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Reply: Overstating harms can have consequences.
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-05 DOI: 10.1093/brain/awaf047
Michael Benatar, Christopher McDermott, Martin R Turner, Ruben P A van Eijk
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引用次数: 0
The landscape of autosomal-dominant Alzheimer’s disease: global distribution and age of onset
IF 14.5 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-04 DOI: 10.1093/brain/awaf038
Haiyan Liu, Thomas W Marsh, Xinyu Shi, Alan E Renton, Kevin M Bowling, Ellen Ziegemeier, Guoqiao Wang, Yuchen Cao, Alisha Aristel, Jessie Li, Alexa Dickson, Richard J Perrin, Alison M Goate, Victoria Fernández, Gregory S Day, Michelle Doering, Alisha Daniels, Brian A Gordon, Tammie L S Benzinger, Jason Hassenstab, Laura Ibanez, Charlene Supnet-Bell, Chengjie Xiong, Ricardo Allegri, Sarah B Berman, Nick C Fox, Natalie Ryan, Edward D Huey, Jonathan Vöglein, James M Noble, Jee Hoon Roh, Mathias Jucker, Christoph Laske, Takeshi Ikeuchi, Raquel Sanchez-Valle, Peter R Schofield, Patricio Chrem Mendez, Jasmeer P Chhatwal, Martin Farlow, Jae-Hong Lee, Allan I Levey, Johannes Levin, Francisco Lopera, Ralph Martins, Yoshiki Niimi, Pedro Rosa-Neto, John C Morris, Randall J Bateman, Celeste M Karch, Carlos Cruchaga, Eric McDade, Jorge J Llibre-Guerra
We present a comprehensive global analysis of genetic variants associated with autosomal-dominant Alzheimer's disease (ADAD). A total of 550 variants in the APP, PSEN1, and PSEN2 genes were identified, of which 279 were classified as pathogenic or likely pathogenic based on ACMG-AMP criteria, utilizing data from the Dominantly Inherited Alzheimer Network (DIAN), literature, and public databases. Symptomatic age at onset (AAO) data was estimated for 227 of these variants, allowing detailed characterization of their frequency, pathogenicity, and AAO. Importantly, 226 variants meet eligibility criteria for inclusion in disease-modifying clinical trials. Furthermore, we demonstrate the predictive value of mean variant AAO and parental AAO in predicting symptomatic AAO, validated against converters who became symptomatic during follow-up in the DIAN Observational Study (DIAN-OBS). This dataset provides critical insights into the global landscape of ADAD and reveals the genetic and AAO heterogeneity of ADAD variants while refining variant trial eligibility criteria.
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引用次数: 0
Pathway-dependent brain stimulation responses indicate motion processing integrity after stroke
IF 14.5 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-04 DOI: 10.1093/brain/awaf043
Michele Bevilacqua, Fabienne Windel, Elena Beanato, Pauline Menoud, Sarah Zandvliet, Nicola Ramdass, Lisa Fleury, Julie Hervé, Krystel R Huxlin, Friedhelm C Hummel, Estelle Raffin
Homonymous Hemianopia (HH), a common visual impairment resulting from occipital lobe lesions, affects a significant number of stroke survivors. Intensive perceptual training can foster recovery, possibly by enhancing surviving visual pathways. This study employed cortico-cortical paired associative stimulation (ccPAS) to induce associative plasticity within the residual and bi-directional primary visual cortex (V1) - middle temporal area (MT) pathways in stroke patients. We used ccPAS, which is thought to tap into Hebbian-like spike-timing dependent plasticity, over a motion processing pathway in stroke patients to transiently improve visual motion discrimination in their blind field. Sixteen stroke patients participated in this double-blind, crossover study comparing the effects of bidirectional ccPAS (V1-to-MT or MT-to-V1) on motion discrimination and EEG-Granger Causality. Additionally, we explored potential multimodal sources of inter-individual variability. Results showed that MT-to-V1 ccPAS enhanced motion direction discrimination, but the expected electrophysiological increase in top-down MT-to-V1 inputs was observed only in patients who showed improvement in motion discrimination. Good responders to MT-V1 ccPAS also demonstrated improved functional coupling between the cortical motion pathway and other relevant areas in the visual network, as well as more preserved ipsilesional V1-MT structural integrity. These findings indicate that targeted ccPAS can effectively engage functionally relevant residual visual pathways in stroke-affected brains, potentially offering new avenues for patient stratification and visual recovery strategies.
