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  • 1
    In: Genetic Epidemiology, Wiley, Vol. 43, No. 4 ( 2019-06), p. 373-401
    Abstract: In Mendelian randomization (MR), inference about causal relationship between a phenotype of interest and a response or disease outcome can be obtained by constructing instrumental variables from genetic variants. However, MR inference requires three assumptions, one of which is that the genetic variants only influence the outcome through phenotype of interest. Pleiotropy, that is, the situation in which some genetic variants affect more than one phenotype, can invalidate these genetic variants for use as instrumental variables; thus a naive analysis will give biased estimates of the causal relation. Here, we present new methods (constrained instrumental variable [CIV] methods) to construct valid instrumental variables and perform adjusted causal effect estimation when pleiotropy exists and when the pleiotropic phenotypes are available. We demonstrate that a smoothed version of CIV performs approximate selection of genetic variants that are valid instruments, and provides unbiased estimates of the causal effects. We provide details on a number of existing methods, together with a comparison of their performance in a large series of simulations. CIV performs robustly across different pleiotropic violations of the MR assumptions. We also analyzed the data from the Alzheimer’s disease (AD) neuroimaging initiative (ADNI; Mueller et al., 2005. Alzheimer's Dementia, 11(1), 55–66) to disentangle causal relationships of several biomarkers with AD progression.
    Type of Medium: Online Resource
    ISSN: 0741-0395 , 1098-2272
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2019
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  • 2
    In: International Journal of Geriatric Psychiatry, Wiley, Vol. 35, No. 1 ( 2020-01), p. 60-68
    Abstract: To study the frequency of suicidal ideation and its association with clinical and neurobiological correlates among cognitively intact autosomal dominant Alzheimer's disease (ADAD) at‐risk individuals. Methods/Design In a cross‐sectional study of 183 ADAD at‐risk individuals (91 mutation carriers and 92 noncarriers), we compared the frequency of suicidal ideation among carriers and noncarriers. Linear mixed‐effects models with family‐level random effects evaluated the relationships between geriatric depression scale (GDS), neuropsychiatric inventory‐questionnaire (NPI‐Q), and suicidal ideation scores among all ADAD at‐risk individuals. An interaction term was added to the regression models to evaluate the interactions of suicidal ideation and mutation status on neuropsychiatric symptoms. Results Twenty‐six (14.20%) ADAD at‐risk individuals (13 [14.28%] carriers and 13 [14.13%] noncarriers) had suicidal ideation. The frequency of suicidal ideation did not differ between carriers and noncarriers. Suicidal ideation was associated with higher GDS among all ADAD at‐risk individuals. When stratified into mutation carrier status, noncarriers with suicidal ideation had higher GDS than carriers. There was no statistically significant association between suicidal ideation and NPI‐Q among ADAD at‐risk individuals. Awareness of mutation status, neuropsychological performances, and cerebrospinal fluid AD biomarkers were not associated with suicidal ideation among carriers and noncarriers. Conclusions Suicidal ideation is common among cognitively intact ADAD at‐risk individuals. While ADAD at‐risk individuals with suicidal ideation have greater depressive symptoms, noncarriers with suicidal ideation have higher GDS scores than carriers. Interestingly, awareness of the mutation status was not associated with suicidal ideation in our study. Early identification of suicidal thoughts can facilitate timely interventions to prevent suicidal behaviours. Keywords autosomal dominant Alzheimer's diseasedominantly inherited Alzheimer's networkneuropsychiatric symptomssuicidal ideation
    Type of Medium: Online Resource
    ISSN: 0885-6230 , 1099-1166
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2020
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  • 3
    In: Brain Communications, Oxford University Press (OUP), Vol. 3, No. 2 ( 2021-04-05)
    Abstract: Alzheimer’s disease biomarkers are primarily evaluated through MRI, PET and CSF methods in order to diagnose and monitor disease. Recently, advances in the assessment of blood-based biomarkers have shown promise for simple, inexpensive, accessible and minimally invasive tools with diagnostic and prognostic value for Alzheimer’s disease. Most recently, plasma phosphorylated tau181 has shown excellent performance. The relationship between plasma phosphorylated tau181 and cerebral metabolic dysfunction assessed by [18F]fluorodeoxyglucose PET in Alzheimer’s disease is still unknown. This study was performed on 892 older individuals (297 cognitively unimpaired; 595 cognitively impaired) from the Alzheimer’s Disease Neuroimaging Initiative cohort. Plasma phosphorylated tau181 was assessed using single molecular array technology and metabolic dysfunction was indexed by [18F] fluorodeoxyglucose PET. Cross-sectional associations between plasma and CSF phosphorylated tau181 and [18F]fluorodeoxyglucose were assessed using voxelwise linear regression models, with individuals stratified by diagnostic group and by β-amyloid status. Associations between baseline plasma phosphorylated tau181 and longitudinal (24 months) rate of brain metabolic decline were also assessed in 389 individuals with available data using correlations and voxelwise regression models. Plasma phosphorylated tau181 was elevated in β-amyloid positive and cognitively impaired individuals as well as in apolipoprotein E ε4 carriers and was significantly associated with age, worse cognitive performance and CSF phosphorylated tau181. Cross-sectional analyses showed strong associations between plasma phosphorylated tau181 and [18F] fluorodeoxyglucose PET in cognitively impaired and β-amyloid positive individuals. Voxelwise longitudinal analyses showed that baseline plasma phosphorylated tau181 concentrations were significantly associated with annual rates of metabolic decline in cognitively impaired individuals, bilaterally in the medial and lateral temporal lobes. The associations between plasma phosphorylated tau181 and reduced brain metabolism, primarily in cognitively impaired and in β-amyloid positive individuals, supports the use of plasma phosphorylated tau181 as a simple, low-cost, minimally invasive and accessible tool to both assess current and predict future metabolic dysfunction associated with Alzheimer’s disease, comparatively to PET, MRI and CSF methods.
