Journal of Alzheimer's Disease - Volume 27, issue 4

Authors: Chen, Ming | Nguyen, Huey T. | Sawmiller, Darrell R.

Article Type: Research Article

Abstract: We have contended that senile conditions—illnesses after age 60 and fully age-penetrating, such as tooth, hearing or memory loss—are not distinct “diseases” in medical nature, because they are caused by aging. Since the pace of aging varies among individuals and is much influenced by risk factors, senile conditions will only affect some but not all elderly. However, perhaps due to its unusually heavy burdens and tremendous social pressures, senile dementia (SD) has been singled out from other senile conditions and redefined as a curable “disease” (Alzheimer's). This highly popular definition has thus opened a Pandora's box that has been confusing …us up until now and warrants further scrutiny. In this article we discuss: a) what should we logically look for in SD beyond “pathogenic” factors?; b) why Ca2+ , a central regulator in neurotransmission, should be the primary player in SD; c) why the functionality of Ca2+ signaling, or its vibrant wave frequency and amplitude, must undergo down-regulation during aging, though this is intriguingly accompanied by an increase of Ca2+ “levels”; d) why intervention for SD should target Ca2+ function by promoting energy metabolisms and by Ca2+ agonists such as caffeine and nicotine, but not by “antagonists” as widely believed; and e) why our study should focus on aging, not “cell death”, a seemingly attractive paradigm but perhaps too late for intervention. We also seek answers for why unproven hypotheses can become dogmas and inhibit self-correcting mechanisms of science. Show more

Keywords: Alzheimer's disease, amyloid, calcium, review

DOI: 10.3233/JAD-2011-111142

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 679-689, 2011

Authors: Clark, Ian A. | Atwood, Craig S.

Article Type: Research Article

Abstract: This commentary addresses a novel mechanism by which aging-related changes in reproductive hormones could mediate their action in the brain. It presents the evidence that dyotic endocrine signals modulate the expression of tumor necrosis factor (TNF) and related cytokines, and that these cytokines are a functionally important downstream link mediating neurodegeneration and dysfunction. This convergence of dyotic signaling on TNF-mediated degeneration and dysfunction has important implications for understanding the pathophysiology of AD, stroke, and traumatic brain disease, and also for the treatment of these diseases.

Keywords: Alzheimer's disease, anxiety, cell cycle, dyotic signaling, endocrine dyscrasia, etanercept, inflammation, oxytocin, sex hormones, tumor necrosis factor (TNF)

DOI: 10.3233/JAD-2011-110887

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 691-699, 2011

Authors: Lloret, Ana | Badia, Mari-Carmen | Giraldo, Esther | Ermak, Gennady | Alonso, Maria-Dolores | Pallardó, Federico V. | Davies, Kelvin J.A. | Viña, Jose

Article Type: Research Article

Abstract: Amyloid-β peptide (Aβ) toxicity and tau hyperphosphorylation are hallmarks of Alzheimer's disease (AD). How their molecular relationships may affect the etiology, progression, and severity of the disease, however, has not been elucidated. We now report that incubation of fetal rat cortical neurons with Aβ upregulates expression of the Regulator of Calcineurin gene RCAN1, and this is mediated by Aβ-induced oxidative stress. Calcineurin (PPP3CA) is a serine-threonine phosphatase that dephosphorylates tau. RCAN1 proteins inhibit this phosphatase activity of calcineurin. Increased expression of RCAN1 also causes upregulation of glycogen synthase kinase-3β (GSK3β), a tau kinase. Thus, increased RCAN1 expression might be expected …to decrease phospho-tau dephosphorylation (via calcineurin inhibition) and increase tau phosphorylation (via increased GSK3β activity). Indeed, we find that incubation of primary cortical neurons with Aβ results in increased phosphorylation of tau, unless RCAN1 gene expression is silenced, or antioxidants are added. Thus we propose a mechanism to link Aβ toxicity and tau hyperphosphorylation in AD: In our hypothesis, Aβ causes mitochondrial oxidative stress and increases production of reactive oxygen species, which result in an upregulation of RCAN1 gene expression. RCAN1 proteins then both inhibit calcineurin and induce expression of GSK3β. Both mechanisms shift tau to a hyperphosphorylated state. We also find that lymphocytes from persons whose ApoE genotype is ε4/ε4 (with high risk of developing AD) show higher levels of RCAN1 and phospho-tau than those carrying the ApoE ε3/ε3 or ε3/ε4 genotypes. Thus upregulation of RCAN1 may be a valuable biomarker for AD risk. Show more

