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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S1 ( 2022-12)
    Abstract: Neurofibrillary tangle pathology is thought to drive neurodegeneration in beta‐amyloid positive (A+) cognitively normal (CN) individuals, i.e., preclinical Alzheimer’s disease (AD).However, in beta‐amyloid negative (A‐) CN, the contribution of tau pathology [primary age‐related tauopathy (PART)] to neurodegeneration remains uncertain. We investigate the correlation between tau burden measured by PET in the medial temporal lobe (MTL) and MRI‐derived cross‐sectional and longitudinal structural atrophy in these cohorts. Methods 420 CN (A‐/A+: 294/101, Table 1) individuals from ADNI with AV1451 PET and T1‐weighted MRI acquired within one year were included. Bilateral anterior/posterior hippocampal volume and thickness of entorhinal cortex (ERC), Brodmann areas 35/36 (BA35/BA36) and parahipocampal cortex (PHC) were obtained from baseline MRI scans. Bilateral MTL tau burden was computed as AV1451 uptake across ERC and BA35. Beta‐amyloid status was determined with PET by standard cut‐offs (Florbetapir: 1.11; Florbetaben: 1.08). In a subset of participants with prospective longitudinal MRI scans (up to 4.5 years), annualized volume change rate of each MTL subregion was estimated. Intracranial volume and MRI follow‐up time were additional covariates for cross‐sectional and longitudinal analysis respectively. We performed the analysis separately for each hemisphere in the whole CN cohort and its A+ and A‐ subgroups. Results Tau burden was significantly associated with cross‐sectional left BA35/36 thickness in the whole cohort and bilateral volume in both A+ CN and the whole cohort (Table 2, Figure 1), but not in in A‐ CN. Stronger correlations between MTL tau burden and longitudinal atrophy, despite smaller sample size, was observed in almost all the MTL subregions regardless of amyloid status (Table 3, Figure 1). In general, effects from the left hemisphere were stronger than those from the right hemisphere. All significant correlations were maintained when corrected for beta‐amyloid PET SUVR. Conclusions The results demonstrated that elevated tau predicts subsequent neurodegeneration in early Braak regions in CN subjects regardless of amyloid status. This indicates that PART may be an important driver of neurodegeneration already during normal ageing in cognitively normal individuals.
    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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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S1 ( 2022-12)
    Abstract: Different tau biomarkers become abnormal at different stages of Alzheimer’s disease (AD), with CSF p‐tau typically being elevated at subthreshold levels of tau‐PET binding. To capitalize on the temporal order of tau biomarker‐abnormality and capture the earliest changes of tau accumulation, we selected a group of amyloid‐β‐positive (A+) individuals with elevated CSF p‐tau levels but negative tau‐PET scans and assessed longitudinal changes in tau‐PET, cortical thickness and cognitive decline. Method Individuals without dementia (i.e., cognitively unimpaired (CU) or mild cognitive impairment, n=231) were selected from the BioFINDER‐2 study. These subjects were categorized into biomarker groups based on Gaussian mixture modelling to determine cut‐offs for abnormal CSF Aβ42/40 (A; 〈 0.078), CSF p‐tau 217 (P; 〉 110 pg/ml) and [ 18 F]RO948 tau‐PET SUVR within a temporal meta‐ROI (T; SUVR 〉 1.40). Resulting groups were: A+P‐T‐ (concordant, n=30), A+P+T‐ (discordant, n=48) and A+P+T+ (concordant, n=18). We additionally used 135 A‐ CU individuals (A‐ CU) as a reference group (Tables 1 and 2). Differences in annual change in regional tau‐PET SUVR, cortical thickness and cognition between the A+P+T‐ group and the other groups were assessed using general linear models, adjusted for age, sex, clinical diagnosis and (for cognitive measures) education. Result Longitudinal change in tau‐PET was faster in the A+P+T‐ group than in the A‐ CU and A+P‐T‐ groups across medial temporal and neocortical regions, with the medial temporal increases being more pronounced. The A+P+T‐ group showed slower rate of increases in tau‐PET compared to the A+P+T+ group, primarily in neocortical regions (Figures 1 and 2). We did not detect differences in yearly change in cortical thickness (Figure 3) or in cognitive decline (Figure 3) between the A+P+T‐ and A+P‐T‐ groups. The A+P+T+ group, however, showed faster cognitive decline compared to all other groups. Conclusion These findings suggest that the A+P+T‐ biomarker profile is associated with early tau accumulation, and with relative sparing of cortical thinning and cognitive decline compared to A+P+T+ individuals. Therefore, the A+P+T‐ group represents an interesting target‐group for early anti‐tau interventions and for examining the emergence of tau aggregates in early AD.
