain areas in rpDLB patients and typical long-lasting Lewy body disease (LBD) with dementia patients as control group. RpDLB patients were older (p = 0.047) and presented more cognitive fluctuations (p = 0.005), visual hallucinations (p = 0.020), neuropsychiatric symptoms (p = 0.006) and seizures (p = 0.032), and fewer cerebellar (p < 0.001) and visual (p = 0.004) signs than CJD ones. Delirium onset was more common than in both CJD (p < 0.001) and rpAD (p = 0.008). Atypical LBD signs (pyramidal, myoclonus, akinetic mutism) were common. All tested patients were positive by CSF αSyn SAA. Concomitant pathologies were common, with only four cases showing relatively “pure” LBP. LBP load and αSyn seeding activity measured through αSyn RT-QuIC SAA were not significantly different between rpDLB patients and typical LBD. We found a likely pathogenic variant in GBA in one patient. Our results indicate that: 1) rpDLB exhibits a distinct clinical signature (2) CSF αSyn SAA is a reliable diagnostic test; 3) rpDLB is a heterogeneous neuropathological entity that can be underlain by both widespread pure LBP, or multiple copathologies 4) rpDLB is likely not sustained by distinct αSyn conformational strains; 5) genetic defects may, at least occasionally, contribute to the poor prognosis in these patients.
快速进展性痴呆(RPD)伴路易体(rpDLB)一词用于指发生快速进展性神经综合征且存活率降低的 DLB 患者。在这里,我们描述了一个大型 rpDLB 神经病理学系列的临床、神经病理学和分子特征。我们纳入了2003年至2022年期间送往我们的朊病毒病转诊中心的所有病程小于4年的路易体病理(LBP)患者,这些患者的主要神经病理诊断为边缘或新皮质阶段的路易体病理(LBP),没有导致病情迅速恶化的全身性疾病,并且之前没有神经功能损害。研究人员检索了这些患者的临床特征,并将其与克雅氏病(CJD)和快速进展性阿尔茨海默病(rpAD)患者进行了比较。我们对 rpDLB 患者的神经病理学和遗传学(全外显子组测序、APOE 基因分型和 C9orf72 重复扩增分析)特征进行了系统研究。我们对rpDLB患者和作为对照组的典型长效路易体病(LBD)伴痴呆患者不同脑区的脑脊液(CSF)和10倍序列稀释的脑匀浆进行了半定量LBP负荷评分和α-突触核蛋白(αSyn)RT-QuIC播种扩增试验(SAA)。与 CJD 患者相比,RpDLB 患者年龄更大(p = 0.047),表现出更多的认知波动(p = 0.005)、视幻觉(p = 0.020)、神经精神症状(p = 0.006)和癫痫发作(p = 0.032),而小脑(p < 0.001)和视觉(p = 0.004)体征较少。谵妄的发病率高于CJD(p < 0.001)和rpAD(p = 0.008)。非典型枸杞多糖体征(锥体、肌阵挛、运动性缄默症)很常见。所有受检患者的脑脊液αSyn SAA均呈阳性。合并病症很常见,只有四例表现为相对 "单纯 "的枸杞多糖症。通过 αSyn RT-QuIC SAA 测量的枸杞多糖负荷和 αSyn 播种活性在 rpDLB 患者和典型枸杞多糖患者之间没有显著差异。我们在一名患者的 GBA 中发现了一个可能的致病变体。我们的研究结果表明1)rpDLB 表现出独特的临床特征(2)CSF αSyn SAA 是一种可靠的诊断测试;3)rpDLB 是一种异质性的神经病理学实体,既可能是广泛的单纯 LBP,也可能是多种共同病理 4)rpDLB 很可能不是由独特的 αSyn 构象株维持的;5)遗传缺陷至少偶尔会导致这些患者预后不良。
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引用次数: 0
Mitigation of synaptic and memory impairments via F-actin stabilization in Alzheimer's disease. 通过稳定 F-肌动蛋白缓解阿尔茨海默病的突触和记忆损伤
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-07 DOI: 10.1186/s13195-024-01558-w
Haseena P A, Nimisha Basavaraju, Mahesh Chandran, Abdul Jaleel, David A Bennett, Reddy Peera Kommaddi

Background: Synaptic dysfunction, characterized by synapse loss and structural alterations, emerges as a prominent correlate of cognitive decline in Alzheimer's disease (AD). Actin cytoskeleton, which serves as the structural backbone of synaptic architecture, is observed to be lost from synapses in AD. Actin cytoskeleton loss compromises synaptic integrity, affecting glutamatergic receptor levels, neurotransmission, and synaptic strength. Understanding these molecular changes is crucial for developing interventions targeting synaptic dysfunction, potentially mitigating cognitive decline in AD.

Methods: In this study, we investigated the synaptic actin interactome using mass spectrometry in a mouse model of AD, APP/PS1. Our objective was to explore how alterations in synaptic actin dynamics, particularly the interaction between PSD-95 and actin, contribute to synaptic and cognitive impairment in AD. To assess the impact of restoring F-actin levels on synaptic and cognitive functions in APP/PS1 mice, we administered F-actin stabilizing agent, jasplakinolide. Behavioral deficits in the mice were evaluated using the contextual fear conditioning paradigm. We utilized primary neuronal cultures to study the synaptic levels of AMPA and NMDA receptors and the dynamics of PSD-95 actin association. Furthermore, we analyzed postmortem brain tissue samples from subjects with no cognitive impairment (NCI), mild cognitive impairment (MCI), and Alzheimer's dementia (AD) to determine the association between PSD-95 and actin.