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引用次数: 0
Neuronal α-synuclein toxicity is the key driver of neurodegeneration in multiple system atrophy
IF 14.5 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-04 DOI: 10.1093/brain/awaf030
James A Wiseman, Glenda M Halliday, Birger Victor Dieriks
Multiple system atrophy (MSA) is a rare, rapidly progressing neurodegenerative disorder often misdiagnosed as Parkinson’s disease (PD). While both conditions share some clinical features, MSA is distinct in its pathological hallmark: oligodendroglial cytoplasmic α-synuclein (α-Syn) inclusions, known as glial cytoplasmic inclusions (GCIs). These GCIs are pathognomonic for MSA, but they do not lead to significant oligodendroglial cell loss. Instead, MSA is characterised by a substantially greater loss of non-dopaminergic neurons in the nigrostriatal and olivopontocerebellar systems compared to PD. This widespread neuronal degeneration, which is not seen to the same extent in PD, plays a critical role in MSA’s clinical presentation and is important to consider if PD is to be redefined as a neuronal α-Syn disease. It also raises the question of differences in the potential toxicity of lesions in MSA and the underlying cause of neuronal death in MSA. By combining an N-terminus α-Syn antibody that reveals more α-Syn pathology and super-resolution microscopy, we identified α-Syn fibrils in MSA neurons penetrating the nucleus from the cytoplasm, leading to nuclear destruction and neuronal death. Our data indicate an early invasion of neuronal nuclei by α-Syn pathology in MSA, precipitating rapid nuclear envelope destruction, as observed through significant structural damage, including the loss of Lamin integrity. Although the progression of α-Syn pathology from the cytoplasm to the nucleus may be similar in oligodendroglia and neurons, the aggregation state of the α-Syn proteoforms involved differs as proteolytic resistance of α-Syn inclusions is significantly higher in neurons and the nucleus is destroyed. We describe the progressive impact of α-Syn nuclear pathology on MSA neurons and show that this is a more detrimental and rapid pathology driving neurodegeneration. Our data suggest that oligodendroglial inclusions contain more soluble, less toxic α-Syn proteoforms, consistent with two distinct α-Syn filaments in MSA. We propose renaming MSA as a neuronal nuclear and oligodendroglial α-synucleinopathy to better reflect these two distinct pathologies.
