Journal of Alzheimer's Disease - Volume 72, issue 1

Authors: Jääskeläinen, Olli | Solje, Eino | Hall, Anette | Katisko, Kasper | Korhonen, Ville | Tiainen, Mika | Kangas, Antti J. | Helisalmi, Seppo | Pikkarainen, Maria | Koivisto, Anne | Hartikainen, Päivi | Hiltunen, Mikko | Ala-Korpela, Mika | Soininen, Hilkka | Soininen, Pasi | Haapasalo, Annakaisa | Remes, Anne M. | Herukka, Sanna-Kaisa

Article Type: Research Article

Abstract:  Decreased levels of serum high-density lipoprotein (HDL) cholesterol have previously been linked to systemic inflammation and neurodegenerative diseases, such as Alzheimer’s disease. Here, we aimed to analyze the lipoprotein profile and inflammatory indicators, the high-sensitivity C-reactive peptide (hs-CRP) and glycoprotein acetyls (GlycA), in sporadic and C9orf72 repeat expansion-associated frontotemporal lobar degeneration (FTLD) patients. The C9orf72 hexanucleotide repeat expansion is the most frequent genetic etiology underlying FTLD. The concentrations of different lipid measures in the sera of 67 FTLD patients (15 C9orf72 repeat expansion carriers), including GlycA, were analyzed by nuclear magnetic resonance spectroscopy. To verify the state …of systemic inflammation, hs-CRP was also quantified from patient sera. We found that the total serum HDL concentration was decreased in C9orf72 repeat expansion carriers when compared to non-carriers. Moreover, decreased concentrations of HDL particles of different sizes and subclass were consistently observed. No differences were detected in the very low- and low-density lipoprotein subclasses between the C9orf72 repeat expansion carriers and non-carriers. Furthermore, hs-CRP and GlycA levels did not differ between the C9orf72 repeat expansion carriers and non-carriers. In conclusion, the HDL-related changes were linked with C9orf72 repeat expansion associated FTLD but were not seen to associate with systemic inflammation. The underlying reason for the HDL changes remains unclear. Show more

Keywords: C9orf72 protein, cholesterol, frontotemporal dementia, frontotemporal lobar degeneration, inflammation, lipoproteins

DOI: 10.3233/JAD-190132

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 127-137, 2019

Authors: Wang, Yiran | Wang, Ying | Bharti, Veni | Zhou, Hong | Hoi, Vanessa | Tan, Hua | Wu, Zijian | Nagakannan, Pandian | Eftekharpour, Eftekhar | Wang, Jun-Feng

Article Type: Research Article

Abstract: Oxidative stress has been hypothesized to play a role in the pathophysiology of Alzheimer’s disease (AD). Previously, we found that total nitrosylated protein levels were increased in the brain of amyloid-β protein precursor (AβPP) and presenilin 1 (PS1) double transgenic mice, an animal model for AD, suggesting that cysteine oxidative protein modification may contribute to this disease. Thioredoxin (Trx) is a major oxidoreductase that can reverse cysteine oxidative modifications such as sulfenylation and nitrosylation, and inhibit oxidative stress. Thioredoxin-interacting protein (Txnip) is an endogenous Trx inhibitor. To understand the involvement of Trx and Txnip in AD development, we investigated Trx …and Txnip in the brain of AβPP/PS1 mice. Using immunoblotting analysis, we found that although Trx protein levels were not changed, Txnip protein levels were significantly increased in hippocampus and frontal cortex of 9- and 12-month-old AβPP/PS1 mice when compared to wild-type mice. Txnip protein levels were also increased by amyloid-β treatment in primary cultured mouse cerebral cortical neurons and HT22 mouse hippocampal cells. Using biotin switch and dimedone conjugation methods, we found that amyloid-β treatment increased protein nitrosylation and sulfenylation in HT22 cells. We also found that downregulation of Txnip, using CRISPR/Cas9 method in HT22 cells, attenuated amyloid-β-induced protein nitrosylation and sulfenylation. Our findings suggest that amyloid-β may increase Txnip levels, subsequently inhibiting Trx reducing capability and enhancing protein cysteine oxidative modification. Our findings also indicate that Txnip may be a potential target for the treatment of AD. Show more

