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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S5 ( 2021-12)
    Abstract: Cerebrospinal fluid (CSF) tau and beta‐amyloid levels in chronic traumatic encephalopathy (CTE), a disease which can be clinically indistinguishable from Alzheimer’s disease (AD), are largely unknown. We examined postmortem CSF analytes among participants with autopsy confirmed CTE and AD. Method A total of 192 participants from the Boston University AD Center and VA‐BU‐CLF Center had post‐mortem CSF collected at autopsy. Participants were divided into pathological groups based on consensus AD and CTE criteria, resulting in 61 participants with CTE (18 low, 43 high stage), 79 participants with AD (23 low, 56 intermediate to high pathological change), 11 participants with concurrent CTE and AD, and 41 participants lacking both CTE and AD neuropathology. The Meso Scale Discovery immunoassay system was utilized to measure amyloid‐beta (Ab 1‐40, Ab 1‐42 ) , total tau (t‐tau), and phosphorylated tau (p‐tau 181 and p‐tau 231 ). Result The low CTE group had higher levels of p‐tau 231 compared no CTE/no AD (p=0.041), and compared to the low AD group (p=0.018). The low CTE group had lower levels of Aβ 1‐42 compared to no CTE/no AD (p=0.016). The high CTE group had higher levels of p‐tau 231 compared to AD (p=0.025) and lower levels of Aβ 1‐42 compared to the AD group (p=0.015). Importantly, p‐tau 231 and Aβ 1‐42 were predictors of diagnosis of CTE vs. no CTE/no AD and CTE vs. AD (Figure 1). Conclusion Increased CSF p‐tau 231 is a promising potentially sensitive biomarkers of CTE and decreased CSF Aβ 1‐42 in CTE warrants further investigation as to underlying mechanism and potential as an additional CTE biomarker.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 2
    In: Brain, Oxford University Press (OUP), Vol. 145, No. 10 ( 2022-10-21), p. 3546-3557
    Abstract: Blood-based biomarkers such as tau phosphorylated at threonine 181 (phosphorylated-tau181) represent an accessible, cost-effective and scalable approach for the in vivo detection of Alzheimer’s disease pathophysiology. Plasma-pathological correlation studies are needed to validate plasma phosphorylated-tau181 as an accurate and reliable biomarker of Alzheimer’s disease neuropathological changes. This plasma-to-autopsy correlation study included participants from the Boston University Alzheimer’s Disease Research Center who had a plasma sample analysed for phosphorylated-tau181 between 2008 and 2018 and donated their brain for neuropathological examination. Plasma phosphorelated-tau181 was measured with single molecule array technology. Of 103 participants, 62 (60.2%) had autopsy-confirmed Alzheimer’s disease. Average time between blood draw and death was 5.6 years (standard deviation = 3.1 years). Multivariable analyses showed higher plasma phosphorylated-tau181 concentrations were associated with increased odds for having autopsy-confirmed Alzheimer’s disease [AUC = 0.82, OR = 1.07, 95% CI = 1.03–1.11, P & lt; 0.01; phosphorylated-tau standardized (z-transformed): OR = 2.98, 95% CI = 1.50–5.93, P & lt; 0.01]. Higher plasma phosphorylated-tau181 levels were associated with increased odds for having a higher Braak stage (OR = 1.06, 95% CI = 1.02–1.09, P & lt; 0.01) and more severe phosphorylated-tau across six cortical and subcortical brain regions (ORs = 1.03–1.06, P & lt; 0.05). The association between plasma phosphorylated-tau181 and Alzheimer’s disease was strongest in those who were demented at time of blood draw (OR = 1.25, 95%CI = 1.02–1.53), but an effect existed among the non-demented (OR = 1.05, 95% CI = 1.01–1.10). There was higher discrimination accuracy for Alzheimer’s disease when blood draw occurred in years closer to death; however, higher plasma phosphorylated-tau181 levels were associated with Alzheimer’s disease even when blood draw occurred & gt;5 years from death. Ante-mortem plasma phosphorylated-tau181 concentrations were associated with Alzheimer’s disease neuropathology and accurately differentiated brain donors with and without autopsy-confirmed Alzheimer’s disease. These findings support plasma phosphorylated-tau181 as a scalable biomarker for the detection of Alzheimer’s disease.