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引用次数: 0
Novel insight into TRPV1-induced mitochondrial dysfunction in neuropathic pain
IF 14.5 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-04 DOI: 10.1093/brain/awaf044
Yaseen Awad-Igbaria, Aviv Ben-Menashe, Reem Sakas, Doron Edelman, Tom Fishboom, Alon Shamir, Jean Francois-Soustiel, Eilam Palzur
Neuropathic pain remains one of the leading causes of global disability. The mechanism of neuropathic pain development and maintenance involves mitochondrial dysfunction induced-neuronal apoptosis of peripheral and central nociceptive pathways. The TRPV1 is a non-selective cation channel, which has a high Ca2+ permeability, playing an essential role in neuronal apoptosis in the spinal cord following peripheral nerve injury. However, the mechanism of how TRPV1 activation in the spinal cord induces mitochondrial dysfunction-mediate neuronal apoptosis, resulting in allodynia is unknown. Here, we found that activating the TRPV1 channel in the spinal cord using capsaicin, a TRPV1 agonist, results in mechanical and thermal hypersensitivity that were found to be mediated by neuroinflammation, elevated level of apoptosis, and a reduction in transcription of the mitochondrial complexes in the spinal cord and DRG. Moreover, during the early activation of the TRPV1 (1h, 24h, 48h following the capsaicin injection in the spinal cord) we observed a robust reduction in mitochondrial oxygen consumption in the non-phosphorylated state, ATP-linked respiration, maximal respiration, and electron transfer capacity (ETC). A more advanced experiment, wherein we controlled capsaicin, Ca2+ concentration and the exposure time in isolated spinal cord tissue (Lumbar, L1-L6), unveiled that TRPV1 activation impairing the mitochondrial function in terms of oxygen consumption, collapsing the Ψm and induction of the mitochondrial permeability transition pore (mPTP), which were reversed by the mPTP inhibitor-Cyclosporin A (CsA) during challenging the mitochondria with Ca2+ in a dose-dependent manner. More critically, injection of TRPV1 antagonist AMG9810 in the spinal cord following sciatic nerve crush reversed mechanical allodynia and modulated thermal hypersensitivity. In addition, the presence of TRPV1 antagonist-AMG9810 along with capsaicin and Ca2+ during challenging the spinal cord tissue completely prevents the early mPTP induction, the reduction in oxygen consumption and. In conclusion, our findings suggest that TRPV1 activation induces neuronal apoptosis, neuroinflammation, and mitochondrial dysfunction in the spinal cord, reflected in mechanical and thermal allodynia. Notable, the mitochondrial dysfunction following the TRPV1 activation in the spinal cord includes crucial elements that contribute to neuronal death, including mPTP induction, reduction in Ψm and oxygen consumption. Strikingly, regulating the TRPV1 following sciatic nerve injury reverses hypersensitivity probably via protection of the mitochondrial, suggesting a fundamental role for the TRPV1 pathway in mitochondrial dysfunction-mediated pain development.
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引用次数: 0
GGC repeat expansions in NOTCH2NLC cause uN2CpolyG cerebral amyloid angiopathy. NOTCH2NLC的GGC重复扩展导致uN2CpolyG脑淀粉样血管病。
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1093/brain/awae274
Lei Bao, Xiaowen Li, Jin Tian, Lulu Wang, Ying Ji, Yingying Cui, Wen Sun, Jing Zhang, Man Xia, Pinyi Zhu, Guiyun Cui, Hao Chen

The expansion of GGC repeats within NOTCH2NLC leads to translation of the uN2CpolyG protein, the primary pathogenic factor in neuronal intranuclear inclusion disease (NIID). The aim of this study was to explore the deposition of uN2CpolyG as an amyloid in the vessel wall, leading to uN2CpolyG cerebral amyloid angiopathy-related cerebral microbleeds (CMBs). A total of 97 patients with genetically confirmed NIID were enrolled in this study. We analysed the presence of CMBs using susceptibility-weighted imaging sequences and compared general clinical information, cerebrovascular risk factors, stroke history, antiplatelet medication use and MRI features between NIID patients with and without CMBs. We also performed haematoxylin and eosin, Perl's, Congo red and Thioflavin S staining, ubiquitin, p62 and uN2CpolyG immunostaining on brain tissue obtained from four NIID patients. A total of 354 CMBs were detected among 41 patients with NIID, with nearly half located in the deep brain, one-third in the lobes and ∼20% in the infratentorial area. No significant differences in cerebrovascular disease risk factors or history of antiplatelet drug use were observed between patients with and without CMBs. However, patients with CMBs had suffered a higher incidence of previous ischaemic and haemorrhagic stroke events. This group also had a higher incidence of recent subcortical infarcts and a higher proportion of white matter lesions in the external capsule and temporal pole. Conversely, patients without CMBs showed higher detection of high signals at the corticomedullary junction on diffusion-weighted imaging and more pronounced brain atrophy. Haematoxylin and eosin staining showed blood vessel leakage and haemosiderin-laden macrophage clusters, and Prussian blue staining revealed iron deposition in brain tissue. CMBs occurred more frequently in small vessels lacking intranuclear inclusions, and extensive degeneration of endothelial cells and smooth muscle fibres was observed mainly in vessels lacking inclusions. Congo red-positive amyloid deposition was observed in the cerebral vessels of NIID patients, with disordered filamentous fibres appearing under an electron microscope. Additionally, the co-localization of Thioflavin S-labelled amyloid and uN2CpolyG protein in the cerebral vascular walls of NIID patients further suggested that uN2CpolyG is the main pathogenic protein in this form of amyloid angiopathy. In conclusion, we reviewed patients with GGC repeat expansion of NOTCH2NLC from a new perspective, providing initial clinical, neuroimaging and pathological evidence suggesting that uN2CpolyG might contribute to a distinct type of cerebral amyloid angiopathy.