Results: We found a significant reduction in PSD-95-actin association in synaptosomes from middle-aged APP/PS1 mice compared to wild-type (WT) mice. Treatment with jasplakinolide, an actin stabilizer, reversed deficits in memory recall, restored PSD-95-actin association, and increased synaptic F-actin levels in APP/PS1 mice. Additionally, actin stabilization led to elevated synaptic levels of AMPA and NMDA receptors, enhanced dendritic spine density, suggesting improved neurotransmission and synaptic strength in primary cortical neurons from APP/PS1 mice. Furthermore, analysis of postmortem human tissue with NCI, MCI and AD subjects revealed disrupted PSD-95-actin interactions, underscoring the clinical relevance of our preclinical studies.

Conclusion: Our study elucidates disrupted PSD-95 actin interactions across different models, highlighting potential therapeutic targets for AD. Stabilizing F-actin restores synaptic integrity and ameliorates cognitive deficits in APP/PS1 mice, suggesting that targeting synaptic actin regulation could be a promising therapeutic strategy to mitigate cognitive decline in AD.

背景:以突触丢失和结构改变为特征的突触功能障碍是阿尔茨海默病(AD)认知能力下降的一个显著相关因素。肌动蛋白细胞骨架是突触结构的结构骨架,据观察,在阿尔茨海默病中,突触会丢失。肌动蛋白细胞骨架的丧失会损害突触的完整性,影响谷氨酸能受体水平、神经传递和突触强度。了解这些分子变化对于开发针对突触功能障碍的干预措施至关重要,这些干预措施有可能缓解 AD 患者的认知能力下降:在这项研究中,我们利用质谱分析法研究了AD小鼠模型APP/PS1的突触肌动蛋白相互作用组。我们的目的是探索突触肌动蛋白动力学的改变,尤其是 PSD-95 与肌动蛋白之间的相互作用,是如何导致 AD 中的突触和认知障碍的。为了评估恢复F-肌动蛋白水平对APP/PS1小鼠突触和认知功能的影响,我们给小鼠注射了F-肌动蛋白稳定剂茉莉内酯(jasplakinolide)。我们使用情境恐惧条件反射范式评估了小鼠的行为缺陷。我们利用原代神经元培养物研究了 AMPA 和 NMDA 受体的突触水平以及 PSD-95 肌动蛋白关联的动态。此外,我们还分析了无认知障碍(NCI)、轻度认知障碍(MCI)和阿尔茨海默氏症痴呆(AD)受试者的死后脑组织样本,以确定 PSD-95 与肌动蛋白之间的关联:结果:我们发现,与野生型(WT)小鼠相比,中年APP/PS1小鼠突触体中的PSD-95与肌动蛋白之间的联系明显减少。用肌动蛋白稳定剂茉莉内酯(jasplakinolide)治疗可逆转APP/PS1小鼠的记忆回忆缺陷,恢复PSD-95-肌动蛋白关联,并提高突触F-肌动蛋白水平。此外,肌动蛋白稳定化还能提高 AMPA 和 NMDA 受体的突触水平,增强树突棘密度,从而改善 APP/PS1 小鼠初级皮层神经元的神经传递和突触强度。此外,对NCI、MCI和AD受试者死后人体组织的分析表明,PSD-95与肌动蛋白之间的相互作用被破坏,这强调了我们临床前研究的临床意义:我们的研究阐明了不同模型中PSD-95肌动蛋白相互作用的紊乱,突出了AD的潜在治疗靶点。稳定F-肌动蛋白可恢复突触完整性并改善APP/PS1小鼠的认知缺陷,这表明针对突触肌动蛋白的调控可能是缓解AD认知功能下降的一种有前景的治疗策略。
{"title":"Mitigation of synaptic and memory impairments via F-actin stabilization in Alzheimer's disease.","authors":"Haseena P A, Nimisha Basavaraju, Mahesh Chandran, Abdul Jaleel, David A Bennett, Reddy Peera Kommaddi","doi":"10.1186/s13195-024-01558-w","DOIUrl":"https://doi.org/10.1186/s13195-024-01558-w","url":null,"abstract":"<p><strong>Background: </strong>Synaptic dysfunction, characterized by synapse loss and structural alterations, emerges as a prominent correlate of cognitive decline in Alzheimer's disease (AD). Actin cytoskeleton, which serves as the structural backbone of synaptic architecture, is observed to be lost from synapses in AD. Actin cytoskeleton loss compromises synaptic integrity, affecting glutamatergic receptor levels, neurotransmission, and synaptic strength. Understanding these molecular changes is crucial for developing interventions targeting synaptic dysfunction, potentially mitigating cognitive decline in AD.</p><p><strong>Methods: </strong>In this study, we investigated the synaptic actin interactome using mass spectrometry in a mouse model of AD, APP/PS1. Our objective was to explore how alterations in synaptic actin dynamics, particularly the interaction between PSD-95 and actin, contribute to synaptic and cognitive impairment in AD. To assess the impact of restoring F-actin levels on synaptic and cognitive functions in APP/PS1 mice, we administered F-actin stabilizing agent, jasplakinolide. Behavioral deficits in the mice were evaluated using the contextual fear conditioning paradigm. We utilized primary neuronal cultures to study the synaptic levels of AMPA and NMDA receptors and the dynamics of PSD-95 actin association. Furthermore, we analyzed postmortem brain tissue samples from subjects with no cognitive impairment (NCI), mild cognitive impairment (MCI), and Alzheimer's dementia (AD) to determine the association between PSD-95 and actin.</p><p><strong>Results: </strong>We found a significant reduction in PSD-95-actin association in synaptosomes from middle-aged APP/PS1 mice compared to wild-type (WT) mice. Treatment with jasplakinolide, an actin stabilizer, reversed deficits in memory recall, restored PSD-95-actin association, and increased synaptic F-actin levels in APP/PS1 mice. Additionally, actin stabilization led to elevated synaptic levels of AMPA and NMDA receptors, enhanced dendritic spine density, suggesting improved neurotransmission and synaptic strength in primary cortical neurons from APP/PS1 mice. Furthermore, analysis of postmortem human tissue with NCI, MCI and AD subjects revealed disrupted PSD-95-actin interactions, underscoring the clinical relevance of our preclinical studies.</p><p><strong>Conclusion: </strong>Our study elucidates disrupted PSD-95 actin interactions across different models, highlighting potential therapeutic targets for AD. Stabilizing F-actin restores synaptic integrity and ameliorates cognitive deficits in APP/PS1 mice, suggesting that targeting synaptic actin regulation could be a promising therapeutic strategy to mitigate cognitive decline in AD.</p>","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":null,"pages":null},"PeriodicalIF":7.9,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142144941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CSF neurogranin levels as a biomarker in Alzheimer's disease and frontotemporal lobar degeneration: a cross-sectional analysis. 作为阿尔茨海默病和额颞叶变性的生物标志物的脑脊液神经粒蛋白水平:横断面分析。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-06 DOI: 10.1186/s13195-024-01566-w
Vanesa Jurasova, Ross Andel, Alzbeta Katonova, Katerina Veverova, Terezie Zuntychova, Hana Horakova, Martin Vyhnalek, Tereza Kolarova, Vaclav Matoska, Kaj Blennow, Jakub Hort