    Type of Medium: Online Resource
    ISSN: 2632-1297
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
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  • 4
    In: Brain Communications, Oxford University Press (OUP), Vol. 5, No. 3 ( 2023-05-02)
    Abstract: A classical early sign of typical Alzheimer’s disease is memory decline, which has been linked to the aggregation of tau in the medial temporal lobe. Verbal delayed free recall and recognition tests have consistently probed useful to detect early memory decline, and there is substantial debate on how performance, particularly in recognition tests, is differentially affected through health and disease in older adults. Using in vivo PET-Braak staging, we investigated delayed recall and recognition memory dysfunction across the Alzheimer’s disease spectrum. Our cross-sectional study included 144 cognitively unimpaired elderly, 39 amyloid-β+ individuals with mild cognitive impairment and 29 amyloid-β+ Alzheimer’s disease patients from the Translational Biomarkers in Aging and Dementia cohort, who underwent [18F]MK6240 tau and [18F] AZD4694 amyloid PET imaging, structural MRI and memory assessments. We applied non-parametric comparisons, correlation analyses, regression models and voxel-wise analyses. In comparison with PET-Braak Stage 0, we found that reduced, but not clinically significant, delayed recall starts at PET-Braak Stage II (adjusted P & lt; 0.0015), and that recognition (adjusted P = 0.011) displayed a significant decline starting at PET-Braak Stage IV. While performance in both delayed recall and recognition related to tau in nearly the same cortical areas, further analyses showed that delayed recall rendered stronger associations in areas of early tau accumulation, whereas recognition displayed stronger correlations in mostly posterior neocortical regions. Our results support the notion that delayed recall and recognition deficits are predominantly associated with tau load in allocortical and neocortical areas, respectively. Overall, delayed recall seems to be more dependent on the integrity of anterior medial temporal lobe structures, while recognition appears to be more affected by tau accumulation in cortices beyond medial temporal regions.