Keywords: Alzheimer’s disease, amyloid-β , nitrosylation, oxidative stress, sulfenylation, thioredoxin, thioredoxin-interacting protein

DOI: 10.3233/JAD-190223

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 139-150, 2019

Authors: Pozueta, Ana | Lage, Carmen | Martínez, María García | Kazimierczak, Martha | Bravo, María | López-García, Sara | Riancho, Javier | González-Suarez, Andrea | Vázquez-Higuera, José Luis | de Arcocha-Torres, María | Banzo, Ignacio | Bonilla, Julio Jimenez | Berciano, José | Rodríguez-Rodríguez, Eloy | Sánchez-Juan, Pascual

Article Type: Research Article

Abstract: Background: Semantic dementia (SD) is a subtype of frontotemporal lobe degeneration characterized by semantic loss, with other cognitive functions initially preserved. SD requires differential diagnosis with Alzheimer’s disease (AD) and behavioral variant frontotemporal dementia (bvFTD). Semantic knowledge can be evaluated through different tests; however, most of them depend on language. Objective: We describe the development of a brief drawing task that may be helpful for the differential diagnosis of SD. Methods: Seventy-two patients, including 32 AD, 19 bvFTD, and 21 SD were asked to draw 12 items with different age of acquisition and familiarity, belonging to …four different semantic categories. We employed the drawings of healthy volunteers to build a scoring scheme. Results: Turtle, strawberry, train, and envelope were the items of each category that best discriminated between groups and were selected for the Brief drawing task. The discriminatory power of the Brief drawing task between SD versus AD and bvFTD patients, estimated through the area under the curve was 0.84 (95% CI = 0.72–0.96, p  = 0.000007). In a logistic model, the Brief drawing task (p  = 0.003) and VOSP “number location” subtest (p  = 0.016) were significant predictors of the diagnosis of SD versus AD and bvFTD after adjustment by the main covariates. The Brief drawing task provided clinically useful qualitative information. SD drawings were characterized by loss of the distinctive features, intrusions, tendency to prototype, and answers like “I don’t know what this is”. Conclusion: The Brief drawing task appears to reveal deficits in semantic knowledge among patients with SD that may assist in the differential diagnosis with other neurodegenerative diseases. Show more

Keywords: Dementia, differential diagnosis, drawings, semantic dementia, semantic knowledge

DOI: 10.3233/JAD-190660

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 151-160, 2019

Authors: Zyśk, Marlena | Clausen, Fredrik | Aguilar, Ximena | Sehlin, Dag | Syvänen, Stina | Erlandsson, Anna

Article Type: Research Article

Abstract: Alzheimer’s disease (AD) is the leading cause of dementia worldwide, affecting over 10% of the elderly population. Epidemiological evidence indicates that traumatic brain injury (TBI) is an important risk factor for developing AD later in life. However, which injury-induced processes that contribute to the disease onset remains unclear. The aim with the present study was to identify cellular processes that could link TBI to AD development, by investigating the chronic impact of two different injury models, controlled cortical impact (CCI) and midline fluid percussion injury (mFPI). The trauma was induced in 3-month-old tg-ArcSwe mice, carrying the Arctic mutation along with …the Swedish mutation, and the influence of TBI on AD progression was analyzed at 12- and 24-weeks post-injury. The long-term effect of the TBI on memory deficiency, amyloid-β (Aβ) pathology, neurodegeneration and inflammation was investigated by Morris water maze, PET imaging, immunohistochemistry, and biochemical analyses. Morris water maze analysis demonstrated that mice subjected to CCI or mFPI performed significantly worse than uninjured tg-ArcSwe mice, especially at the later time point. Moreover, the injured mice showed a late upregulation of reactive gliosis, which concurred with a more pronounced Aβ pathology, compared to uninjured AD mice. Our results suggest that the delayed glial activation following TBI may be an important link between the two diseases. However, further studies in both experimental models and human TBI patients will be required to fully elucidate the reasons why TBI increases the risk of neurodegeneration. Show more