Background: There is initial evidence suggesting that biomarker neurogranin (Ng) may distinguish Alzheimer's disease (AD) from other neurodegenerative diseases. Therefore, we assessed (a) the discriminant ability of cerebrospinal fluid (CSF) Ng levels to distinguish between AD and frontotemporal lobar degeneration (FTLD) pathology and between different stages within the same disease, (b) the relationship between Ng levels and cognitive performance in both AD and FTLD pathology, and (c) whether CSF Ng levels vary by apolipoprotein E (APOE) polymorphism in the AD continuum.

Methods: Participants with subjective cognitive decline (SCD) (n = 33), amnestic mild cognitive impairment (aMCI) due to AD (n = 109), AD dementia (n = 67), MCI due to FTLD (n = 25), and FTLD dementia (n = 29) were recruited from the Czech Brain Aging Study. One-way analysis of covariance (ANCOVA) assessed Ng levels in diagnostic subgroups. Linear regressions evaluated the relationship between CSF Ng levels, memory scores, and APOE polymorphism.

Results: Ng levels were higher in aMCI-AD patients compared to MCI-FTLD (F[1, 134] = 15.16, p < .001), and in AD-dementia compared to FTLD-dementia (F[1, 96] = 4.60, p = .029). Additionally, Ng levels were higher in FTLD-dementia patients compared to MCI-FTLD (F[1, 54]= 4.35, p = .034), lower in SCD participants compared to aMCI-AD (F[1, 142] = 10.72, p = .001) and AD-dementia (F[1, 100] = 20.90, p < .001), and did not differ between SCD participants and MCI-FTLD (F[1, 58]= 1.02, p = .491) or FTLD-dementia (F[1, 62]= 2.27, p = .051). The main effect of diagnosis across the diagnostic subgroups on Aβ1-42/Ng ratio was significant too (F[4, 263]=, p < .001). We found a non-significant association between Ng levels and memory scores overall (β=-0.25, p = .154) or in AD diagnostic subgroups, and non-significant differences in this association between overall AD APOE ε4 carriers and non-carriers (β=-0.32, p = .358).

Conclusions: In this first study to-date to assess MCI and dementia due to AD or FTLD within one study, elevated CSF Ng appears to be an early biomarker of AD-related impairment, but its role as a biomarker appears to diminish after dementia diagnosis, whereby dementia-related underlying processes in AD and FTLD may begin to merge. The Aβ1-42/Ng ratio discriminated AD from FTLD patients better than Ng alone. CSF Ng levels were not related to memory in AD or FTLD, suggesting that Ng may be a marker of the biological signs of disease state rather than cognitive deficits.

背景:有初步证据表明,生物标志物神经粒蛋白(Ng)可区分阿尔茨海默病(AD)和其他神经退行性疾病。因此,我们评估了:(a) 脑脊液(CSF)Ng水平在区分AD和额颞叶变性(FTLD)病理以及同一疾病不同阶段之间的鉴别能力;(b) 在AD和FTLD病理中Ng水平与认知能力之间的关系;(c) 脑脊液Ng水平是否随AD连续体中载脂蛋白E(APOE)多态性的不同而变化:方法:从捷克脑老化研究(Czech Brain Aging Study)中招募患有主观认知功能下降(SCD)(n = 33)、AD导致的记忆性轻度认知障碍(aMCI)(n = 109)、AD痴呆(n = 67)、FTLD导致的MCI(n = 25)和FTLD痴呆(n = 29)的参与者。单向协方差分析(ANCOVA)评估了诊断亚组中的Ng水平。线性回归评估了 CSF Ng 水平、记忆评分和 APOE 多态性之间的关系:结果:与 MCI-FTLD 相比,aMCI-AD 患者的 Ng 水平更高(F[1, 134]= 15.16, p 1-42/Ng 比率也很显著(F[4, 263]=, p 结论:Ng 水平在 MCI-FTLD 患者中更高:在这项迄今为止首次在一项研究中评估MCI和AD或FTLD导致的痴呆的研究中,CSF Ng的升高似乎是AD相关损伤的早期生物标志物,但其作为生物标志物的作用在痴呆诊断后似乎会减弱,AD和FTLD中与痴呆相关的潜在过程可能开始融合。Aβ1-42/Ng比值比单独使用Ng更能区分AD和FTLD患者。CSF Ng水平与AD或FTLD患者的记忆力无关,这表明Ng可能是疾病状态的生物学标志,而不是认知缺陷。
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引用次数: 0
Reliability of the assessment of the clinical dementia rating scale from the analysis of medical records in comparison with the reference method. 从病历分析中评估临床痴呆评级量表的可靠性与参考方法的比较。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1186/s13195-024-01567-9
Virginie Dauphinot, Sylvain Calvi, Claire Moutet, Jing Xie, Sophie Dautricourt, Anthony Batsavanis, Pierre Krolak-Salmon, Antoine Garnier-Crussard