    Type of Medium: Online Resource
    ISSN: 2632-1297
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
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  • 5
    In: Nature Medicine, Springer Science and Business Media LLC, Vol. 27, No. 9 ( 2021-09), p. 1592-1599
    Type of Medium: Online Resource
    ISSN: 1078-8956 , 1546-170X
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
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  • 6
    In: Brain, Oxford University Press (OUP), Vol. 143, No. 9 ( 2020-09-01), p. 2818-2830
    Abstract: Braak stages of tau neurofibrillary tangle accumulation have been incorporated in the criteria for the neuropathological diagnosis of Alzheimer’s disease. It is expected that Braak staging using brain imaging can stratify living individuals according to their individual patterns of tau deposition, which may prove crucial for clinical trials and practice. However, previous studies using the first-generation tau PET agents have shown a low sensitivity to detect tau pathology in areas corresponding to early Braak histopathological stages (∼20% of cognitively unimpaired elderly with tau deposition in regions corresponding to Braak I–II), in contrast to ∼80–90% reported in post-mortem cohorts. Here, we tested whether the novel high affinity tau tangles tracer 18F-MK-6240 can better identify individuals in the early stages of tau accumulation. To this end, we studied 301 individuals (30 cognitively unimpaired young, 138 cognitively unimpaired elderly, 67 with mild cognitive impairment, 54 with Alzheimer’s disease dementia, and 12 with frontotemporal dementia) with amyloid-β 18F-NAV4694, tau 18F-MK-6240, MRI, and clinical assessments. 18F-MK-6240 standardized uptake value ratio images were acquired at 90–110 min after the tracer injection. 18F-MK-6240 discriminated Alzheimer’s disease dementia from mild cognitive impairment and frontotemporal dementia with high accuracy (∼85–100%). 18F-MK-6240 recapitulated topographical patterns consistent with the six hierarchical stages proposed by Braak in 98% of our population. Cognition and amyloid-β status explained most of the Braak stages variance (P  & lt; 0.0001, R2 = 0.75). No single region of interest standardized uptake value ratio accurately segregated individuals into the six topographic Braak stages. Sixty-eight per cent of the cognitively unimpaired elderly amyloid-β-positive and 37% of the cognitively unimpaired elderly amyloid-β-negative subjects displayed tau deposition, at least in the transentorhinal cortex (Braak I). Tau deposition solely in the transentorhinal cortex was associated with an elevated prevalence of amyloid-β, neurodegeneration, and cognitive impairment (P  & lt; 0.0001). 18F-MK-6240 deposition in regions corresponding to Braak IV–VI was associated with the highest prevalence of neurodegeneration, whereas in Braak V–VI regions with the highest prevalence of cognitive impairment. Our results suggest that the hierarchical six-stage Braak model using 18F-MK-6240 imaging provides an index of early and late tau accumulation as well as disease stage in preclinical and symptomatic individuals. Tau PET Braak staging using high affinity tracers has the potential to be incorporated in the diagnosis of living patients with Alzheimer’s disease in the near future.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
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  • 7
    In: Brain, Oxford University Press (OUP), Vol. 147, No. 5 ( 2024-05-03), p. 1680-1695
    Abstract: Insulin, insulin-like growth factors (IGF) and their receptors are highly expressed in the adult hippocampus. Thus, disturbances in the insulin-IGF signalling pathway may account for the selective vulnerability of the hippocampus to nascent Alzheimer's disease (AD) pathology. In the present study, we examined the predominant IGF-binding protein in the CSF, IGFBP2. CSF was collected from 109 asymptomatic members of the parental history-positive PREVENT-AD cohort. CSF levels of IGFBP2, core AD and synaptic biomarkers were measured using proximity extension assay, ELISA and mass spectrometry. Cortical amyloid-beta (Aβ) and tau deposition were examined using 18F-NAV4694 and flortaucipir. Cognitive assessments were performed during up to 8 years of follow-up, using the Repeatable Battery for the Assessment of Neuropsychological Status. T1-weighted structural MRI scans were acquired, and neuroimaging analyses were performed on pre-specified temporal and parietal brain regions. Next, in an independent cohort, we allocated 241 dementia-free ADNI-1 participants into four stages of AD progression based on the biomarkers CSF Aβ42 and total-tau (t-tau). In this analysis, differences in CSF and plasma IGFBP2 levels were examined across the pathological stages. Finally, IGFBP2 mRNA and protein levels were examined in the frontal cortex of 55 autopsy-confirmed AD and 31 control brains from the Quebec Founder Population (QFP) cohort, a unique population isolated from Eastern Canada. CSF IGFBP2 progressively increased over 5 years in asymptomatic PREVENT-AD participants. Baseline CSF IGFBP2 was positively correlated with CSF AD biomarkers and synaptic biomarkers, and negatively correlated with longitudinal changes in delayed memory (P = 0.024) and visuospatial abilities (P = 0.019). CSF IGFBP2 was negatively correlated at a trend-level with entorhinal cortex volume (P = 0.082) and cortical thickness in the piriform (P = 0.039), inferior temporal (P = 0.008), middle temporal (P = 0.014) and precuneus (P = 0.033) regions. In ADNI-1, CSF (P = 0.009) and plasma (P = 0.001) IGFBP2 were significantly elevated in Stage 2 [CSF Aβ(+)/t-tau(+)]. In survival analyses in ADNI-1, elevated plasma IGFBP2 was associated with a greater rate of AD conversion (hazard ratio = 1.62, P = 0.021). In the QFP cohort, IGFBP2 mRNA was reduced (P = 0.049); however, IGFBP2 protein levels did not differ in the frontal cortex of autopsy-confirmed AD brains (P = 0.462). Nascent AD pathology may induce an upregulation in IGFBP2 in asymptomatic individuals. CSF and plasma IGFBP2 may be valuable markers for identifying CSF Aβ(+)/t-tau(+) individuals and those with a greater risk of AD conversion.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
