The nonlinear relationship between cerebrospinal fluid A beta(42) and tau in preclinical Alzheimer's disease
Por:
de Leon, MJ, Pirraglia, E, Osorio, RS, Glodzik, L, Saint-Louis, L, Kim, HJ, Fortea, J, Fossati, S, Laska, E, Siegel, C, Butler, T, Li, Y, Rusinek, H, Zetterberg, H, Blennow, K, Alzheimer's Dis Neuroimaging, Natl Alzheimer's Coordinating Ctr
Publicada:
7 feb 2018
Resumen:
Cerebrospinal fluid (CSF) studies consistently show that CSF levels of amyloid-beta 1-42 (A beta(42)) are reduced and tau levels increased prior to the onset of cognitive decline related to Alzheimer's disease (AD). However, the preclinical prediction accuracy for low CSF A beta(42) levels, a surrogate for brain A beta(42) deposits, is not high. Moreover, the pathology data suggests a course initiated by tauopathy contradicting the contemporary clinical view of an A beta initiated cascade. CSF A beta(42) and tau data from 3 normal aging cohorts (45-90 years) were combined to test both cross-sectional (n = 766) and longitudinal (n = 651) hypotheses: 1) that the relationship between CSF levels of A beta(42) and tau are not linear over the adult life-span; and 2) that non-linear models improve the prediction of cognitive decline. Supporting the hypotheses, the results showed that a u-shaped quadratic fit (A beta(2)) best describes the relationship for CSF A beta(42) with CSF tau levels. Furthermore we found that the relationship between A beta(42) and tau changes with age-between 45 and 70 years there is a positive linear association, whereas between 71 and 90 years there is a negative linear association between A beta(42) and tau. The quadratic effect appears to be unique to A beta(42), as A beta(38) and A beta(40) showed only positive linear relationships with age and CSF tau. Importantly, we observed the prediction of cognitive decline was improved by considering both high and low levels of A beta(42). Overall, these data suggest an earlier preclinical stage than currently appreciated, marked by CSF elevations in tau and accompanied by either elevations or reductions in A beta(42). Future studies are needed to examine potential mechanisms such as failing CSF clearance as a common factor elevating CSF A beta(xx) analyte levels prior to A beta(42) deposition in brain.
Filiaciones:
de Leon, MJ:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Pirraglia, E:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
NYU Med Ctr, Dept Populat Hlth, Div Biostat, New York, NY 10016 USA
Osorio, RS:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Nathan S Kline Inst Psychiat Res, Orangeburg, NY USA
Glodzik, L:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
NYU Med Ctr, Dept Radiol, New York, NY 10016 USA
Saint-Louis, L:
Lennox Hill Radiol, New York, NY USA
Kim, HJ:
Hanyang Univ, Dept Neurol, Memory Unit, Seoul, South Korea
Fortea, J:
Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Barcelona, Spain
Fossati, S:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Laska, E:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Siegel, C:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Butler, T:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Li, Y:
NYU Med Ctr, Dept Psychiat, Ctr Brain Hlth, New York, NY 10016 USA
Rusinek, H:
NYU Med Ctr, Dept Radiol, New York, NY 10016 USA
Zetterberg, H:
Univ Gothenburg, Sahlgrenska Univ Hosp, Molndal, Sweden
Univ Gothenburg, Sahlgrenska Acad, Dept Psychiat & Neurochem, Inst Neurosci & Physiol, Molndal, Sweden
UCL Inst Neurol, Dept Mol Neurosci, London, England
UK Dementia Res Inst, London, England
Blennow, K:
Univ Gothenburg, Sahlgrenska Univ Hosp, Molndal, Sweden
Univ Gothenburg, Sahlgrenska Acad, Dept Psychiat & Neurochem, Inst Neurosci & Physiol, Molndal, Sweden
Gold, Green Published
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