Keywords: Alzheimer's disease, amyloid-β toxicity, oxidative stress, RCAN1

DOI: 10.3233/JAD-2011-110890

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 701-709, 2011

Authors: Yang, Jing | Lunde, Lisa K. | Nuntagij, Paworn | Oguchi, Tomohiro | Camassa, Laura M.A. | Nilsson, Lars N.G. | Lannfelt, Lars | Xu, Yuming | Amiry-Moghaddam, Mahmood | Ottersen, Ole Petter | Torp, Reidun

Article Type: Research Article

Abstract: Aquaporin-4 (AQP4) is the predominant water channel in brain and is selectively expressed in astrocytes. Astrocytic endfoot membranes exhibit tenfold higher densities of AQP4 than non-endfoot membranes, making AQP4 an excellent marker of astrocyte polarization. Loss of astrocyte polarization is known to compromise astrocytic function and to be associated with impaired water and K+ homeostasis. Here we investigate by a combination of light and electron microscopic immunocytochemistry whether amyloid deposition is associated with a loss of astrocyte polarization, using AQP4 as a marker. We used the tg-ArcSwe mouse model of Alzheimer's disease, as this model displays perivascular plaques as …well as plaques confined to the neuropil. 3D reconstructions were done to establish the spatial relation between plaques and astrocytic endfeet, the latter known to contain the perivascular pool of AQP4. Changes in AQP4 expression emerge just after the appearance of the first plaques. Typically, there is a loss of AQP4 from endfoot membranes at sites of perivascular amyloid deposits, combined with an upregulation of AQP4 in the neuropil surrounding plaques. By electron microscopy it could be verified that the upregulation reflects an increased concentration of AQP4 in those delicate astrocytic processes that abound in synaptic regions. Thus, astrocytes exhibit a redistribution of AQP4 from endfoot membranes to non-endfoot membrane domains. The present data suggest that the development of amyloid deposits is associated with a loss of astrocyte polarization. The possible perturbation of water and K+ homeostasis could contribute to cognitive decline and seizure propensity in patients with Alzheimer's disease. Show more

Keywords: Aquaporin-4, cerebral amyloid angiopathy, electron microscopy, immunocytochemistry, 3D reconstruction

DOI: 10.3233/JAD-2011-110725

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 711-722, 2011

Authors: Reese, Jens Peter | Heßmann, Philipp | Seeberg, Greta | Henkel, Dajana | Hirzmann, Pamela | Rieke, Jürgen | Baum, Erika | Dannhoff, Frank | Müller, Matthias J. | Jessen, Frank | Geldsetzer, Monika-Balzer | Dodel, Richard

Article Type: Research Article

Abstract: The study aims to report service use and costs for patients with Alzheimer's disease (AD) and to explore the incremental influence of sociodemographic and illness-related determinants in ambulatory and inpatient settings within the German health care system. 395 patients with dementia were recruited at the following sites: 1) University hospital, 2) general practitioners' offices, 3) office-based neurologists, 4) a regional psychiatric hospital, and 5) nursing homes. Sociodemographic, economic, and clinical parameters were assessed using a standardized questionnaire. Informal care was not evaluated. Disease severity was measured using the Mini-Mental Status Examination and the Alzheimer's Disease Assessment Scale - Cognitive Subscale. …Neuropsychiatric status was assessed using the Geriatric Depression Scale, the Neuropsychiatric Inventory, and the Alzheimer's Disease Cooperative-Study-Activities of Daily Living. Annual total costs were estimated to be $\euro$13,080 per patient. The most important cost component was (long-term) care, constituting about 43% of total costs. Indirect costs comprised about 18% of total costs and were mainly due to reductions in working time of caregivers. Poorer functional status was associated with higher total and caregiving costs. In multivariate analyses, we identified younger age, female gender, and impaired activities of daily living as independent predictors of higher costs. Given that care for patients with AD is complex and expensive, our models were only able to explain about 17–43% of the variability in total costs. This suggests that further social and individual factors considerably influence the costs associated with AD. Direct medical care costs and long-term care costs related differently to the patient's clinical characteristics. Longitudinal and population-based studies are necessary for thoroughly evaluating the burden of disease. Show more