Keywords: Alzheimer’s disease, amyloid-β, inflammation, Morris water maze, neurodegeneration astrocytes, PET, traumatic brain injury

DOI: 10.3233/JAD-190572

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 161-180, 2019

Authors: Sutin, Angelina R. | Stephan, Yannick | Terracciano, Antonio

Article Type: Research Article

Abstract: Personality traits, such as higher Neuroticism and lower Conscientiousness, are associated with risk of Alzheimer’s disease and other dementias. A diagnosis of dementia relies, in part, on informant ratings of the individual’s cognitive status. Here we examine whether self-reported personality traits are associated with four measures of informant-rated cognition up to a decade later. Participants from the Health and Retirement Study (N = 2,536) completed a five-factor model measure of personality in 2006 or 2008. Informants completed the 2016 Harmonized Cognitive Assessment Protocol (HCAP), which included ratings of the participant’s current cognitive functioning and change in cognitive function over the last decade …assessed with the IQCODE, Blessed, 1066, and CSID. Controlling for characteristics of the participant, informant, and their relationship, higher Neuroticism and lower Conscientiousness were associated consistently with worse informant-rated cognition. The association between Openness and better informant-rated cognition was due primarily to higher baseline cognitive function. Extraversion and Agreeableness were associated with better informant-rated cognition only among participants who were cognitively intact at follow-up. The present research suggests that knowledgeable informants are able to detect cognitive deficits associated with personality. Show more

Keywords: Cognitive decline, dementia, five factor model, informant-rated cognition

DOI: 10.3233/JAD-190555

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 181-190, 2019

Authors: Chou, Ping-Song | Wu, Meng-Ni | Yang, Chen-Cheng | Shen, Cheng-Ting | Yang, Yuan-Han

Article Type: Research Article

Abstract: Background: Shared links between type 2 diabetes mellitus (T2DM) and Alzheimer’s disease (AD) have been well-known. A high concentration of advanced glycation end products (AGEs) has been reported to contribute to impaired mobility in patients with AD, but there is limited understanding regarding the longitudinal impact of AGEs on cognitive performance. Objective: This study aims to explore whether the concentrations of AGEs mediate the clinical progression of cognitive performance in patients with AD and T2DM. Methods: Twenty-five patients aged 79.0±5.8 years who were diagnosed with probable AD with a Clinical Dementia Rating (CDR) of 0.5 or …1 and T2DM were enrolled in this study. When patients participated in the study, the concentration of plasma AGEs was tested. A series of neuropsychological tests, namely the Mini-Mental Status Examination (MMSE), Cognitive Assessment Screening Instrument (CASI), and CDR, were performed annually during follow-up. The association between the concentration of AGEs and changes in overall cognition and cognition related daily living performance was analyzed. Results: After the mean 48.6±2.1 months of follow-up, AGEs were found to be significantly associated with a change in CDR. A total of 12 (48%) patients experienced a decline in CDR; they had a significantly higher concentration of AGEs than did those whose CDR did not deteriorate (100.5 ± 14.2 versus 81.5 ± 17.7; p  = 0.007). This difference in CDR remained significant after adjustment for age, sex, education level, and apolipoprotein E4 status (adjusted p  = 0.023). Conclusion: In conclusion, this study indicates that a high concentration of AGEs may be a predictor of a long-term decline in cognition related daily living performance in patients with AD and T2DM. Show more

Keywords: Advanced glycation end products, Alzheimer’s disease, clinical dementia rating, diabetes mellitus

DOI: 10.3233/JAD-190639

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 191-197, 2019

Authors: Wang, Qian | Jiang, Hailun | Wang, Linlin | Yi, Hong | Li, Zhuorong | Liu, Rui