Background: The Clinical Dementia Rating (CDR) scale allows to detect the presence of dementia and to assess its severity, however its evaluation requires a significant time (45 min). We evaluated the agreement between two methods of collection of the CDR: face-to-face interview or based on the information available in the patient's medical record.

Methods: The CLIMER study was conducted among patients attending a memory center. The CDR scale was evaluated during face-to-face interviews between neuropsychologists and patients and their caregivers and based on blind analysis of the information of the patients' medical record by neuropsychologists. The agreement of the CDR sum of boxes (CDR-SB), the 5-point scale CDR and the different domains of the CDR evaluated between the different methods was measured using intraclass correlation (ICC) coefficient, Bland and Altman method, and linearly weighted Kappa.

Results: The study included 139 patients (means ± SD age 80.1 ± 6, 58.3% women, 71.9% with dementia). The ICC for the CDR-SB score assessed by face-to-face and with all the information available in the patient's medical record was 0.95 (95% CI: 0.93-0.97). The mean difference between the CDR-SB score assessed by face-to-face and with the medical record was 0.098 ± 1.036, and 92.4% of the patients lay within the 95% limits of agreement. The ICC for the 5-point scale CDR assessed by face-to-face and with the patient's medical record was 0.92 (95% CI: 0.88-0.95) when all the available information of the patient's medical record was used. The linear weighted Kappa coefficients was 0.79 (95% CI: 0.68-0.91) for the 5-point scale CDR comparison between the two evaluation methods. The analysis by domain of the CDR showed ICC ranging from 0.65 to 0.91 depending of the domains and the methods of evaluation.

Conclusion: This study showed an excellent level of agreement of the evaluation of the CDR- SB and the 5-point scale CDR when using all the information of the patient's medical record compared to the face-to-face interview.

Trial registration: https//clinicaltrials.gov/ct2/show/NCT04763941 Registration Date 02/17/2021.

背景:临床痴呆评定量表(CDR)可以检测痴呆的存在并评估其严重程度,但其评估需要大量时间(45 分钟)。我们评估了两种临床痴呆评定量表收集方法之间的一致性:面对面访谈或基于患者病历中的信息:CLIMER研究在一家记忆中心的患者中进行。CDR量表是在神经心理学家与患者及其护理人员进行面对面访谈时以及在神经心理学家对患者病历信息进行盲法分析的基础上进行评估的。采用类内相关系数(ICC)、布兰德和阿尔特曼法以及线性加权卡帕法测量了不同方法评估的CDR方框总和(CDR-SB)、5点量表CDR以及CDR不同领域的一致性:研究包括 139 名患者(平均年龄(±SD)为 80.1±6 岁,58.3% 为女性,71.9% 为痴呆症患者)。根据患者病历中的所有信息,通过面对面评估 CDR-SB 得分的 ICC 为 0.95(95% CI:0.93-0.97)。面对面评估的 CDR-SB 得分与病历评估的 CDR-SB 得分之间的平均差异为 0.098 ± 1.036,92.4% 的患者在 95% 的一致性范围内。在使用患者病历中所有可用信息的情况下,通过面谈和病历评估的 5 分制 CDR 的 ICC 为 0.92(95% CI:0.88-0.95)。两种评估方法的 5 分 CDR 线性加权卡帕系数为 0.79(95% CI:0.68-0.91)。按 CDR 领域进行的分析表明,根据领域和评价方法的不同,ICC 在 0.65 至 0.91 之间:该研究表明,与面对面访谈相比,在使用患者病历的所有信息时,CDR- SB 和 5 点量表 CDR 的评价具有极高的一致性。试验注册:https//clinicaltrials.gov/ct2/show/NCT04763941 注册日期:02/17/2021。
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引用次数: 0
A novel PDHK inhibitor restored cognitive dysfunction and limited neurodegeneration without affecting amyloid pathology in 5xFAD mouse, a model of Alzheimer's disease. 一种新型 PDHK 抑制剂可恢复阿尔茨海默病模型 5xFAD 小鼠的认知功能障碍并限制其神经退行性变,但不会影响其淀粉样病理学。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-05 DOI: 10.1186/s13195-024-01552-2
Katsuya Sakimura, Takashi Kawai, Reiko Nashida, Yuji Ishida, Kana Harada, Takashi Suzuki, Chihiro Okuma, Gregory M Cole

Background: Alzheimer's disease (AD) is the most common form of dementia. Although drugs focusing on reducing amyloid β slow progression, they fail to improve cognitive function. Deficits in glucose metabolism are reflected in FDG-PET and parallel the neurodegeneration and synaptic marker loss closely preceding cognitive decline, but the role of metabolic deficits as a cause or consequence of neurodegeneration is unclear. Pyruvate dehydrogenase (PDH) is lost in AD and an important enzyme connecting glycolysis and the tricarboxylic acid (TCA) cycle by converting pyruvate into acetyl-CoA. It is negatively regulated by pyruvate dehydrogenase kinase (PDHK) through phosphorylation.

