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Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease.
JAMA Neurol. 2015 Jun; 72(6):656-65.JN

Abstract

IMPORTANCE

Measures of neuronal loss are likely good surrogates for clinical and radiological disease progression in Alzheimer disease (AD). Cerebrospinal fluid (CSF) markers of neuronal injury or neurodegeneration may offer usefulness in predicting disease progression and guiding outcome assessments and prognostic decisions in clinical trials of disease-modifying therapies. Visinin-like protein 1 (VILIP-1) has demonstrated potential usefulness as a marker of neuronal injury in AD.

OBJECTIVE

To investigate the usefulness of CSF VILIP-1, tau, p-tau181, and Aβ42 levels in predicting rates of whole-brain and regional atrophy in early AD and cognitively normal control subjects over time.

DESIGN, SETTING, AND PARTICIPANTS

Longitudinal observational study of brain atrophy in participants with early AD and cognitively normal controls. Study participants had baseline CSF biomarker measurements and longitudinal magnetic resonance imaging assessments for a mean follow-up period of 2 to 3 years. Mixed linear models assessed the ability of standardized baseline CSF biomarker measures to predict rates of whole-brain and regional atrophy over the follow-up period. The setting was The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis. Participants (mean age, 72.6 years) were individuals with a clinical diagnosis of very mild AD (n = 23) and cognitively normal controls (n = 64) who were enrolled in longitudinal studies of healthy aging and dementia. The study dates were 2000 to 2010.

MAIN OUTCOMES AND MEASURES

Correlations between baseline CSF biomarker measures and rates of whole-brain or regional atrophy in the AD and control cohorts over the follow-up period.

RESULTS

Baseline CSF VILIP-1, tau, and p-tau181 levels (but not Aβ42 levels) predicted rates of whole-brain and regional atrophy in AD over the follow-up period. Baseline CSF VILIP-1 levels predicted whole-brain (P = .006), hippocampal (P = .01), and entorhinal (P = .001) atrophy rates at least as well as tau and p-tau181 in early AD. Cognitively normal controls whose CSF VILIP-1, tau, or p-tau181 levels were in the upper tercile had higher rates of whole-brain (P = .02, P = .003, and P = .02, respectively), hippocampal (P = .001, P = .01, and P = .02, respectively), and entorhinal (P = .007, P = .01, and P = .01, respectively) atrophy compared with those whose levels were in the lower 2 terciles.

CONCLUSIONS AND RELEVANCE

Cerebrospinal fluid VILIP-1 levels predict rates of whole-brain and regional atrophy similarly to tau and p-tau181 and may provide a useful CSF biomarker surrogate for neurodegeneration in early symptomatic and preclinical AD.

Authors+Show Affiliations

Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri2Hope Center for Neurological Disorders, Washington University School of Medicine in St Louis, St Louis, Missouri3The Charles F. and Joanne Knight Alzheimer's.The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri5Department of Radiology, Washington University School of Medicine in St Louis, St Louis, Missouri6Department of.Department of Psychology, Washington University School of Medicine in St Louis, St Louis, Missouri.Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri3The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri.Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri2Hope Center for Neurological Disorders, Washington University School of Medicine in St Louis, St Louis, Missouri3The Charles F. and Joanne Knight Alzheimer's.Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri.Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri3The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis, St Louis, Missouri7Department of.Department of Neurology, Washington University School of Medicine in St Louis, St Louis, Missouri2Hope Center for Neurological Disorders, Washington University School of Medicine in St Louis, St Louis, Missouri3The Charles F. and Joanne Knight Alzheimer's.