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  • 8
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 88, No. 16_supplement ( 2017-04-18)
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 9
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S10 ( 2023-12)
    Abstract: Plasma markers of tau are currently being studied as proxies of cerebral neurofibrillary tangle (NFT) accumulation. Phosphorylated tau (pTau) and N‐terminal tau fragment (NTA) assays are associated with present and future tau‐PET load. Our aim was to investigate whether plasma markers could predict whether someone will be a slow or fast accumulator. Method We assessed 143 individuals [72 CU, 54 MCI, 17 AD] from the TRIAD cohort, with two available [18F] MK6240 tau‐PET scans and calculated the relative change (Δ[18F]MK6240) between baseline and follow‐up [mean follow‐up time: 2.1 ± 0.7 years] . We used tertiles to divide individuals as slow, medium and fast accumulators. Additionally, we measured baseline plasma pTau181, pTau217, pTau231 and NTA concentrations. We computed the effect size (Cohen’s d) and area under the curve (AUC) for each plasma marker for Δ[18F]MK6240 between slow and fast accumulators. Δ[18F] MK6240 was calculated in Braak stages I/II, III/IV and V/VI. Result We first observed that the highest effect size for Δ[18F]MK6240 in Braak I/II was depicted by pTau231. For Δ[18F] MK6240 in Braak III/IV and Braak V/VI, pTau217 presented the highest effect size (Figure 1). Moreover, AUC values were the highest, and highly similar, in ΔBraak I/II for pTau181, pTau217 and pTau231. For ΔBraak III/IV, pTau181 and pTau217 presented the highest values. Finally, AUC for ΔBraak V/VI, pTau231 and NTA had the highest values, which were also similar (Figure 2). Conclusion Plasma pTau biomarkers (181, 217 and 231) are great predictors of fast accumulation in early to middle Braak regions. For late Braak regions, fast accumulation was best predicted by pTau217 and NTA. Plasma markers are able to determine whether someone will be a fast accumulator in a stage‐specific manner. The currently available tau biofluid measures could be used in the clinical and clinical trial settings, as these are less invasive and cheaper than CSF or PET assessments. Especially in the recruitment phase, pTau217 could be used for screening individuals that are more likely to accumulate tau fast.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2211627-8
    detail.hit.zdb_id: 2201940-6
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  • 10
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S15 ( 2023-12)
    Abstract: Plasma markers of tau are currently being studied as proxies of cerebral neurofibrillary tangle (NFT) accumulation. Phosphorylated tau (pTau) and N‐terminal tau fragment (NTA) assays are associated with present and future tau‐PET load. Our aim was to investigate whether plasma markers could predict whether someone will be a slow or fast accumulator. Method We assessed 143 individuals [72 CU, 54 MCI, 17 AD] from the TRIAD cohort, with two available [ 18 F]MK6240 tau‐PET scans and calculated the relative change (Δ[ 18 F]MK6240) between baseline and follow‐up [mean follow‐up time: 2.1 ± 0.7 years] . We used tertiles to divide individuals as slow, medium and fast accumulators. Additionally, we measured baseline plasma pTau181, pTau217, pTau231 and NTA concentrations. We computed the effect size (Cohen’s d) and area under the curve (AUC) for each plasma marker for Δ[ 18 F]MK6240 between slow and fast accumulators. Δ[ 18 F]MK6240 was calculated in Braak stages I/II, III/IV and V/VI. Result We first observed that the highest effect size for Δ[ 18 F]MK6240 in Braak I/II was depicted by pTau231. For Δ[ 18 F]MK6240 in Braak III/IV and Braak V/VI, pTau217 presented the highest effect size (Figure 1). Moreover, AUC values were the highest, and highly similar, in ΔBraak I/II for pTau181, pTau217 and pTau231. For ΔBraak III/IV, pTau181 and pTau217 presented the highest values. Finally, AUC for ΔBraak V/VI, pTau231 and NTA had the highest values, which were also similar (Figure 2). Conclusion Plasma pTau biomarkers (181, 217 and 231) are great predictors of fast accumulation in early to middle Braak regions. For late Braak regions, fast accumulation was best predicted by pTau217 and NTA. Plasma markers are able to determine whether someone will be a fast accumulator in a stage‐specific manner. The currently available tau biofluid measures could be used in the clinical and clinical trial settings, as these are less invasive and cheaper than CSF or PET assessments. Especially in the recruitment phase, pTau217 could be used for screening individuals that are more likely to accumulate tau fast.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2211627-8
    detail.hit.zdb_id: 2201940-6
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