NOTCH2NLC内GGC重复序列的扩展导致uN2CpolyG蛋白的翻译,而uN2CpolyG蛋白是神经元核内包涵体病(NIID)的主要致病因素。本研究旨在探讨uN2CpolyG作为淀粉样蛋白沉积在血管壁,导致与uN2CpolyG脑淀粉样血管病(CAA)相关的脑微小出血(CMB)。本研究共招募了 97 名经基因证实的 NIID 患者。我们使用感度加权成像序列分析了CMB的存在情况,并比较了有CMB和无CMB的NIID患者的一般临床信息、脑血管风险因素、中风病史、抗血小板药物使用情况和磁共振成像特征。我们还对四名 NIID 患者的脑组织进行了苏木精和伊红(H&E)、珀尔氏、刚果红、硫黄素 S 染色、泛素、p62 和 uN2CpolyG 免疫染色。41 名 NIID 患者共检测到 354 个 CMB,其中近一半位于大脑深部,三分之一位于脑叶,约 20% 位于幕下区。在脑血管疾病风险因素或抗血小板药物使用史方面,有CMB和没有CMB的患者没有明显差异。不过,CMBs 患者既往缺血性和出血性中风事件的发生率较高。这组患者近期皮层下梗死的发生率也较高,外囊和颞极白质病变的比例也较高。相反,没有 CMB 的患者在弥散加权成像中皮质髓质交界处的高信号检出率更高,脑萎缩更明显。H&E 染色显示血管渗漏和含血色素的巨噬细胞群,普鲁士蓝染色显示脑组织铁沉积。CMB多发生在缺乏核内包涵体的小血管中,而内皮细胞和平滑肌纤维的广泛变性主要出现在缺乏包涵体的血管中。在NIID患者的脑血管中观察到刚果红阳性的淀粉样沉积,在电子显微镜下出现无序的丝状纤维。此外,硫黄素 S 标记的淀粉样蛋白和 uN2CpolyG 蛋白在 NIID 患者脑血管壁上的共定位进一步表明,uN2CpolyG 是这种淀粉样血管病的主要致病蛋白。总之,我们从一个新的角度回顾了NOTCH2NLC GGC重复扩增的患者,提供了初步的临床、神经影像学和病理学证据,表明uN2CpolyG可能是一种独特类型的CAA的致病因子。
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引用次数: 0
Targeting spinal mechanistic target of rapamycin complex 2 alleviates inflammatory and neuropathic pain. 雷帕霉素复合物 2 的脊髓机制靶点可减轻炎症性和神经性疼痛。
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1093/brain/awae275
Calvin Wong, Luis David Rodriguez-Hernandez, Kevin C Lister, Ning Gu, Weihua Cai, Mehdi Hooshmandi, Jonathan Fan, Nicole Brown, Vivienne Nguyen, Alfredo Ribeiro-da-Silva, Robert P Bonin, Arkady Khoutorsky

The development and maintenance of chronic pain involve the reorganization of spinal nocioceptive circuits. The mechanistic target of rapamycin complex 2 (mTORC2), a central signalling hub that modulates both actin-dependent structural changes and mechanistic target of rapamycin complex 1 (mTORC1)-dependent mRNA translation, plays key roles in hippocampal synaptic plasticity and memory formation. However, its function in spinal plasticity and chronic pain is poorly understood. Here, we show that pharmacological activation of spinal mTORC2 induces pain hypersensitivity, whereas its inhibition, using downregulation of the mTORC2-defining component Rictor, alleviates both inflammatory and neuropathic pain. Cell type-specific deletion of Rictor showed that the selective inhibition of mTORC2 in a subset of excitatory neurons impairs spinal synaptic potentiation and alleviates inflammation-induced mechanical and thermal hypersensitivity and nerve injury-induced heat hyperalgesia. The ablation of mTORC2 in inhibitory interneurons strongly alleviated nerve injury-induced mechanical hypersensitivity. Our findings reveal the role of mTORC2 in chronic pain and highlight its cell type-specific functions in mediating pain hypersensitivity in response to peripheral inflammation and nerve injury.