Methods: In the present study, we assessed the in vitro/ in vivo pharmacological profile of the novel PDHK inhibitor that we discovered, Compound A. We also assessed the effects of Compound A on AD-related phenotypes including neuron loss and cognitive impairment using 5xFAD model mice.

Results: Compound A inhibited human PDHK1, 2 and 3 but had no inhibitory activity on PDHK4. In primary neurons, Compound A enhanced pyruvate and lactate utilization, but did not change glucose levels. In contrast, in primary astrocytes, Compound A enhanced pyruvate and glucose utilization and enhanced lactate production. In an efficacy study using 5xFAD mice, Compound A ameliorated the cognitive dysfunction in the novel object recognition test and Morris water maze. Moreover, Compound A prevented neuron loss in the hippocampus and cerebral cortex of 5xFAD without affecting amyloid β deposits.

Conclusions: These results suggest ameliorating metabolic deficits by activating PDH by Compound A can limit neurodegeneration and is a promising therapeutic strategy for treating AD.

背景:阿尔茨海默病(AD)是最常见的痴呆症。虽然减少淀粉样蛋白 β 的药物能减缓病情发展,但却无法改善认知功能。葡萄糖代谢缺陷反映在 FDG-PET 中,并与认知功能衰退之前的神经变性和突触标记丧失密切相关,但代谢缺陷作为神经变性的原因或结果所起的作用尚不清楚。丙酮酸脱氢酶(PDH)是连接糖酵解和三羧酸(TCA)循环的一种重要酶,它将丙酮酸转化为乙酰-CoA。它通过磷酸化受丙酮酸脱氢酶激酶(PDHK)的负调控:在本研究中,我们评估了我们发现的新型 PDHK 抑制剂化合物 A 的体外/体内药理学特征。我们还利用 5xFAD 模型小鼠评估了化合物 A 对 AD 相关表型(包括神经元缺失和认知障碍)的影响:结果:化合物 A 可抑制人类 PDHK1、2 和 3,但对 PDHK4 没有抑制活性。在原代神经元中,化合物 A 可提高丙酮酸和乳酸的利用率,但不会改变葡萄糖水平。相反,在原代星形胶质细胞中,化合物 A 可提高丙酮酸和葡萄糖的利用率,并增强乳酸的生成。在一项使用 5xFAD 小鼠进行的药效研究中,化合物 A 改善了小鼠在新物体识别测试和莫里斯水迷宫中的认知功能障碍。此外,化合物 A 还能防止 5xFAD 小鼠海马和大脑皮层神经元的丢失,而不会影响淀粉样蛋白 β 的沉积:这些结果表明,化合物 A 通过激活 PDH 来改善代谢缺陷,可以限制神经退行性变,是治疗 AD 的一种很有前景的治疗策略。
{"title":"A novel PDHK inhibitor restored cognitive dysfunction and limited neurodegeneration without affecting amyloid pathology in 5xFAD mouse, a model of Alzheimer's disease.","authors":"Katsuya Sakimura, Takashi Kawai, Reiko Nashida, Yuji Ishida, Kana Harada, Takashi Suzuki, Chihiro Okuma, Gregory M Cole","doi":"10.1186/s13195-024-01552-2","DOIUrl":"10.1186/s13195-024-01552-2","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is the most common form of dementia. Although drugs focusing on reducing amyloid β slow progression, they fail to improve cognitive function. Deficits in glucose metabolism are reflected in FDG-PET and parallel the neurodegeneration and synaptic marker loss closely preceding cognitive decline, but the role of metabolic deficits as a cause or consequence of neurodegeneration is unclear. Pyruvate dehydrogenase (PDH) is lost in AD and an important enzyme connecting glycolysis and the tricarboxylic acid (TCA) cycle by converting pyruvate into acetyl-CoA. It is negatively regulated by pyruvate dehydrogenase kinase (PDHK) through phosphorylation.</p><p><strong>Methods: </strong>In the present study, we assessed the in vitro/ in vivo pharmacological profile of the novel PDHK inhibitor that we discovered, Compound A. We also assessed the effects of Compound A on AD-related phenotypes including neuron loss and cognitive impairment using 5xFAD model mice.</p><p><strong>Results: </strong>Compound A inhibited human PDHK1, 2 and 3 but had no inhibitory activity on PDHK4. In primary neurons, Compound A enhanced pyruvate and lactate utilization, but did not change glucose levels. In contrast, in primary astrocytes, Compound A enhanced pyruvate and glucose utilization and enhanced lactate production. In an efficacy study using 5xFAD mice, Compound A ameliorated the cognitive dysfunction in the novel object recognition test and Morris water maze. Moreover, Compound A prevented neuron loss in the hippocampus and cerebral cortex of 5xFAD without affecting amyloid β deposits.</p><p><strong>Conclusions: </strong>These results suggest ameliorating metabolic deficits by activating PDH by Compound A can limit neurodegeneration and is a promising therapeutic strategy for treating AD.</p>","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":null,"pages":null},"PeriodicalIF":7.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11376040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142138996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neuropsychiatric symptoms and lifelong mental activities in cerebral amyloid angiopathy - a cross-sectional study. 脑淀粉样变性血管病的神经精神症状和终生智力活动--一项横断面研究。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-04 DOI: 10.1186/s13195-024-01519-3
Marc Dörner, Anthony Tyndall, Nicolin Hainc, Roland von Känel, Katja Neumann, Sebastian Euler, Frank Schreiber, Philipp Arndt, Erelle Fuchs, Cornelia Garz, Wenzel Glanz, Michaela Butryn, Jan Ben Schulze, Sarah Lavinia Florence Schiebler, Anna-Charlotte John, Annkatrin Hildebrand, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Pawel Tacik, Alexander Grimm, Robin Jansen, Marc Pawlitzki, Solveig Henneicke, Jose Bernal, Valentina Perosa, Emrah Düzel, Sven G Meuth, Stefan Vielhaber, Hendrik Mattern, Stefanie Schreiber

