Nonoverlapping UPSIT items were identified that were individually associated with age and disease. Despite a modest predictive value of the AD-specific items for conversion to AD, the AD-specific items may be useful in enriching samples to better identify those at risk for AD. Further studies are needed with monomolecular and unilateral stimulation and orthogonal biomarker validation to further refine disease- and age-associated signals.
Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loci and evaluate underlying genetic architecture in 37,382 non-Hispanic White (NHW), 6,728 African American, 8,899 Hispanic (HIS), and 3,232 East Asian individuals, performing within-ancestry fixed-effects meta-analysis followed by a cross-ancestry random-effects meta-analysis. We identified 13 loci with cross-ancestry associations including known loci at/near CR1, BIN1, TREM2, CD2AP, PTK2B, CLU, SHARPIN, MS4A6A, PICALM, ABCA7, APOE and two novel loci not previously reported at 11p12 (LRRC4C) and 12q24.13 (LHX5-AS1). Reflecting the power of diverse ancestry in GWAS, we observed the SHARPIN locus using 7.1% the sample size of the original discovering single-ancestry GWAS (n=788,989). We additionally identified three GWS ancestry-specific loci at/near (PTPRK (P=2.4E10-8) and GRB14 (P=1.7E10-8) in HIS), and KIAA0825 (P=2.9E10-8 in NHW). Pathway analysis implicated multiple amyloid regulation pathways (strongest with Padjusted=1.6E10-4) and the classical complement pathway (Padjusted=1.3E10-3). Genes at/near our novel loci have known roles in neuronal development (LRRC4C, LHX5-AS1, and PTPRK) and insulin receptor activity regulation (GRB14). These findings provide compelling support for using traditionally-underrepresented populations for gene discovery, even with smaller sample sizes.
Mounting evidence suggests that amyloid-β (Aβ) and vascular etiologies are intertwined in the pathogenesis of Alzheimer′s disease. Spontaneous fluctuations of the brain blood-oxygen-level-dependent (BOLD) signal, as measured by resting-state functional MRI (rs-fMRI), have been shown to be associated with neuronal activities as well as cerebrovascular hemodynamics. Nevertheless, it is unclear if rs-fMRI BOLD fluctuations are associated with brain Aβ deposition in individuals with an elevated risk of Alzheimer's disease.
We recruited 33 patients with amnestic mild cognitive impairment who underwent rs-fMRI and positron emission tomography (PET). The Aβ standardized uptake value ratio (SUVR) was calculated with cortical white matter as the reference region to improve sensitivity for cortical Aβ quantification. We calculated the amplitudes of low-frequency fluctuations (ALFF) of local BOLD signals in the frequency band of 0.01-0.08 Hz. Applying physiological/vascular signal regression in stepwise increasing levels on the rs-fMRI data, we examined whether local correlations between ALFF and brain Aβ deposition were driven by vascular hemodynamics, spontaneous neuronal activities, or both.
We found that ALFF and Aβ SUVR were negatively correlated in brain regions involving the default-mode and visual networks, with peak correlation at the precuneus, and angular, lingual, and fusiform gyri. Regions with higher ALFF had less Aβ accumulation. The correlated cluster sizes in MNI space were reduced from 3018 mm3 with no physiological/vascular regression to 1072 mm3 with strong physiological/vascular regression, with mean cluster r values at approximately -0.47.
Results demonstrate that both vascular hemodynamics and neuronal activities, as reflected by BOLD fluctuations, are negatively associated with brain Aβ deposition. These findings further imply that local brain blood fluctuations due to either vascular hemodynamics or neuronal activities can affect Aβ homeostasis.
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