慢性疼痛的发展和维持涉及脊髓痛觉回路的重组。雷帕霉素机制靶点复合体 2(mTORC2)是调节肌动蛋白依赖性结构变化和 mTORC1 依赖性 mRNA 翻译的中心信号枢纽,在海马突触可塑性和记忆形成中发挥着关键作用。然而,人们对它在脊髓可塑性和慢性疼痛中的功能却知之甚少。在这里,我们发现药理激活脊髓 mTORC2 会诱导痛觉过敏,而通过下调 mTORC2 定义成分 Rictor 来抑制它,则可减轻炎症性和神经性疼痛。细胞类型特异性删除 Rictor 表明,在兴奋性神经元亚群中选择性抑制 mTORC2 会损害脊髓突触电位,减轻炎症诱导的机械和热超敏反应,以及神经损伤诱导的热超敏痛。抑制性中间神经元中的mTORC2被消减后,神经损伤诱导的机械超敏反应会得到明显缓解。我们的研究结果揭示了mTORC2在慢性疼痛中的作用,并强调了它在外周炎症和神经损伤时介导痛觉过敏的细胞特异性功能。
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引用次数: 0
Biallelic PTPMT1 variants disrupt cardiolipin metabolism and lead to a neurodevelopmental syndrome. 双叶 PTPMT1 变体会破坏心磷脂代谢,导致神经发育综合征。
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1093/brain/awae268
Micol Falabella, Chiara Pizzamiglio, Luis Carlos Tabara, Benjamin Munro, Mohamed S Abdel-Hamid, Ece Sonmezler, William L Macken, Shanti Lu, Lisa Tilokani, Padraig J Flannery, Nina Patel, Simon A S Pope, Simon J R Heales, Dania B H Hammadi, Charlotte L Alston, Robert W Taylor, Hanns Lochmuller, Cathy E Woodward, Robyn Labrum, Jana Vandrovcova, Henry Houlden, Efstathia Chronopoulou, Germaine Pierre, Reza Maroofian, Michael G Hanna, Jan-Willem Taanman, Semra Hiz, Yavuz Oktay, Maha S Zaki, Rita Horvath, Julien Prudent, Robert D S Pitceathly

Primary mitochondrial diseases (PMDs) are among the most common inherited neurological disorders. They are caused by pathogenic variants in mitochondrial or nuclear DNA that disrupt mitochondrial structure and/or function, leading to impaired oxidative phosphorylation (OXPHOS). One emerging subcategory of PMDs involves defective phospholipid metabolism. Cardiolipin, the signature phospholipid of mitochondria, resides primarily in the inner mitochondrial membrane, where it is biosynthesized and remodelled via multiple enzymes and is fundamental to several aspects of mitochondrial biology. Genes that contribute to cardiolipin biosynthesis have recently been linked with PMD. However, the pathophysiological mechanisms that underpin human cardiolipin-related PMDs are not fully characterized. Here, we report six individuals, from three independent families, harbouring biallelic variants in PTPMT1, a mitochondrial tyrosine phosphatase required for de novo cardiolipin biosynthesis. All patients presented with a complex, neonatal/infantile onset neurological and neurodevelopmental syndrome comprising developmental delay, microcephaly, facial dysmorphism, epilepsy, spasticity, cerebellar ataxia and nystagmus, sensorineural hearing loss, optic atrophy and bulbar dysfunction. Brain MRI revealed a variable combination of corpus callosum thinning, cerebellar atrophy and white matter changes. Using patient-derived fibroblasts and skeletal muscle tissue, combined with