Pub Type(s)

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25867677

Citation

Tarawneh, Rawan, et al. "Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease." JAMA Neurology, vol. 72, no. 6, 2015, pp. 656-65.
Tarawneh R, Head D, Allison S, et al. Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease. JAMA Neurol. 2015;72(6):656-65.
Tarawneh, R., Head, D., Allison, S., Buckles, V., Fagan, A. M., Ladenson, J. H., Morris, J. C., & Holtzman, D. M. (2015). Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease. JAMA Neurology, 72(6), 656-65. https://doi.org/10.1001/jamaneurol.2015.0202
Tarawneh R, et al. Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease. JAMA Neurol. 2015;72(6):656-65. PubMed PMID: 25867677.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cerebrospinal Fluid Markers of Neurodegeneration and Rates of Brain Atrophy in Early Alzheimer Disease. AU - Tarawneh,Rawan, AU - Head,Denise, AU - Allison,Samantha, AU - Buckles,Virginia, AU - Fagan,Anne M, AU - Ladenson,Jack H, AU - Morris,John C, AU - Holtzman,David M, PY - 2015/4/14/entrez PY - 2015/4/14/pubmed PY - 2015/8/20/medline SP - 656 EP - 65 JF - JAMA neurology JO - JAMA Neurol VL - 72 IS - 6 N2 - IMPORTANCE: Measures of neuronal loss are likely good surrogates for clinical and radiological disease progression in Alzheimer disease (AD). Cerebrospinal fluid (CSF) markers of neuronal injury or neurodegeneration may offer usefulness in predicting disease progression and guiding outcome assessments and prognostic decisions in clinical trials of disease-modifying therapies. Visinin-like protein 1 (VILIP-1) has demonstrated potential usefulness as a marker of neuronal injury in AD. OBJECTIVE: To investigate the usefulness of CSF VILIP-1, tau, p-tau181, and Aβ42 levels in predicting rates of whole-brain and regional atrophy in early AD and cognitively normal control subjects over time. DESIGN, SETTING, AND PARTICIPANTS: Longitudinal observational study of brain atrophy in participants with early AD and cognitively normal controls. Study participants had baseline CSF biomarker measurements and longitudinal magnetic resonance imaging assessments for a mean follow-up period of 2 to 3 years. Mixed linear models assessed the ability of standardized baseline CSF biomarker measures to predict rates of whole-brain and regional atrophy over the follow-up period. The setting was The Charles F. and Joanne Knight Alzheimer's Disease Research Center, Washington University School of Medicine in St Louis. Participants (mean age, 72.6 years) were individuals with a clinical diagnosis of very mild AD (n = 23) and cognitively normal controls (n = 64) who were enrolled in longitudinal studies of healthy aging and dementia. The study dates were 2000 to 2010. MAIN OUTCOMES AND MEASURES: Correlations between baseline CSF biomarker measures and rates of whole-brain or regional atrophy in the AD and control cohorts over the follow-up period. RESULTS: Baseline CSF VILIP-1, tau, and p-tau181 levels (but not Aβ42 levels) predicted rates of whole-brain and regional atrophy in AD over the follow-up period. Baseline CSF VILIP-1 levels predicted whole-brain (P = .006), hippocampal (P = .01), and entorhinal (P = .001) atrophy rates at least as well as tau and p-tau181 in early AD. Cognitively normal controls whose CSF VILIP-1, tau, or p-tau181 levels were in the upper tercile had higher rates of whole-brain (P = .02, P = .003, and P = .02, respectively), hippocampal (P = .001, P = .01, and P = .02, respectively), and entorhinal (P = .007, P = .01, and P = .01, respectively) atrophy compared with those whose levels were in the lower 2 terciles. CONCLUSIONS AND RELEVANCE: Cerebrospinal fluid VILIP-1 levels predict rates of whole-brain and regional atrophy similarly to tau and p-tau181 and may provide a useful CSF biomarker surrogate for neurodegeneration in early symptomatic and preclinical AD. SN - 2168-6157 UR - https://www.unboundmedicine.com/medline/citation/25867677/Cerebrospinal_Fluid_Markers_of_Neurodegeneration_and_Rates_of_Brain_Atrophy_in_Early_Alzheimer_Disease_ DB - PRIME DP - Unbound Medicine ER -