Article Type: Research Article

Abstract: Alzheimer’s disease (AD) is a chronic neurodegenerative disorder characterized by progressive cognitive impairments. Vitegnoside is a flavonoid present in the medicinal plant Vitex negundo , widely used as a folk medicine in several Asian countries including China. It possesses several biological activities, including axon outgrowth, but no evidence is available on its effect on AD. Since no effective treatment is available to cure AD, the effect of vitegnoside on this disease was investigated. The human neuroblastoma SH-SY5Y cell line carrying the Swedish mutation that induces AβPP overexpression was used as an in vitro AD cell model. AβPP overexpression does …not induce toxicity per se unless triggered by copper. Vitegnoside promoted neuroprotection through the improvement of cell viability, maintenance of cytomembrane integrity and nuclear homogeneity in these cells, but these effects were not observed in the copper-treated SH-SY5Y cells without AβPP overexpression used as the wild-type control, indicating that vitegnoside exerted neuroprotection under copper-triggered Aβ toxic conditions. Vitegnoside failed to decrease AβPP expression, Aβ40/42 levels, and oxidative stress due to copper-induced Aβ toxicity. However, its administration protected the mitochondrial function and restored the imbalance between pro-apoptotic and anti-apoptotic proteins. Additionally, vitegnoside inactivated p38 MAPK/MK2, JNK/c-Jun, and downstream NF-κ B inflammatory transductions. Furthermore, the inactivation of p38 MAPK/JNK signaling contributed to vitegnoside-mediated neuroprotection resulting from pharmacological inhibition of p38 MAPK/JNK and in silico interaction prediction. Our study revealed the neuroprotective effect of vitegnoside and its potential mechanisms against copper-induced Aβ neurotoxicity. These findings highlighted the potential therapeutic effect of vitegnoside against AD progression. Show more

Keywords: Alzheimer’s disease, amyloid-β, apoptosis, mitogen-activated protein kinase, vitegnoside

DOI: 10.3233/JAD-190640

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 199-214, 2019

Authors: Toppala, Sini | Ekblad, Laura L. | Lötjönen, Jyrki | Helin, Semi | Hurme, Saija | Johansson, Jarkko | Jula, Antti | Karrasch, Mira | Koikkalainen, Juha | Laine, Hanna | Parkkola, Riitta | Viitanen, Matti | Rinne, Juha O.

Article Type: Research Article

Abstract: Background: Type 2 diabetes (T2DM) increases the risk for Alzheimer’s disease (AD) but not for AD neuropathology. The association between T2DM and AD is assumed to be mediated through vascular mechanisms. However, insulin resistance (IR), the hallmark of T2DM, has been shown to associate with AD neuropathology and cognitive decline. Objective: To evaluate if midlife IR predicts late-life cognitive performance and cerebrovascular lesions (white matter hyperintensities and total vascular burden), and whether cerebrovascular lesions and brain amyloid load are associated with cognitive functioning. Methods: This exposure-to-control follow-up study examined 60 volunteers without dementia (mean age 70.9 …years) with neurocognitive testing, brain 3T-MRI and amyloid-PET imaging. The volunteers were recruited from the Finnish Health 2000 survey (n  = 6062) to attend follow-up examinations in 2014–2016 according to their insulin sensitivity in 2000 and their APOE genotype. The exposure group (n  = 30) had IR in 2000 and the 30 controls had normal insulin sensitivity. There were 15 APOE ɛ 4 carriers per group. Statistical analyses were performed with multivariable linear models. Results: At follow-up the IR+group performed worse on executive functions (p  = 0.02) and processing speed (p  = 0.007) than the IR- group. The groups did not differ in cerebrovascular lesions. No associations were found between cerebrovascular lesions and neurocognitive test scores. Brain amyloid deposition associated with slower processing speed. Conclusion: Midlife IR predicted poorer executive functions and slower processing speed, but not cerebrovascular lesions. Brain amyloid deposition was associated with slower processing speed. The association between midlife IR and late-life cognition might not be mediated through cerebrovascular lesions measured here. Show more

Keywords: Alzheimer’s disease, amyloid, APOE , 11C-PIB, cerebrovascular lesions, cognition, follow-up study, insulin resistance, magnetic resonance imaging, PET scan