cellular rescue experiments, we characterized the molecular defects associated with mutant PTPMT1 and confirmed the downstream pathogenic effects that loss of PTPMT1 has on mitochondrial structure and function. To further characterize the functional role of PTPMT1 in cardiolipin homeostasis, we created a ptpmt1 knockout zebrafish. This model had abnormalities in body size, developmental alterations, decreased total cardiolipin levels and OXPHOS deficiency. Together, these data indicate that loss of PTPMT1 function is associated with a new autosomal recessive PMD caused by impaired cardiolipin metabolism, highlighting the contribution of aberrant cardiolipin metabolism towards human disease and emphasizing the importance of normal cardiolipin homeostasis during neurodevelopment.

原发性线粒体疾病(PMDs)是最常见的遗传性神经系统疾病之一。它们是由线粒体或核 DNA 中的致病变异引起的,这些变异破坏了线粒体结构和/或功能,导致氧化磷酸化(OXPHOS)功能受损。一种新出现的 PMD 亚类涉及磷脂(PL)代谢缺陷。心磷脂(CL)是线粒体的标志性磷脂,主要存在于线粒体内膜中,通过多种酶进行生物合成和重塑,对线粒体生物学的多个方面起着重要作用。有助于 CL 生物合成的基因最近与 PMD 联系在一起。然而,人类与 CL 相关的 PMD 的病理生理机制尚未完全定性。在这里,我们报告了来自三个独立家庭的六名携带 PTPMT1 双唇变体的患者,PTPMT1 是一种线粒体酪氨酸磷酸酶,需要用于 CL 的新生物合成。所有患者均表现为复杂的、新生儿期/婴儿期发病的神经和神经发育综合征,包括发育迟缓、小头畸形、面部畸形、癫痫、痉挛、小脑共济失调和眼球震颤、感音神经性听力损失、视神经萎缩和球部功能障碍。脑部核磁共振成像显示,胼胝体变薄、小脑萎缩和白质改变的组合各不相同。我们利用患者来源的成纤维细胞和骨骼肌组织,结合细胞挽救实验,确定了与突变型 PTPMT1 相关的分子缺陷的特征,并证实了 PTPMT1 缺失对线粒体结构和功能的下游致病效应。为了进一步描述 PTPMT1 在 CL 平衡中的功能作用,我们建立了一个斑马鱼 ptpmt1 基因敲除模型,该模型与体型异常、发育改变、总 CL 水平下降和 OXPHOS 缺乏有关。这些数据共同表明,PTPMT1 功能的缺失与一种由 CL 代谢受损引起的新型常染色体隐性遗传 PMD 有关,突出了 CL 代谢异常对人类疾病的影响,并强调了神经发育过程中正常 CL 平衡的重要性。
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引用次数: 0
A comprehensive head-to-head comparison of key plasma phosphorylated tau 217 biomarker tests. 主要血浆磷酸化 tau 217 生物标志物检测的全面正面比较。
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1093/brain/awae346
Noëlle Warmenhoven, Gemma Salvadó, Shorena Janelidze, Niklas Mattsson-Carlgren, Divya Bali, Anna Orduña Dolado, Hartmuth Kolb, Gallen Triana-Baltzer, Nicolas R Barthélemy, Suzanne E Schindler, Andrew J Aschenbrenner, Cyrus A Raji, Tammie L S Benzinger, John C Morris, Laura Ibanez, Jigyasha Timsina, Carlos Cruchaga, Randall J Bateman, Nicholas Ashton, Burak Arslan, Henrik Zetterberg, Kaj Blennow, Alexa Pichet Binette, Oskar Hansson
<p><p>Plasma phosphorylated-tau 217 (p-tau217) is currently the most promising biomarker for reliable detection of Alzheimer's disease pathology. Various p-tau217 assays have been developed, but their relative performance is unclear. We compared key plasma p-tau217 tests using cross-sectional and longitudinal measures of amyloid-β (Aβ)-PET, tau-PET and cognition as outcomes and benchmarked them against CSF biomarker tests. Samples from 998 individuals [mean (range) age 68.5 (20.0-92.5) years, 53% female] from the Swedish BioFINDER-2 cohort, including both cognitively unimpaired and cognitively impaired individuals, were analysed. Plasma p-tau217 was measured with mass spectrometry assays [the ratio between phosphorylated and non-phosphorylated (%p-tau217WashU) and p-tau217WashU] and with immunoassays (p-tau217Lilly, p-tau217Janssen and p-tau217ALZpath). CSF biomarkers included p-tau217Lilly, the US Food and Drug Administration-approved p-tau181/Aβ42Elecsys, and p-tau181Elecsys. All plasma p-tau217 tests exhibited a high ability to detect abnormal Aβ-PET [area under the curve (AUC) range: 0.91-0.96] and tau-PET (AUC range: 0.94-0.97). Plasma %p-tau217WashU had the highest performance, with significantly higher AUCs than all the immunoassays (Pdiff < 0.007). For detecting Aβ-PET status, %p-tau217WashU had an accuracy of 0.93 (immunoassays: 0.83-0.88), sensitivity of 0.91 (immunoassays: 0.84-0.87) and a specificity of 0.94 (immunoassays: 0.85-0.89). Among immunoassays, p-tau217Lilly and plasma p-tau217ALZpath had higher AUCs than plasma p-tau217Janssen for Aβ-PET status (Pdiff < 0.006), and p-tau217Lilly outperformed plasma p-tau217ALZpath for tau-PET status (Pdiff = 0.025). Plasma %p-tau217WashU exhibited stronger associations with all PET load outcomes compared with immunoassays; baseline Aβ-PET load (R2: 0.72; immunoassays: 0.47-0.58; Pdiff < 0.001), baseline tau-PET load (R2: 0.51; immunoassays: 0.38-0.45; Pdiff < 0.001), longitudinal Aβ-PET load (R2: 0.53; immunoassays: 0.31-0.38; Pdiff < 0.001) and longitudinal tau-PET load (R2: 0.50; immunoassays: 0.35-0.43; Pdiff < 0.014). Among immunoassays, plasma p-tau217Lilly was more associated with Aβ-PET load than plasma p-tau217Janssen (Pdiff < 0.020) and with tau-PET load than both plasma p-tau217Janssen and plasma p-tau217ALZpath (all Pdiff < 0.010). Plasma %p-tau217 also correlated more strongly with baseline cognition (Mini-Mental State Examination) than all immunoassays (R2: %p-tau217WashU: 0.33; immunoassays: 0.27-0.30; Pdiff < 0.024). The main results were replicated in an external cohort from Washington University in St Louis (n = 219). Finally, p-tau217NULISA showed similar performance to other immunoassays in subsets of both cohorts. In summary, both mass spectrometry- and immunoassay-based p-tau217 tests generally perform well in identifying Aβ-PET, tau-PET and cognitive abnormalities, but %p-tau217WashU performed significantly better than all the examined immunoassays. Plasma %p-tau217 ma