    Type of Medium: Online Resource
    ISSN: 0006-8950 , 1460-2156
    RVK:
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
    detail.hit.zdb_id: 1474117-9
    SSG: 12
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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S5 ( 2021-12)
    Abstract: In Alzheimer’s disease (AD), plasma biomarkers of neurodegeneration and phosphorylated tau have initial support for their relationship to clinical diagnosis and cognitive outcomes over time (total tau [t‐tau], neurofilament light [NfL] , and p‐tau). To date, only one study has assessed a network model with these data. Here, we assessed the network relations (i.e., conditional dependencies) between diagnostic variables, plasma biomarkers, neuropsychological test performance, and demographic variables using a Gaussian graphical model (GGM) with participants from the Boston University (BU) Alzheimer’s Disease Research Center (ADRC) Longitudinal Clinical Core Registry. Method The sample included individuals with normal cognition (n=235), MCI due to AD (n=181), and AD dementia (n=153). Participants completed a comprehensive battery of neuropsychological tests to assess global cognition, attention, executive function, episodic memory, and language abilities. Diagnoses were adjudicated during multidisciplinary diagnostic consensus conferences. Plasma samples were analyzed using the Simoa technique. Regularized GGMs were estimated with Pearson, polychoric, and polyserial correlations depending on whether the variables were continuous, ordinal, or mixed. Network stability was assessed with a non‐parametric bootstrap of standardized edge weights and a person‐dropping bootstrap of centrality measures with 10,000 samples. Latent dimensions were estimated with Markov chain Monte Carlo (MCMC) simulation. Result Assessment of the model suggested adequate fit, χ 2 (184, N = 569) = 620.46, EBIC = 27,444.53, RMSEA = 0.06, TLI = 0.95. Metrics of strength, closeness centrality, and expected influence met established thresholds of stability. Among biomarkers, diagnosis was connected to p‐tau 181 , β z = 0.07, 95% CI [0.01, 0.12]. Assessment of network centrality suggested that p‐tau 181 ranked relatively highly for betweenness centrality and expected influence and NfL ranked highly for betweenness centrality. In contrast, t‐tau was not connected to any functional or diagnostic variable and did not rank highly for centrality. The biomarker variables loaded similarly on the two latent dimensions and were clustered near consensus conference diagnosis. Conclusion Unlike t‐tau, plasma biomarkers p‐tau 181 and NfL were influential as “central junctions” for other connections in a network of diagnostic, biomarker, and demographic data. The findings support recent research that posits p‐tau 181 and NfL reflect distinct aspects of AD progression (respectively, AD pathology and neurodegeneration).
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. 8 ( 2022-08), p. 1523-1536
    Abstract: We examined the ability of plasma hyperphosphorylated tau (p‐tau) 181 to detect cognitive impairment due to Alzheimer's disease (AD) independently and in combination with plasma total tau (t‐tau) and neurofilament light (NfL). Methods Plasma samples were analyzed using the Simoa platform for 235 participants with normal cognition (NC), 181 with mild cognitive impairment due to AD (MCI), and 153 with AD dementia. Statistical approaches included multinomial regression and Gaussian graphical models (GGMs) to assess a network of plasma biomarkers, neuropsychological tests, and demographic variables. Results Plasma p‐tau 181 discriminated AD dementia from NC, but not MCI, and correlated with dementia severity and worse neuropsychological test performance. Plasma NfL similarly discriminated diagnostic groups. Unlike plasma NfL or t‐tau, p‐tau 181 had a direct association with cognitive diagnosis in a bootstrapped GGM. Discussion These results support plasma p‐tau 181 for the detection of AD dementia and the use of blood‐based biomarkers for optimal disease detection.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2201940-6
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  • 5
    In: Alzheimer's Research & Therapy, Springer Science and Business Media LLC, Vol. 14, No. 1 ( 2022-02-09)
    Abstract: Cerebrospinal fluid (CSF) tau and beta-amyloid levels in chronic traumatic encephalopathy (CTE), a disease which can be clinically indistinguishable from Alzheimer’s disease (AD), are largely unknown. We examined postmortem CSF analytes among participants with autopsy confirmed CTE and AD. Methods In this cross-sectional study 192 participants from the Boston University AD Research Center, VA-BU-CLF Center, and Framingham Heart Study (FHS) had post-mortem CSF collected at autopsy. Participants were divided into pathological groups based on AD and CTE criteria, with 61 CTE participants (18 low, 43 high stage), 79 AD participants (23 low, 56 intermediate to high), 11 participants with CTE combined with AD, and 41 participants lacking both CTE and AD neuropathology. The Meso Scale Discovery immunoassay system was utilized to measure amyloid-beta (Aβ 1-40, Aβ 1-42 ) , total tau (t-tau), and phosphorylated tau (p-tau 181 and p-tau 231 ). CSF analytes were then compared across the pathological groups: no CTE/no AD (control), Low CTE, Low AD, High CTE, Intermediate/High AD, and AD+CTE. Results Among the Low disease state groups, the Low CTE group had significantly higher levels of p-tau 231 versus the control group and compared to the Low AD group. The Low CTE group was also found to have significantly lower levels of Aβ 1-42 compared to the control group. The high CTE group had higher levels of p-tau 231 and lower levels of Aβ 1-42 compared to Intermediate/High AD group. Conclusions Importantly, p-tau 231 and Aβ 1-42 were predictors of diagnosis of CTE vs. control and CTE vs. AD. Increased CSF p-tau 231 is a promising potentially sensitive biomarker of CTE, and CSF Aβ 1-42 needs further investigation in CTE.