DOI: 10.3233/JAD-190691

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 215-228, 2019

Authors: Hamezah, Hamizah Shahirah | Durani, Lina Wati | Yanagisawa, Daijiro | Ibrahim, Nor Faeizah | Aizat, Wan Mohd | Makpol, Suzana | Wan Ngah, Wan Zurinah | Damanhuri, Hanafi Ahmad | Tooyama, Ikuo

Article Type: Research Article

Abstract: Tocotrienol-rich fraction (TRF) is a mixture of vitamin E analogs derived from palm oil. We previously demonstrated that supplementation with TRF improved cognitive function and modulated amyloid pathology in AβPP/PS1 mice brains. The current study was designed to examine proteomic profiles underlying the therapeutic effect of TRF in the brain. Proteomic analyses were performed on samples of hippocampus, medial prefrontal cortex (mPFC), and striatum using liquid chromatography coupled to Q Exactive HF Orbitrap mass spectrometry. From these analyses, we profiled a total of 5,847 proteins of which 155 proteins were differentially expressed between AβPP/PS1 and wild-type mice. TRF supplementation of …these mice altered the expression of 255 proteins in the hippocampus, mPFC, and striatum. TRF also negatively modulated the expression of amyloid beta A4 protein and receptor-type tyrosine-protein phosphatase alpha protein in the hippocampus. The expression of proteins in metabolic pathways, oxidative phosphorylation, and those involved in Alzheimer’s disease were altered in the brains of AβPP/PS1 mice that received TRF supplementation. Show more

Keywords: Alzheimer’s disease, LC-MS, palm oil, proteomics, tocotrienol

DOI: 10.3233/JAD-181171

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 229-246, 2019

Authors: Smeijer, David | Ikram, M. Kamran | Hilal, Saima

Article Type: Research Article

Abstract: Perivascular compartments surrounding the penetrating arteries in the brain are part of a physiologic system, which facilitates fluids exchange and clearance of solutes from the brain. The perivascular compartments become visible on MRI when enlarged and are commonly referred to as perivascular spaces (ePVS). Previous studies on the association between ePVS and dementia have been inconsistent due to varying methods of measuring ePVS. As a frame of reference for future MRI studies on ePVS, we systematically review the literature on ePVS as a marker of vascular brain injury related to dementia from population-based as well as hospital-based settings. We identified …three longitudinal and ten cross-sectional studies involving 7,581 persons. Potential outcomes were all-cause dementia, Alzheimer’s disease, and vascular dementia. There was considerable heterogeneity in ePVS assessment: with studies using either visual inspection or segmentation, examining different brain locations and implementing different grading scales. Moreover, out of the total of 13 studies, all five studies on vascular dementia reported an association with presence of basal ganglia ePVS after adjustment for age, gender, and white matter hyperintensities. For seven studies on Alzheimer’s disease and all-cause dementia, the results were ambiguous. This review did not identify an independent association of ePVS with prevalent or incident dementia. Harmonized methods for ePVS assessment, tested across different populations, may benefit future MRI studies on ePVS and dementia. Show more

Keywords: Cerebral small vessel disease, dementia, enlarged perivascular spaces, magnetic resonance imaging

DOI: 10.3233/JAD-190527

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 247-256, 2019

Authors: Castora, Frank J. | Conyers, Barbara L. | Gershon, Blake S. | Kerns, Kimberly A. | Campbell, Jr , Robert | Simsek-Duran, Fatma