Background: While several studies in cerebral amyloid angiopathy (CAA) focus on cognitive function, data on neuropsychiatric symptoms (NPS) and lifelong mental activities in these patients are scarce. Since NPS are associated with functional impairment, faster cognitive decline and faster progression to death, replication studies in more diverse settings and samples are warranted.

Methods: We prospectively recruited n = 69 CAA patients and n = 18 cognitively normal controls (NC). The number and severity of NPS were assessed using the Alzheimer's Disease (AD) Assessment Scale's (ADAS) noncognitive subscale. We applied different regression models exploring associations between NPS number or severity and group status (CAA vs. NC), CAA severity assessed with magnetic resonance imaging (MRI) or cognitive function (Mini-Mental State Examination (MMSE), ADAS cognitive subscale), adjusting for age, sex, years of education, arterial hypertension, AD pathology, and apolipoprotein E status. Mediation analyses were performed to test indirect effects of lifelong mental activities on CAA severity and NPS.

Results: Patients with CAA had 4.86 times (95% CI 2.20-10.73) more NPS and 3.56 units (95% CI 1.94-5.19) higher expected NPS severity than NC. Higher total CAA severity on MRI predicted 1.14 times (95% CI 1.01.-1.27) more NPS and 0.57 units (95% CI 0.19-0.95) higher expected NPS severity. More severe white matter hyperintensities were associated with 1.21 times more NPS (95% CI 1.05-1.39) and 0.63 units (95% CI 0.19-1.08) more severe NPS. NPS number (MMSE mean difference - 1.15, 95% CI -1.67 to -0.63; ADAS cognitive mean difference 1.91, 95% CI 1.26-2.56) and severity (MMSE - 0.55, 95% CI -0.80 to -0.30; ADAS cognitive mean difference 0.89, 95% CI 0.57-1.21) predicted lower cognitive function. Greater lifelong mental activities partially mediated the relationship between CAA severity and NPS (indirect effect 0.05, 95% CI 0.0007-0.13), and greater lifelong mental activities led to less pronounced CAA severity and thus to less NPS (indirect effect - 0.08, 95% CI -0.22 to -0.002).

Discussion: This study suggests that NPS are common in CAA, and that this relationship may be driven by CAA severity. Furthermore, NPS seem to be tied to lower cognitive function. However, lifelong mental activities might mitigate the impact of NPS in CAA.