    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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  • 3
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S5 ( 2022-12)
    Abstract: Ex vivo magnetic resonance imaging (MRI) of the brain provides remarkable advantages over in vivo MRI for linking neuroanatomy and morphometry to underlying pathology (Yushkevich et al. 2021, Ravikumar et al. 2021). Subcortical structures show atrophy in certain neurodegenerative diseases, especially Frontotemporal Lobar Degeneration with TDP‐43 (FTLD‐TDP) and four‐repeat (4R) tauopathies (i.e., Corticobasal Degeneration, Progressive Supranuclear Palsy) (Miletić et al. 2022), yet few methods exist to measure subcortical atrophy in ex vivo MRI. We present a framework to quantify subcortical morphometry using 7 Tesla ex vivo MRI and distinguish atrophy patterns across neurodegenerative spectrums. Method A deep learning method, nnU‐Net (Isensee et al. 2021), was trained on manual segmentations from only 3 brain hemispheres to obtain automated segmentations of 4 subcortical structures (caudate, putamen, globus pallidus, thalamus) across 38 subjects spanning Alzheimer's Disease (AD), Lewy Body Disease (LBD), FTLD‐TDP, 4R tauopathies and miscellaneous tauopathies (Figure 1, Table 1). Subcortical volumes were extracted from automated segmentations. Cerebral cortical volume was computed via cortical segmentation method in Khandelwal et al. 2021. Regional volumes were evaluated via likelihood ratio tests (Figure 2), adjusted for covariates (age, sex and intracranial volume from in vivo MRI) and multiple tests. Separately, correlations were computed between subcortical volumes, cortical thicknesses at 18 landmark locations and neuropathological ratings (Khandelwal et al. 2021, Wisse et al. 2021, Figure 3). Result The pipeline validated regional volumetric relationships in neurodegeneration. Global cortex volume did not significantly differ among disease groups (Figure 2). Compared to AD, FTLD‐TDP had significantly lower putamen and thalamus volumes while 4R tauopathies had reduced putamen and caudate volumes ( P ’s 〈 0.05, adjusted for covariates/multiple comparisons). Before multiple tests correction, there were decreased covariate‐adjusted volumes in globus pallidus and caudate in FTLD‐TDP and thalamus in 4R tauopathy relative to AD. Subcortical volumes correlated with each other ( P ’s 〈 0.05) but not with cortical thickness, with trends in motor cortex (Figure 3). Subcortical volumes also trended with local tau pathology (Figure 4). Conclusion Our ex vivo neuroimaging framework differentiates subcortical atrophy patterns in FTLD‐TDP and 4R tauopathies compared to AD, highlighting utility in ex vivo imaging for diagnosing and investigating neurodegeneration.