Article Type: Research Article

Abstract: Mitochondrial dysfunction is recognized as a critical component in the pathogenesis of neurodegenerative diseases, including Alzheimer’s disease (AD). Deficits in oxidative capacity and, specifically, cytochrome c oxidase (CO) activity have been reported in AD brains and platelets. We previously identified a point mutation at np 9861 in AD brain mitochondrial DNA (mtDNA) that alters amino acid 219 of subunit III of CO from phenylalanine to leucine. We rapidly screened and quantitated levels of T9861C in samples using mismatched PCR-RFLP and nucleotide extension assays. Six of 40 AD brains possessed the T9861C mutation (designated AD+ ) compared to zero of 40 …age-matched control brains. The 15% frequency of T9861C in AD brain is 115-fold higher than the frequency (0.13%) reported in 9,986 human mtDNA samples queried in world-wide databases. T9861C is heteroplasmic, with mutant load varying from 11% to >95%. Detected initially in parietal cortex, T9861C is not localized to that region but is also found in temporal cortex and caudate but not in hippocampus. The mutant load is unequally distributed throughout these brain regions with the highest load occurring in the parietal or temporal cortex. CO activity normalized to citrate synthase (CS) is reduced an average of 48.5% in AD+ brains. CO/CS ratios amongst controls and the two AD populations (AD and AD+) were significantly different (p  = 0.001). Post hoc differences were also significant between controls and AD+ (p  = 0.001) and controls and AD (p  = 0.019). There was no significant difference between AD and AD+ (p  = 0.317). Show more

Keywords: Alzheimer’s disease, cytochrome oxidase subunit III, DNA, DNA mutational analysis, mitochondrial

DOI: 10.3233/JAD-190176

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 257-269, 2019

Authors: Jingami, Naoto | Uemura, Kengo | Asada-Utsugi, Megumi | Kuzuya, Akira | Yamada, Shigeki | Ishikawa, Masatsune | Kawahara, Takashi | Iwasaki, Takuya | Atsuchi, Masamichi | Takahashi, Ryosuke | Kinoshita, Ayae

Article Type: Research Article

Abstract: Background: Extensive research into cerebrospinal fluid (CSF) biomarkers was performed in patients with idiopathic normal pressure hydrocephalus (iNPH). Most prior research into CSF biomarkers has been one-point observation. Objective: To investigate dynamic changes in CSF biomarkers during routine tap test in iNPH patients. Methods: We analyzed CSF concentrations of tau, amyloid-β (Aβ) 42 and 40, and leucine rich α -2-glycoprotein (LRG) in 88 consecutive potential iNPH patients who received a tap test. We collected two-point lumbar CSF separately at the first 1 ml (First Drip (FD)) and at the last 1 ml (Last Drip (LD)) during the tap …test and 9 patients who went on to receive ventriculo-peritoneal shunt surgery each provided 1 ml of ventricular CSF (VCSF). Results: Tau concentrations were significantly elevated in LD and VCSF compared to FD (LD/FD = 1.22, p  = 0.003, VCSF/FD = 2.76, p  = 0.02). Conversely, Aβ42 (LD/FD = 0.80, p  < 0.001, VCSF/FD = 0.38, p  = 0.03) and LRG (LD/FD = 0.74, p  < 0.001, VCSF/FD = 0.09, p  = 0.002) concentrations were significantly reduced in LD and VCSF compared to FD. Gait responses to the tap test and changes in cognitive function in response to shunt were closely associated with LD concentrations of tau (p  = 0.02) and LRG (p  = 0.04), respectively. Conclusions: Dynamic changes were different among the measured CSF biomarkers, suggesting that LD of CSF as sampled during the tap test reflects an aspect of VCSF contributing to the pathophysiology of iNPH and could be used to predict shunt effectiveness. Show more

Keywords: Alzheimer’s disease, amyloid-β, cerebrospinal fluid biomarker, idiopathic normal pressure hydrocephalus, leucine rich α-2-glycoprotein, tap test, tau

DOI: 10.3233/JAD-190775

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 271-277, 2019

Authors: Robinson, Rebecca L. | Rentz, Dorene M. | Bruemmer, Valerie | Scott Andrews, Jeffrey | Zagar, Anthony | Kim, Yongin | Schwartz, Ronald L. | Ye, Wenyu | Fillit, Howard M.