    Type of Medium: Online Resource
    ISSN: 1758-9193
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2506521-X
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S6 ( 2021-12)
    Abstract: Repetitive head impact (RHI) exposure has been associated with the neurodegenerative disease chronic traumatic encephalopathy (CTE). Magnetic resonance imaging (MRI) and postmortem research suggest frontotemporal atrophy may be characteristic of CTE. The late effects of RHI on cortical volume remain poorly understood due to focus on male former professional American football players and lack of examination of specific lobar gyri. We leveraged the Boston University Alzheimer’s Disease Research Center (BU ADRC) to compare frontal, temporal, and parietal gyri gray matter thickness between participants with and without RHI exposure. Method 39 participants exposed to RHI and 33 similar‐aged (+/‐ 5 years) participants without RHI from the BU ADRC, all spanning the cognitive continuum, underwent MRI on a 3T Philips. Freesurfer was used to derive regional gray matter cortical thickness values. For the frontal, temporal, and parietal lobes, we computed mean composites of superior, middle, and inferior gyri gray matter measures. Analysis of covariance compared participants with and without RHI, controlling for age, sex, race, education and hippocampal volume. Result Mean age was 62.31 (SD=8.87), 34 (47.2%) were female, and 65 (90.3%) were White. Of the RHI group, 23 (59.0%) played American football, 9 (23.1%) ice hockey, 5 (12.8%) were boxers, and 3 (7.7%) were amateur wrestlers. Compared to non‐RHI, RHI‐exposed participants had decreased gray matter thickness of superior (marginal mean diff [MD]=0.10, p 〈 0.01) and middle frontal gyri (MD=0.06, p=0.03), and the middle temporal gyrus (MD=0.07, p=0.03). There were no differences in gray matter thickness for inferior frontal, superior or inferior temporal, or parietal gyri. Because the CTE tau lesion is uniquely at the sulcal depths, we examined the gray matter thickness of the banks of superior temporal sulcus and RHI participants had reduced thickness (MD=0.09, p=0.02). Conclusion Frontotemporal atrophy may be a characteristic late effect of RHI exposure. Further examination of thickness of different lobar gyri in the setting of RHI may facilitate disease differentiation. Larger samples will be important to examine how the effects of RHI on gray matter cortical thickness differ by sex, sport played, etc.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 7
    In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Wiley, Vol. 15, No. 4 ( 2023-10)
    Abstract: This study examined plasma glial fibrillary acidic protein (GFAP) as a biomarker of cognitive impairment due to Alzheimer's disease (AD) with and against plasma neurofilament light chain (NfL), and phosphorylated tau (p‐tau) 181+231 . Methods Plasma samples were analyzed using Simoa platform for 567 participants spanning the AD continuum. Cognitive diagnosis, neuropsychological testing, and dementia severity were examined for cross‐sectional and longitudinal outcomes. Results Plasma GFAP discriminated AD dementia from normal cognition (adjusted mean difference = 0.90 standard deviation [SD]) and mild cognitive impairment (adjusted mean difference = 0.72 SD), and demonstrated superior discrimination compared to alternative plasma biomarkers. Higher GFAP was associated with worse dementia severity and worse performance on 11 of 12 neuropsychological tests. Longitudinally, GFAP predicted decline in memory, but did not predict conversion to mild cognitive impairment or dementia. Discussion Plasma GFAP was associated with clinical outcomes related to suspected AD and could be of assistance in a plasma biomarker panel to detect in vivo AD.