    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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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S6 ( 2022-12)
    Abstract: Tau pathology in the medial temporal lobe (MTL) is closely linked to neurodegeneration, and is an early pathological change associated with Alzheimer’s disease (AD). MRI measures of MTL neurodegeneration have proven to be sensitive to change during preclinical AD. Current measures are confounded by the presence of non‐AD pathologies (e.g., TDP‐43, ageing). Here, we combine ex vivo imaging with histopathological ratings of tau and TDP‐43 to identify fine‐grained MTL atrophy patterns specific to tau. Such an analysis could be used to define MTL “hotspots” where in vivo measures of neurodegeneration are expected to be strongly associated with tau, potentially enabling the development of biomarkers that are more effective during early AD clinical trials. Method Ex vivo MRI scans (0.2x0.2x0.2mm 3 , 9.4T) of human MTL specimens were combined using a customized registration approach to construct a 3D atlas. Using serial histology available in a subset of specimens (n = 11), MTL subregions in the atlas were labelled based on cytoarchitecture (Ravikumar et al., 2021) (Figure 1A). To perform thickness analysis, 29 specimens containing a primary diagnosis of AD or primary age‐related tauopathy were registered to the atlas (13 specimens were registered to the atlas during atlas construction, and 16 were registered to the atlas after it was constructed) (Figure 1B, Table 1). Using histopathology measures of tau and TDP‐43 pathology (based on contralateral sampling), we investigated the association between tau and thickness by fitting a linear model (with age/TDP‐43 as covariates) at each point along the MTL and SRLM surface. Result Pointwise thickness analysis reveals significant atrophy patterns in the transentorhinal region and SRLM. When excluding age from the model, stronger tau associations are observed in the SRLM, entorhinal cortex, and extending further towards Brodmann Area 35 (Figure 2). Conclusion Our findings are consistent with early Braak stages but suggest that covarying for age may be obscuring some associations due to tau since age and tau burden have a highly correlated relationship (Figure 3). In future work, quantitative maps of NFT burden will be mapped from serial pathology images into atlas space, allowing us to characterize NFT distribution in 3D (Yushkevich et al., 2021).
    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 & Dementia, Wiley, Vol. 18, No. S6 ( 2022-12)
    Abstract: The medial temporal lobe (MTL) is hypothesized to be relatively spared in early‐onset compared to late‐onset Alzheimer’s disease (AD). However, detailed examination of MTL subfields comparing amnestic early‐ and late‐onset AD is lacking. We investigate MTL subfield atrophy patterns in individuals with amnestic early‐ and late‐onset cognitive impairment (EOCI and LOCI). Methods Cognitively impaired (mild cognitive impairment and dementia) adults from the BioFINDER‐2 study with memory impairment ( 〉 1.5SD age‐ and education‐specific norms), amyloid‐beta (Aβ+ based on CSF Aβ42/40), and tau positivity were included (Table 1). [ 18 F]RO948‐PET standardized uptake value ratios (SUVRs) were calculated for the MTL, and tau‐PET positivity was determined from a temporal meta‐ROI. EOCI individuals were 〈 65 years, LOCI 〉 70 years of age. Self‐reported age‐of‐onset matched with EO/LO status. Two reference groups of Aβ‐ cognitively unimpaired (CU) which were age‐matched to EOCI/LOCI were included. Hippocampal subfield volumes and thickness of entorhinal cortex, Brodmann areas (BA)35/36, and parahippocampal cortex were obtained using Automated Segmentation for Hippocampal Subfields packages for T1‐ and T2‐weighted MRI. We focused particularly on BA35, region with earliest tau accumulation. Episodic memory was determined (errors on delayed word‐list recall). Results Compared to CU, LOCI showed widespread atrophy across all MTL subfields, while the atrophy pattern in EOCI was slightly more restrictive (Fig. 1). Compared to EOCI, LOCI showed more severe atrophy in hippocampal subfields and entorhinal cortex. There was no difference between EOCI and LOCI for MTL tau‐PET SUVR (Fig. 2). Zooming in on BA35, there was a trend for an association between MTL tau‐PET SUVR and BA35 atrophy in LOCI. This association was stronger for EOCI but non‐significant, likely due to limited power (Fig. 2C). In both groups, smaller BA35 was associated with worse episodic memory (Fig. 3A). In LOCI, higher MTL tau‐PET SUVR was associated with worse episodic memory (Fig. 3B). Conclusion The findings suggest that MTL tau‐PET uptake and atrophy is present in both amnestic LOCI/EOCI and is related to the observed memory impairment in these groups. The MTL atrophy pattern is more extensive in LOCI, which may be due to longer presence of tau pathology and/or the involvement of comorbid pathologies.