Article Type: Research Article

Abstract: Background: Alzheimer’s disease (AD) is one of the costliest diseases in the United States. Objective: To describe aspects of real-world patient and caregiver burden in patients with clinician-diagnosed early AD, including mild cognitive impairment (MCI) and mild dementia (MILD) due to AD. Methods: Cross-sectional assessment of GERAS-US, a 36-month cohort study of patients seeking care for early AD. Eligible patients were categorized based on study-defined categories of MCI and MILD and by amyloid positivity [+] or negativity [–] within each severity cohort. Demographic characteristics, health-related outcomes, medical history, and caregiver burden by amyloid status are described. …Results: Of 1,198 patients with clinician-diagnosed early AD, 52% were amyloid[+]. For patients in both cohorts, amyloid[–] was more likely to occur in those with: delayed time to an AD-related diagnosis, higher rates of depression, poorer Bath Assessment of Subjective Quality of Life in Dementia scores, and Hispanic/Latino ethnicity (all p  < 0.05). MILD[–] patients (versus MILD[+]) were more medically complex with greater rates of depression (55.7% versus 40.4%), sleep disorders (34.3% versus 26.5%), and obstructive pulmonary disease (11.8% versus 6.6%); and higher caregiver burden (Zarit Burden Interview) (all p  < 0.05). MILD[+] patients had lower function according to the Functional Activities Questionnaire (p  < 0.001), yet self-assessment of cognitive complaints across multiple measures did not differ by amyloid status in either severity cohort. Conclusions: Considerable patient and caregiver burden was observed in patients seeking care for memory concerns. Different patterns emerged when both disease severity and amyloid status were evaluated underscoring the need for further diagnostic assessment and care for patients. Study Registry: H8A-US-B004; ClinicalTrials.gov: NCT02951598. Show more

Keywords: Alzheimer’s disease, amyloid, burden of illness, florbetapir F18, mild Alzheimer’s dementia, mild cognitive impairment

DOI: 10.3233/JAD-190430

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 279-292, 2019

Authors: Meysami, Somayeh | Raji, Cyrus A. | Merrill, David A. | Porter, Verna R. | Mendez, Mario F.

Article Type: Research Article

Abstract: Background: While traumatic brain injury (TBI) is recognized as a risk factor for dementia, there is lack of clinical tools to identify brain changes that may confer such vulnerability. Brain MRI volumetric quantification can sensitively identify brain atrophy. Objective: To characterize regional brain volume loss in persons with TBI presenting with cognitive impairment. Methods: IRB approved review of medical records in patients with cognitive decline focused on those who had documented TBI histories and brain MRI scans after TBI (n  = 40, 67.7±14.5 years) with volumetric quantification by applying an FDA cleared software program. TBI documentation included …head trauma mechanism. Brain volumes were compared to a normative database to determine the extent of atrophy. Correlations between these regions and global tests of cognition (MMSE in n  = 17, MoCA in n  = 27, n  = 14 in both) were performed. Results: Multiple regions demonstrated volume loss in TBI, particularly ventral diencephalon, putamen, and pallidum with smaller magnitude of atrophy in temporal lobes and brainstem. Lobar structures showed strongest correlations between atrophy and lower scores on MMSE and MoCA. The hippocampus, while correlated to tests of cognitive function, was the least atrophic region as a function of TBI history. Conclusion: Persons with TBI history exhibit show regional brain atrophy. Several of these areas, such as thalamus and temporal lobes, also correlate with cognitive function. Alzheimer’s disease atrophy was less likely given relative sparing of the hippocampi. Volumetric quantification of brain MRI in TBI warrants further investigation to further determine its clinical potential in TBI and differentiating causes of cognitive impairment. Show more

Keywords: Magnetic resonance imaging, traumatic brain injury, volumetric quantification

DOI: 10.3233/JAD-190708

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 293-300, 2019

Authors: Amlie-Wolf, Alexandre | Tang, Mitchell | Way, Jessica | Dombroski, Beth | Jiang, Ming | Vrettos, Nicholas | Chou, Yi-Fan | Zhao, Yi | Kuzma, Amanda | Mlynarski, Elisabeth E. | Leung, Yuk Yee | Brown, Christopher D. | Wang, Li-San | Schellenberg, Gerard D.