背景:尽管对脑淀粉样血管病(CAA)的一些研究侧重于认知功能,但有关这些患者的神经精神症状(NPS)和终生精神活动的数据却很少。由于神经精神症状与功能障碍、认知功能衰退加快和死亡进展加快有关,因此有必要在更多样化的环境和样本中进行重复研究:我们前瞻性地招募了 n = 69 名 CAA 患者和 n = 18 名认知功能正常的对照组(NC)。使用阿尔茨海默病(AD)评估量表(ADAS)的非认知子量表评估非认知功能障碍的数量和严重程度。我们采用了不同的回归模型来探索 NPS 数量或严重程度与群体状况(CAA 与 NC)、磁共振成像(MRI)评估的 CAA 严重程度或认知功能(迷你精神状态检查(MMSE)、ADAS 认知分量表)之间的关联,并对年龄、性别、受教育年限、动脉高血压、AD 病理和载脂蛋白 E 状态进行了调整。进行了中介分析,以检验终生心理活动对CAA严重程度和NPS的间接影响:与 NC 相比,CAA 患者的 NPS 增加了 4.86 倍(95% CI 2.20-10.73),预期 NPS 严重程度增加了 3.56 个单位(95% CI 1.94-5.19)。MRI 上总 CAA 严重程度越高,NPS 预测值越高 1.14 倍(95% CI 1.01.-1.27),预期 NPS 严重程度越高 0.57 个单位(95% CI 0.19-0.95)。更严重的白质高密度与 1.21 倍的 NPS(95% CI 1.05-1.39)和 0.63 个单位(95% CI 0.19-1.08)的更严重 NPS 相关。NPS数量(MMSE平均差异-1.15,95% CI-1.67至-0.63;ADAS认知平均差异1.91,95% CI 1.26至2.56)和严重程度(MMSE-0.55,95% CI-0.80至-0.30;ADAS认知平均差异0.89,95% CI 0.57至1.21)预示着认知功能较低。更多的终生心理活动部分调解了CAA严重程度与NPS之间的关系(间接效应为0.05,95% CI为0.0007-0.13),更多的终生心理活动导致CAA严重程度不那么明显,从而导致NPS较低(间接效应为-0.08,95% CI为-0.22至-0.002):本研究表明,NPS 在 CAA 中很常见,而这种关系可能是由 CAA 的严重程度所决定的。此外,NPS 似乎与认知功能低下有关。然而,终生的心理活动可能会减轻 NPS 对 CAA 的影响。
{"title":"Neuropsychiatric symptoms and lifelong mental activities in cerebral amyloid angiopathy - a cross-sectional study.","authors":"Marc Dörner, Anthony Tyndall, Nicolin Hainc, Roland von Känel, Katja Neumann, Sebastian Euler, Frank Schreiber, Philipp Arndt, Erelle Fuchs, Cornelia Garz, Wenzel Glanz, Michaela Butryn, Jan Ben Schulze, Sarah Lavinia Florence Schiebler, Anna-Charlotte John, Annkatrin Hildebrand, Andreas B Hofmann, Lena Machetanz, Johannes Kirchebner, Pawel Tacik, Alexander Grimm, Robin Jansen, Marc Pawlitzki, Solveig Henneicke, Jose Bernal, Valentina Perosa, Emrah Düzel, Sven G Meuth, Stefan Vielhaber, Hendrik Mattern, Stefanie Schreiber","doi":"10.1186/s13195-024-01519-3","DOIUrl":"10.1186/s13195-024-01519-3","url":null,"abstract":"<p><strong>Background: </strong>While several studies in cerebral amyloid angiopathy (CAA) focus on cognitive function, data on neuropsychiatric symptoms (NPS) and lifelong mental activities in these patients are scarce. Since NPS are associated with functional impairment, faster cognitive decline and faster progression to death, replication studies in more diverse settings and samples are warranted.</p><p><strong>Methods: </strong>We prospectively recruited n = 69 CAA patients and n = 18 cognitively normal controls (NC). The number and severity of NPS were assessed using the Alzheimer's Disease (AD) Assessment Scale's (ADAS) noncognitive subscale. We applied different regression models exploring associations between NPS number or severity and group status (CAA vs. NC), CAA severity assessed with magnetic resonance imaging (MRI) or cognitive function (Mini-Mental State Examination (MMSE), ADAS cognitive subscale), adjusting for age, sex, years of education, arterial hypertension, AD pathology, and apolipoprotein E status. Mediation analyses were performed to test indirect effects of lifelong mental activities on CAA severity and NPS.</p><p><strong>Results: </strong>Patients with CAA had 4.86 times (95% CI 2.20-10.73) more NPS and 3.56 units (95% CI 1.94-5.19) higher expected NPS severity than NC. Higher total CAA severity on MRI predicted 1.14 times (95% CI 1.01.-1.27) more NPS and 0.57 units (95% CI 0.19-0.95) higher expected NPS severity. More severe white matter hyperintensities were associated with 1.21 times more NPS (95% CI 1.05-1.39) and 0.63 units (95% CI 0.19-1.08) more severe NPS. NPS number (MMSE mean difference - 1.15, 95% CI -1.67 to -0.63; ADAS cognitive mean difference 1.91, 95% CI 1.26-2.56) and severity (MMSE - 0.55, 95% CI -0.80 to -0.30; ADAS cognitive mean difference 0.89, 95% CI 0.57-1.21) predicted lower cognitive function. Greater lifelong mental activities partially mediated the relationship between CAA severity and NPS (indirect effect 0.05, 95% CI 0.0007-0.13), and greater lifelong mental activities led to less pronounced CAA severity and thus to less NPS (indirect effect - 0.08, 95% CI -0.22 to -0.002).</p><p><strong>Discussion: </strong>This study suggests that NPS are common in CAA, and that this relationship may be driven by CAA severity. Furthermore, NPS seem to be tied to lower cognitive function. However, lifelong mental activities might mitigate the impact of NPS in CAA.</p>","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":null,"pages":null},"PeriodicalIF":7.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Different associations between body mass index and Alzheimer's markers depending on metabolic health. 新陈代谢健康状况不同,体重指数与阿尔茨海默氏症标志物之间的关系也不同。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-08-29 DOI: 10.1186/s13195-024-01563-z
Eun Hye Lee, Heejin Yoo, Young Ju Kim, Bo Kyoung Cheon, Seungho Ryu, Yoosoo Chang, Jihwan Yun, Hyemin Jang, Jun Pyo Kim, Hee Jin Kim, Seong-Beom Koh, Jee Hyang Jeong, Duk L Na, Sang Won Seo, Sung Hoon Kang

Background: Increasing evidence supports the association between body mass index (BMI), Alzheimer's disease, and vascular markers. Recently, metabolically unhealthy conditions have been reported to affect the expression of these markers. We aimed to investigate the effects of BMI status on Alzheimer's and vascular markers in relation to metabolic health status.

Methods: We recruited 1,736 Asians without dementia (71.6 ± 8.0 years). Participants were categorized into underweight, normal weight, or obese groups based on their BMI. Each group was further divided into metabolically healthy (MH) and unhealthy (MU) groups based on the International Diabetes Foundation definition of metabolic syndrome. The main outcome was Aβ positivity, defined as a Centiloid value of 20.0 or above and the presence of vascular markers, defined as severe white matter hyperintensities (WMH). Logistic regression analyses were performed for Aβ positivity and severe WMH with BMI status or interaction terms between BMI and metabolic health status as predictors. Mediation analyses were performed with hippocampal volume (HV) and baseline Mini-Mental State Examination (MMSE) scores as the outcomes, and linear mixed models were performed for longitudinal change in MMSE scores.

Results: Being underweight increased the risk of Aβ positivity (odds ratio [OR] = 2.37, 95% confidence interval [CI] 1.13-4.98), whereas obesity decreased Aβ positivity risk (OR = 0.63, 95% CI 0.50-0.80). Especially, obesity decreased the risk of Aβ positivity (OR = 0.38, 95% CI 0.26-0.56) in the MH group, but not in the MU group. Obesity increased the risk of severe WMH (OR = 1.69, 1.16-2.47). Decreased Aβ positivity mediate the relationship between obesity and higher HV and MMSE scores, particularly in the MH group. Obesity demonstrated a slower decline in MMSE (β = 1.423, p = 0.037) compared to being normal weight, especially in the MH group.