    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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  • 6
    In: Neurobiology of Aging, Elsevier BV, Vol. 109 ( 2022-01), p. 135-144
    Type of Medium: Online Resource
    ISSN: 0197-4580
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 1498414-3
    SSG: 12
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  • 7
    In: Journal of Cerebral Blood Flow & Metabolism, SAGE Publications, Vol. 36, No. 10 ( 2016-10), p. 1708-1717
    Abstract: Cerebral perivascular spaces (PVS) are small physiological structures around blood vessels in the brain. MRI visible PVS are associated with ageing and cerebral small vessel disease (SVD). 7 Tesla (7T) MRI improves PVS detection. We investigated the association of age, vascular risk factors, and imaging markers of SVD with PVS counts on 7 T MRI, in 50 persons aged ≥ 40. The average PVS count ± SD in the right hemisphere was 17 ± 6 in the basal ganglia and 71 ± 28 in the semioval centre. We observed no relation between age or vascular risk factors and PVS counts. The presence of microbleeds was related to more PVS in the basal ganglia (standardized beta 0.32; p = 0.04) and semioval centre (standardized beta 0.39; p = 0.01), and white matter hyperintensity volume to more PVS in the basal ganglia (standardized beta 0.41; p = 0.02). We conclude that PVS counts on 7T MRI are high and are related SVD markers, but not to age and vascular risk factors. This latter finding may indicate that due to the high sensitivity of 7T MRI, the correlation of PVS counts with age or vascular risk factors may be attenuated by the detection of “normal”, non-pathological PVS.
    Type of Medium: Online Resource
    ISSN: 0271-678X , 1559-7016
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2016
    detail.hit.zdb_id: 2039456-1
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  • 8
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S1 ( 2022-12)
    Abstract: The medial temporal lobe (MTL) is hypothesized to be relatively spared in early‐onset compared to late‐onset Alzheimer’s disease (AD). However, detailed examination of MTL subfields comparing amnestic early‐ and late‐onset AD is lacking. We investigate MTL subfield atrophy patterns in individuals with amnestic early‐ and late‐onset cognitive impairment (EOCI and LOCI). Methods Cognitively impaired (mild cognitive impairment and dementia) adults from the BioFINDER‐2 study with memory impairment ( 〉 1.5SD age‐ and education‐specific norms), amyloid‐beta (Aβ+ based on CSF Aβ42/40), and tau positivity were included (Table 1). [ 18 F]RO948‐PET standardized uptake value ratios (SUVRs) were calculated for the MTL, and tau‐PET positivity was determined from a temporal meta‐ROI. EOCI individuals were 〈 65 years, LOCI 〉 70 years of age. Self‐reported age‐of‐onset matched with EO/LO status. Two reference groups of Aβ‐ cognitively unimpaired (CU) which were age‐matched to EOCI/LOCI were included. Hippocampal subfield volumes and thickness of entorhinal cortex, Brodmann areas (BA)35/36, and parahippocampal cortex were obtained using Automated Segmentation for Hippocampal Subfields packages for T1‐ and T2‐weighted MRI. We focused particularly on BA35, region with earliest tau accumulation. Episodic memory was determined (errors on delayed word‐list recall). Results Compared to CU, LOCI showed widespread atrophy across all MTL subfields, while the atrophy pattern in EOCI was slightly more restrictive (Fig. 1). Compared to EOCI, LOCI showed more severe atrophy in hippocampal subfields and entorhinal cortex. There was no difference between EOCI and LOCI for MTL tau‐PET SUVR (Fig. 2). Zooming in on BA35, there was a trend for an association between MTL tau‐PET SUVR and BA35 atrophy in LOCI. This association was stronger for EOCI but non‐significant, likely due to limited power (Fig. 2C). In both groups, smaller BA35 was associated with worse episodic memory (Fig. 3A). In LOCI, higher MTL tau‐PET SUVR was associated with worse episodic memory (Fig. 3B). Conclusion The findings suggest that MTL tau‐PET uptake and atrophy is present in both amnestic LOCI/EOCI and is related to the observed memory impairment in these groups. The MTL atrophy pattern is more extensive in LOCI, which may be due to longer presence of tau pathology and/or the involvement of comorbid pathologies.