Keywords: Cost, dementia, economic burden, long-term care

DOI: 10.3233/JAD-2011-110539

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 723-736, 2011

Authors: Picco, Agnese | Archetti, Silvana | Ferrara, Michela | Arnaldi, Dario | Piccini, Alessandra | Serrati, Carlo | di Lorenzo, Diego | Morbelli, Silvia | Nobili, Flavio

Article Type: Research Article

Abstract: This study describes late-onset Alzheimer's disease (LOAD) in the mild cognitive impairment (MCI) stage, debuting with seizures in a 72 year-old woman. Prodromal AD was consistently diagnosed with four among amyloidosis and neurodegeneration biomarkers about 1 year after onset of seizures. Genetic assessment demonstrated apolipoprotein E ε2/ε3 genotype and three intronic single nucleotide substitutions, two in presenilin 1 and one in amyloid-β protein precursor genes. This case of seizures at onset of LOAD with severe signs of brain amyloidosis and neurodegeneration but with just MCI leads to a re-appraisal of the intriguing relationship between AD pathology and neuron excitability in …humans. Show more

Keywords: Alzheimer's disease, amyloid-β protein precursor, biological markers, presenilins, seizures

DOI: 10.3233/JAD-2011-110896

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 737-742, 2011

Authors: Rockenstein, Edward | Ubhi, Kiren | Doppler, Edith | Novak, Philipp | Moessler, Herbert | Li, Bin | Blanchard, Julie | Grundke-Iqbal, Inge | Iqbal, Khalid | Mante, Michael | Adame, Anthony | Crews, Leslie | Masliah, Eliezer

Article Type: Research Article

Abstract: Adult neurogenesis, the production of new neurons in certain brain regions, is known to decrease with age and the loss of neurogenic potential has been implicated in Alzheimer's disease (AD), a leading cause of dementia in the elderly. Cerebrolysin (CBL) has been shown to increase neurogenesis in models of stroke and AD. CBL is composed of small peptides with activity similar to neurotrophic factors including ciliary neurotrophic factor (CNTF), which may mediate its neurogenic effects. This study compares the effects of CBL and two peptides with corresponding to an active region of CNTF (Peptide 6 and 6A) across neurogenic brain …regions in amyloid-β protein precursor (AβPP) transgenic (tg) mice. Both CBL and Peptides 6 and 6A were able to increase the numbers of neuroblasts (DCX+ cells) and BrdU+ cells in a regionally specific manner across the subventricular zone, olfactory bulb, and hippocampus. The increased generation of new cells and cell survival in animals treated with Peptides 6 and 6A was accompanied by an increase in PCNA+ cells. In contrast, AβPP tg mice treated with CBL displayed reduced levels of TUNEL staining, while levels of PCNA were unaltered. Collectively these results demonstrate that while CBL and Peptides 6 and 6A all potentiate neurogenesis in the AβPP tg mice, their relative modes of action may differ with CBL associated with reduced apoptosis and Peptides 6 and 6A working by augmenting cell proliferation. These results are consistent with a potential therapeutic relevance for Peptides 6 and 6A in AD and other disorders characterized by neurogenic deficits. Show more

Keywords: Alzheimer's disease, neurogenesis, transgenic

DOI: 10.3233/JAD-2011-110914

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 743-752, 2011

Authors: Sinha, Maitrayee | Behera, Prajna | Bhowmick, Pritha | Banerjee, Kalpita | Basu, Sumitran | Chakrabarti, Sasanka

Article Type: Research Article

Abstract: The entangled relationship of brain aging, mitochondrial dysfunction, and amyloid-β peptide (Aβ42 ) toxicity occupies the center stage in the pathogenesis of Alzheimer's disease (AD). The present study examines some of the toxic effects of Aβ42 on brain mitochondria and provides evidence that aged brain mitochondria are significantly more vulnerable to Aβ42 toxicity. In particular, the study has shown that the aggregated, but not the monomeric, form of Aβ42 in varying concentrations (10–40 μM) during in vitro incubation causes a loss of mitochondrial membrane potential, a decrease in phosphorylation capacity and ATP synthesis, and the release of …cytochrome c from the mitochondria but without any noticeable change in the activities of respiratory chain complexes. Such effects of Aβ42 are strikingly more conspicuous on aged rat (22–24 months) brain mitochondria compared to that on brain mitochondria of young rats (4–6 months). More interestingly is the observation that in contrast to young rat brain mitochondria, a significantly higher level of Aβ42 remains associated with aged brain mitochondria under basal incubation condition as well as after exposure to exogenously added peptide. Extrapolated to an in vivo scenario, the results have clear implications in AD pathogenesis and also partly explain why brain aging is a dominant risk factor for this disease condition. Show more