血浆磷酸化-tau 217(p-tau217)是目前最有希望可靠检测阿尔茨海默病(AD)病理的生物标记物。目前已开发出多种 p-tau217 检测方法,但其相对性能尚不明确。我们使用淀粉样蛋白-β(Aβ)-PET、tau-PET和认知能力的横断面和纵向测量结果比较了主要的血浆p-tau217检测方法,并将它们与脑脊液(CSF)生物标记物检测方法进行了比较。研究人员分析了来自瑞典 BioFINDER-2 队列的 998 名患者(平均年龄[范围]68.5[20.0-92.5],53% 为女性)的样本,其中包括认知功能未受损和认知功能受损的患者。血浆中的p-tau217通过质谱(MS)测定法(磷酸化与非磷酸化的比率[%p-tau217WashU]和p-tau217WashU)以及免疫测定法(p-tau217Lilly、p-tau217Janssen、p-tau217ALZpath)进行测量。脑脊液生物标记物包括p-tau217Lilly、FDA批准的p-tau181/Aβ42Elecsys和p-tau181Elecsys。所有血浆p-tau217检测试剂盒对异常Aβ-PET(AUC范围:0.91-0.96)和tau-PET(AUC范围:0.94-0.97)的检测能力都很高。血浆 %p-tau217WashU 的性能最高,其 AUC 明显高于所有免疫测定(Pdiff
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引用次数: 0
BOK-engaged mitophagy alleviates neuropathology in Alzheimer's disease. BOK 激活的有丝分裂可减轻阿尔茨海默病的神经病理变化。
IF 10.6 1区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-02-03 DOI: 10.1093/brain/awae241
Yang Yang, Hui Chen, Shuwen Huang, Hao Chen, Alexei Verkhratsky, Jianqin Niu, Yibo Qu, Chenju Yi

Mitochondrial malfunction associated with impaired mitochondrial quality control and self-renewal machinery, known as mitophagy, is an under-appreciated mechanism precipitating synaptic loss and cognitive impairments in Alzheimer's disease. Promoting mitophagy has been shown to improve cognitive function in Alzheimer's disease animals. However, the regulatory mechanism was unclear, which formed the aim of this study. Here, we found that a neuron-specific loss of Bcl-2 family member BOK in patients with Alzheimer's disease and APPswe/PS1dE9 (APP/PS1) mice is closely associated with mitochondrial damage and mitophagy defects. We further revealed that BOK is the key to the Parkin-mediated mitophagy through competitive binding to the MCL1/Parkin complex, resulting in Parkin release and translocation to damaged mitochondria to initiate mitophagy. Furthermore, overexpressing bok in hippocampal neurons of APP/PS1 mice alleviated mitophagy and mitochondrial malfunction, resulting in improved cognitive function. Conversely, the knockdown of bok worsened the aforementioned Alzheimer's disease-related changes. Our findings uncover a novel mechanism of BOK signalling through regulating Parkin-mediated mitophagy to mitigate amyloid pathology, mitochondrial and synaptic malfunctions, and cognitive decline in Alzheimer's disease, thus representing a promising therapeutic target.

与线粒体质量控制和自我更新机制受损有关的线粒体功能失调(即线粒体吞噬)是导致阿尔茨海默病(AD)突触丧失和认知障碍的一个未得到充分重视的机制。研究表明,促进有丝分裂可改善阿尔茨海默病动物的认知功能。然而,其调控机制尚不清楚,这也是本研究的目的所在。在这里,我们发现在AD患者和APPswe/PS1dE9(APP/PS1)小鼠中,神经元特异性Bcl-2家族成员BOK的缺失与线粒体损伤和有丝分裂缺陷密切相关。我们进一步发现,BOK是Parkin介导的有丝分裂的关键,它通过与MCL1/Parkin复合物竞争性结合,导致Parkin释放并转位到受损线粒体以启动有丝分裂。此外,在 APP/PS1 小鼠的海马神经元中过表达 bok 可缓解有丝分裂和线粒体功能障碍,从而改善认知功能。相反,敲除 bok 则会加剧上述与 AD 相关的变化。我们的研究结果揭示了 BOK 信号通过调节 Parkin 介导的有丝分裂来缓解淀粉样蛋白病理学、线粒体和突触功能障碍以及 AD 中认知功能下降的新机制,因此是一个很有前景的治疗靶点。
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