    Type of Medium: Online Resource
    ISSN: 2352-8729 , 2352-8729
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2832898-X
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  • 8
    Online Resource
    Online Resource
    Cambridge University Press (CUP) ; 2020
    In:  Journal of the International Neuropsychological Society Vol. 26, No. 6 ( 2020-07), p. 545-556
    In: Journal of the International Neuropsychological Society, Cambridge University Press (CUP), Vol. 26, No. 6 ( 2020-07), p. 545-556
    Abstract: To measure caregivers’ and clinicians’ perception of false memories in the lives of patients with memory loss due to Alzheimer’s disease (AD) and mild cognitive impairment (MCI) using a novel false memories questionnaire. Our hypotheses were that false memories are occurring as often as forgetting according to clinicians and family members. Method: This prospective, questionnaire-based study consisting of 20 false memory questions paired with 20 forgetting questions had two forms: one for clinicians and the other for family members of older subjects. In total, 226 clinicians and 150 family members of 49 patients with AD, 44 patients with MCI, and 57 healthy older controls (OCs) completed the questionnaire. Results: False memories occurred nearly as often as forgetting according to clinicians and family members of patients with MCI and AD. Family members of OCs and patients with MCI reported fewer false memories compared to those of the AD group. As Mini-Mental State Examination scores decreased, the mean score increased for both forgetting and false memories. Among clinicians, correlations were observed between the dementia severity of patients seen with both forgetting and false memories questionnaire scores as well as with the impact of forgetting and false memories on daily life. Conclusion: Patients with AD experience false memories almost as frequently as they do forgetting. Given how common false memories are in AD patients, additional work is needed to understand the clinical implications of these false memories on patients’ daily lives. The novel false memories questionnaire developed may be a valuable tool.
    Type of Medium: Online Resource
    ISSN: 1355-6177 , 1469-7661
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2000018-2
    SSG: 5,2
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  • 9
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Cognitive and Behavioral Neurology Vol. 35, No. 3 ( 2022-07-13), p. 188-197
    In: Cognitive and Behavioral Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 35, No. 3 ( 2022-07-13), p. 188-197
    Abstract: Individuals with probable Alzheimer disease (AD) may perform below cutoffs on traditional, memory-based performance validity tests. Previous studies have found success using event-related potentials (ERPs) to detect feigned neurocognitive impairment in younger populations. Objective: To evaluate the utility of an auditory oddball task in conjunction with the P3b peak amplitude to distinguish probable AD from simulated dementia. Method: Twenty individuals with probable AD and 20 older healthy controls (HC) underwent an ERP auditory oddball protocol and the Test of Memory Malingering (TOMM). The HC were asked to perform honestly for one condition and to simulate dementia for the other. The individuals with probable AD were asked to perform honestly. The P3b peak amplitude and button press accuracy were collected from each participant and were analyzed to determine their effectiveness in detecting performance validity. Results: The P3b peak amplitude remained stable regardless of behavioral condition in the HC group. When combined with the TOMM Trial 2 score, the P3b peak amplitude further improved the ability to correctly differentiate individuals with probable AD from HC simulating dementia with 100% sensitivity and 90% specificity. Conclusion: The P3b peak amplitude was found to be an effective physiologic measure of cognitive impairment in individuals with probable AD compared with HC simulating dementia. When combined with the TOMM Trial 2 score, the P3b peak amplitude served as a promising performance validity measure for differentiating individuals with probable AD from HC simulating dementia.
    Type of Medium: Online Resource
    ISSN: 1543-3641
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2063084-0
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  • 10
    In: Alzheimer's & Dementia: Translational Research & Clinical Interventions, Wiley, Vol. 8, No. 1 ( 2022-01)
    Abstract: We aimed to characterize the clinical impact of amyloid PET (APET) in a veteran population with cognitive decline by comparing differences in management between those who did and did not have an APET. Methods This was a retrospective observational study. Poisson regressions and logistic regression were used for comparisons. Results Out of 565 veterans, 197 underwent APET; positivity rate was 36.55%. Having an APET was associated with longer follow‐up, and increased diagnostic variability; it was not associated with number of additional studies, cholinesterase inhibitors prescription, or referrals to research. A positive APET was associated with less diagnostic variability, fewer additional tests, greater cholinesterase inhibitor prescriptions, and more research referrals. Discussion In a medically complex, real‐world population, APET yielded lower positivity rates and was not associated with classical clinical utility variables when comparing patients with and without an APET. APET may be used more to “rule out” rather than to confirm Alzheimer's disease. Highlights Amyloid PET was associated with longer follow‐up, and higher diagnostic variability. No association was seen with cholinesterase inhibitors prescription, or referrals to research. In complex patients, expected amyloid PET positivity rates are lower than previously described. Amyloid PETs were used to “rule out” AD than to confirm the diagnosis of AD.
    Type of Medium: Online Resource
    ISSN: 2352-8737 , 2352-8737
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2832891-7
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