Keywords: Alzheimer's disease, amyloid-β peptide, brain aging, cytochrome c, mitochondria, respiratory chain complexes

DOI: 10.3233/JAD-2011-110686

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 753-765, 2011

Authors: Gauci, Alison J. | Caruana, Mario | Giese, Armin | Scerri, Charles | Vassallo, Neville

Article Type: Research Article

Abstract: Amyloid-β (Aβ) aggregation is a recognized key process in the pathogenesis of Alzheimer's disease (AD). Misfolded Aβ peptides self-assemble into higher-order oligomers that compromise membrane integrity, leading to synaptic degeneration and neuronal cell death. The main aim of this study was to explore whether small-molecule compounds and black tea extract can protect phospholipid membranes from disruption by Aβ aggregates. We first established a robust protocol for aggregating Aβ42 peptides into a range of oligomers that efficiently permeabilized small unilamellar liposomes. Next, 15 natural plant polyphenolic compounds, 8 N′-benzylidene-benzohydrazide (NBB) compounds and black tea extract were assessed for their ability …to antagonize liposome permeabilization by the Aβ42 oligomers. Our data indicates that black tea extract, the flavones apigenin and baicalein, and the stilbene nordihydroguaiaretic acid (NDGA) are indeed potent inhibitors. Taking into consideration the results of all the small-molecule polyphenols and NBB compounds, it can be proposed that a dihydroxyphenyl ring structure, alone or as part of a flavone scaffold, is particularly effective for protection against membrane damage by the Aβ42 oligomers. Given the critical role of membrane perforation in the neurodegenerative cascade, these conclusions may guide the design and development of novel therapeutic drugs in AD. Show more

Keywords: Alzheimer's disease, amyloid-β, black tea, liposomes, N′-benzylidene-benzohydrazide, oligomers, polyphenols

DOI: 10.3233/JAD-2011-111061

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 767-779, 2011

Authors: Carecchio, Miryam | Fenoglio, Chiara | Cortini, Francesca | Comi, Cristoforo | Benussi, Luisa | Ghidoni, Roberta | Borroni, Barbara | De Riz, Milena | Serpente, Maria | Cantoni, Claudia | Franceschi, Massimo | Albertini, Valentina | Monaco, Francesco | Rainero, Innocenzo | Binetti, Giuliano | Padovani, Alessandro | Bresolin, Nereo | Scarpini, Elio | Galimberti, Daniela

Article Type: Research Article

Abstract: Cerebrospinal fluid (CSF) biomarkers (Aβ1-42 , total tau, P-181 tau) are currently used to support a clinical diagnosis of Alzheimer's disease (AD). The CSF profile in frontotemporal lobar degeneration (FTLD) caused by Progranulin (GRN) mutation is unknown. We assessed CSF biomarkers in 145 AD, 140 FTLD (20 GRN positive, 120 GRN negative) patients, and 38 controls. Taking into account the reference values used in clinical practice, GRN mutation carriers and controls did not differ significantly for any biomarker, whereas GRN negative FTLD patients had higher tau levels than controls (p < 0.001) and patients carrying GRN Thr272fs mutation (p = …0.033, Chi-Square test). Comparing CSF biomarkers mean values among groups, total tau was significantly increased in GRN negative FTLD and in mutation carriers compared with controls (p < 0.001). P-181 tau CSF was increased in AD patients and in GRN negative FTLD compared with controls (p < 0.001), but not in 17 patients carrying the Thr272fs mutation. 88.2% of mutation carriers had normal CSF tau, despite the neurodegenerative nature of FTLD. Our results suggest that GRN mutation carriers have normal or borderline CSF biomarkers. In patients with an AD-like phenotype but normal or borderline CSF biomarkers, a diagnosis of FTLD-U caused by GRN mutations should be considered. Show more

Keywords: Biomarkers, cerebrospinal fluid, frontotemporal lobar degeneration (FTLD), neurodegeneration, progranulin, tau

DOI: 10.3233/JAD-2011-111046

Citation: Journal of Alzheimer's Disease, vol. 27, no. 4, pp. 781-790, 2011