    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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  • 9
    In: Alzheimer's & Dementia, Wiley, Vol. 18, No. S6 ( 2022-12)
    Abstract: Different tau biomarkers become abnormal at different stages of Alzheimer’s disease (AD), with CSF p‐tau typically being elevated at subthreshold levels of tau‐PET binding. To capitalize on the temporal order of tau biomarker‐abnormality and capture the earliest changes of tau accumulation, we selected a group of amyloid‐β‐positive (A+) individuals with elevated CSF p‐tau levels but negative tau‐PET scans and assessed longitudinal changes in tau‐PET, cortical thickness and cognitive decline. Method Individuals without dementia (i.e., cognitively unimpaired (CU) or mild cognitive impairment, n=231) were selected from the BioFINDER‐2 study. These subjects were categorized into biomarker groups based on Gaussian mixture modelling to determine cut‐offs for abnormal CSF Aβ42/40 (A; 〈 0.078), CSF p‐tau 217 (P; 〉 110 pg/ml) and [ 18 F]RO948 tau‐PET SUVR within a temporal meta‐ROI (T; SUVR 〉 1.40). Resulting groups were: A+P‐T‐ (concordant, n=30), A+P+T‐ (discordant, n=48) and A+P+T+ (concordant, n=18). We additionally used 135 A‐ CU individuals (A‐ CU) as a reference group (Tables 1 and 2). Differences in annual change in regional tau‐PET SUVR, cortical thickness and cognition between the A+P+T‐ group and the other groups were assessed using general linear models, adjusted for age, sex, clinical diagnosis and (for cognitive measures) education. Result Longitudinal change in tau‐PET was faster in the A+P+T‐ group than in the A‐ CU and A+P‐T‐ groups across medial temporal and neocortical regions, with the medial temporal increases being more pronounced. The A+P+T‐ group showed slower rate of increases in tau‐PET compared to the A+P+T+ group, primarily in neocortical regions (Figures 1 and 2). We did not detect differences in yearly change in cortical thickness (Figure 3) or in cognitive decline (Figure 3) between the A+P+T‐ and A+P‐T‐ groups. The A+P+T+ group, however, showed faster cognitive decline compared to all other groups. Conclusion These findings suggest that the A+P+T‐ biomarker profile is associated with early tau accumulation, and with relative sparing of cortical thinning and cognitive decline compared to A+P+T+ individuals. Therefore, the A+P+T‐ group represents an interesting target‐group for early anti‐tau interventions and for examining the emergence of tau aggregates in early AD.
    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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  • 10
    In: Journal of Alzheimer's Disease, IOS Press, Vol. 89, No. 1 ( 2022-08-30), p. 39-49
    Abstract: Background: Alzheimer’s disease is characterized by the accumulation of amyloid-β (Aβ) into plaques, aggregation of tau into neurofibrillary tangles, and neurodegenerative processes including atrophy. However, there is a poorly understood spatial discordance between initial Aβ deposition and local neurodegeneration. Objective: Here, we test the hypothesis that the cingulum bundle links Aβ deposition in the cingulate cortex to medial temporal lobe (MTL) atrophy. Methods: 21 participants with mild cognitive impairment (MCI) from the UMC Utrecht memory clinic (UMCU, discovery sample) and 37 participants with MCI from Alzheimer’s Disease Neuroimaging Initiative (ADNI, replication sample) with available Aβ-PET scan, T1-weighted and diffusion-weighted MRI were included. Aβ load of the cingulate cortex was measured by the standardized uptake value ratio (SUVR), white matter integrity of the cingulum bundle was assessed by mean diffusivity and atrophy of the MTL by normalized MTL volume. Relationships were tested with linear mixed models, to accommodate multiple measures for each participant. Results: We found at most a weak association between cingulate Aβ and MTL volume (added R2 〈 0.06), primarily for the posterior hippocampus. In neither sample, white matter integrity of the cingulum bundle was associated with cingulate Aβ or MTL volume (added R2 〈 0.01). Various sensitivity analyses (Aβ-positive individuals only, posterior cingulate SUVR, MTL sub region volume) provided similar results. Conclusion: These findings, consistent in two independent cohorts, do not support our hypothesis that loss of white matter integrity of the cingulum is a connecting factor between cingulate gyrus Aβ deposition and MTL atrophy.
    Type of Medium: Online Resource
    ISSN: 1387-2877 , 1875-8908
    Language: Unknown
    Publisher: IOS Press
    Publication Date: 2022
    detail.hit.zdb_id: 2070772-1
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