Article Type: Research Article

Abstract: Most of the loci identified by genome-wide association studies (GWAS) for late-onset Alzheimer’s disease (LOAD) are in strong linkage disequilibrium (LD) with nearby variants all of which could be the actual functional variants, often in non-protein-coding regions and implicating underlying gene regulatory mechanisms. We set out to characterize the causal variants, regulatory mechanisms, tissue contexts, and target genes underlying these associations. We applied our INFERNO algorithm to the top 19 non-APOE loci from the IGAP GWAS study. INFERNO annotated all LD-expanded variants at each locus with tissue-specific regulatory activity. Bayesian co-localization analysis of summary statistics and eQTL data was performed …to identify tissue-specific target genes. INFERNO identified enhancer dysregulation in all 19 tag regions analyzed, significant enrichments of enhancer overlaps in the immune-related blood category, and co-localized eQTL signals overlapping enhancers from the matching tissue class in ten regions (ABCA7, BIN1, CASS4, CD2AP, CD33, CELF1, CLU, EPHA1, FERMT2, ZCWPW1 ). In several cases, we identified dysregulation of long noncoding RNA (lncRNA) transcripts and applied the lncRNA target identification algorithm from INFERNO to characterize their downstream biological effects. We also validated the allele-specific effects of several variants on enhancer function using luciferase expression assays. By integrating functional genomics with GWAS signals, our analysis yielded insights into the regulatory mechanisms, tissue contexts, genes, and biological processes affected by noncoding genetic variation associated with LOAD risk. Show more

Keywords: Alzheimer’s disease, bioinformatics, genetics, genomics, long noncoding RNA

DOI: 10.3233/JAD-190568

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 301-318, 2019

Authors: Paley, Elena L.

Article Type: Research Article

Abstract: Alzheimer’s disease (AD)-associated sequence (ADAS) of cultured fecal bacteria was discovered in human gut targeted screening. This study provides important information to expand our current understanding of the structure/activity relationship of ADAS and putative inhibitors/activators that are potentially involved in ADAS appearance/disappearance. The NCBI database analysis revealed that ADAS presents at a large proportion in American Indian Oklahoman (C&A) with a high prevalence of obesity/diabetes and in colorectal cancer (CRC) patients from the US and China. An Oklahoman non-native group (NNI) showed no ADAS. Comparison of two large US populations reveals that ADAS is more frequent in individuals aged ≥66 …and in females. Prevalence and levels of fecal metabolites are altered in the C&A and CRC groups versus controls. Biogenic amines (histamine, tryptamine, tyramine, phenylethylamine, cadaverine, putrescine, agmatine, spermidine) that present in food and are produced by gut microbiota are significantly higher in C&A (e.g., histamine/histidine 95-fold) versus NNI (histamine/histidine 16-fold). The majority of these bio-amines are cytotoxic at concentrations found in food. Inositol phosphate signaling implicated in AD is altered in C&A and CRC. Tryptamine stimulated accumulation of inositol phosphate. The seizure-eliciting tryptamine induced cytoplasmic vacuolization and vesiculation with cell fragmentation. Present additions of ADAS-carriers at different ages including infants led to an ADAS-comprising human sample size of 2,830 from 27 studies from four continents (North America, Australia, Asia, Europe). Levels of food-derived monoamine oxidase inhibitors and anti-bacterial compounds, the potential modulators of ADAS-bacteria growth and biogenic amine production, were altered in C&A versus NNI. ADAS is attributable to potentially modifiable risk factors of AD associated diseases. Show more

Keywords: Alzheimer’s human gut metagenome, angiogenesis, biogenic amines, food, gut metabolomics, protein biosynthesis

DOI: 10.3233/JAD-190873

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 319-355, 2019

Article Type: Correction

DOI: 10.3233/JAD-199009

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 357-357, 2019

Article Type: Correction

DOI: 10.3233/JAD-199010

Citation: Journal of Alzheimer's Disease, vol. 72, no. 1, pp. 359-359, 2019