Conclusions: Our findings provide new evidence that metabolic health has a significant effect on the relationship between obesity and Alzheimer's markers, which, in turn, lead to better clinical outcomes.

背景:越来越多的证据表明,体重指数(BMI)、阿尔茨海默病和血管标志物之间存在关联。最近有报道称,新陈代谢不健康会影响这些标志物的表达。我们旨在研究 BMI 状态对阿尔茨海默病和血管标记物的影响与代谢健康状况的关系:我们招募了 1736 名无痴呆症的亚洲人(71.6 ± 8.0 岁)。根据体重指数将参与者分为体重不足组、体重正常组和肥胖组。根据国际糖尿病基金会对代谢综合征的定义,每组又分为代谢健康组(MH)和不健康组(MU)。主要结果是 Aβ 阳性(定义为 Centiloid 值达到或超过 20.0)和血管标记物的存在(定义为严重的白质高密度(WMH))。以 BMI 状态或 BMI 与代谢健康状况之间的交互项为预测因素,对 Aβ 阳性和严重 WMH 进行逻辑回归分析。以海马体积(HV)和基线迷你精神状态检查(MMSE)评分为结果进行了中介分析,并对MMSE评分的纵向变化进行了线性混合模型分析:结果:体重不足会增加 Aβ 阳性的风险(几率比 [OR] = 2.37,95% 置信区间 [CI]:1.13-4.98),而肥胖会降低 Aβ 阳性的风险(OR = 0.63,95% 置信区间 [CI]:0.50-0.80)。特别是,肥胖会降低 MH 组 Aβ 阳性的风险(OR = 0.38,95% CI 0.26-0.56),但不会降低 MU 组 Aβ 阳性的风险。肥胖会增加严重 WMH 的风险(OR = 1.69,1.16-2.47)。Aβ 阳性降低是肥胖与较高 HV 和 MMSE 评分之间关系的中介,尤其是在 MH 组。与体重正常者相比,肥胖者的 MMSE 下降较慢(β = 1.423,p = 0.037),尤其是在 MH 组:我们的研究结果提供了新的证据,证明代谢健康对肥胖与阿尔茨海默氏症标志物之间的关系有显著影响,而肥胖反过来又会带来更好的临床结果。
{"title":"Different associations between body mass index and Alzheimer's markers depending on metabolic health.","authors":"Eun Hye Lee, Heejin Yoo, Young Ju Kim, Bo Kyoung Cheon, Seungho Ryu, Yoosoo Chang, Jihwan Yun, Hyemin Jang, Jun Pyo Kim, Hee Jin Kim, Seong-Beom Koh, Jee Hyang Jeong, Duk L Na, Sang Won Seo, Sung Hoon Kang","doi":"10.1186/s13195-024-01563-z","DOIUrl":"10.1186/s13195-024-01563-z","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence supports the association between body mass index (BMI), Alzheimer's disease, and vascular markers. Recently, metabolically unhealthy conditions have been reported to affect the expression of these markers. We aimed to investigate the effects of BMI status on Alzheimer's and vascular markers in relation to metabolic health status.</p><p><strong>Methods: </strong>We recruited 1,736 Asians without dementia (71.6 ± 8.0 years). Participants were categorized into underweight, normal weight, or obese groups based on their BMI. Each group was further divided into metabolically healthy (MH) and unhealthy (MU) groups based on the International Diabetes Foundation definition of metabolic syndrome. The main outcome was Aβ positivity, defined as a Centiloid value of 20.0 or above and the presence of vascular markers, defined as severe white matter hyperintensities (WMH). Logistic regression analyses were performed for Aβ positivity and severe WMH with BMI status or interaction terms between BMI and metabolic health status as predictors. Mediation analyses were performed with hippocampal volume (HV) and baseline Mini-Mental State Examination (MMSE) scores as the outcomes, and linear mixed models were performed for longitudinal change in MMSE scores.</p><p><strong>Results: </strong>Being underweight increased the risk of Aβ positivity (odds ratio [OR] = 2.37, 95% confidence interval [CI] 1.13-4.98), whereas obesity decreased Aβ positivity risk (OR = 0.63, 95% CI 0.50-0.80). Especially, obesity decreased the risk of Aβ positivity (OR = 0.38, 95% CI 0.26-0.56) in the MH group, but not in the MU group. Obesity increased the risk of severe WMH (OR = 1.69, 1.16-2.47). Decreased Aβ positivity mediate the relationship between obesity and higher HV and MMSE scores, particularly in the MH group. Obesity demonstrated a slower decline in MMSE (β = 1.423, p = 0.037) compared to being normal weight, especially in the MH group.</p><p><strong>Conclusions: </strong>Our findings provide new evidence that metabolic health has a significant effect on the relationship between obesity and Alzheimer's markers, which, in turn, lead to better clinical outcomes.</p>","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":null,"pages":null},"PeriodicalIF":7.9,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Impact of cumulative exposure to anticholinergic and sedative drugs on cognition in older adults: a memory clinic cohort study. 更正:抗胆碱能药物和镇静药物的累积接触对老年人认知能力的影响:记忆诊所队列研究。
IF 7.9 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-08-29 DOI: 10.1186/s13195-024-01560-2
Elsa Reallon, Frédéric Gervais, Claire Moutet, Virginie Dauphinot, Pauline Desnavailles, Teddy Novais, Pierre Krolak-Salmon, Antoine Garnier-Crussard, Christelle Mouchoux
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引用次数: 0
期刊
Alzheimer's Research & Therapy
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