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Lewy body pathology exacerbates brain hypometabolism and cognitive decline in Alzheimer’s disease

Collij, Lyduine E. LU ; Mastenbroek, Sophie E. LU ; Mattsson-Carlgren, Niklas LU orcid ; Strandberg, Olof LU ; Smith, Ruben LU ; Janelidze, Shorena LU ; Palmqvist, Sebastian LU orcid ; Ossenkoppele, Rik LU and Hansson, Oskar LU orcid (2024) In Nature Communications 15(1).
Abstract

Identifying concomitant Lewy body (LB) pathology through seed amplification assays (SAA) might enhance the diagnostic and prognostic work-up of Alzheimer’s disease (AD) in clinical practice and trials. This study examined whether LB pathology exacerbates AD-related disease progression in 795 cognitively impaired individuals (Mild Cognitive Impairment and dementia) from the longitudinal multi-center observational ADNI cohort. Participants were on average 75 years of age (SD = 7.89), 40.8% were female, 184 (23.1%) had no biomarker evidence of AD/LB pathology, 39 (4.9%) had isolated LB pathology (AD-LB+), 395 (49.7%) had only AD pathology (AD+LB-), and 177 (22.3%) had both pathologies (AD+LB+). The AD+LB+ group showed worst baseline... (More)

Identifying concomitant Lewy body (LB) pathology through seed amplification assays (SAA) might enhance the diagnostic and prognostic work-up of Alzheimer’s disease (AD) in clinical practice and trials. This study examined whether LB pathology exacerbates AD-related disease progression in 795 cognitively impaired individuals (Mild Cognitive Impairment and dementia) from the longitudinal multi-center observational ADNI cohort. Participants were on average 75 years of age (SD = 7.89), 40.8% were female, 184 (23.1%) had no biomarker evidence of AD/LB pathology, 39 (4.9%) had isolated LB pathology (AD-LB+), 395 (49.7%) had only AD pathology (AD+LB-), and 177 (22.3%) had both pathologies (AD+LB+). The AD+LB+ group showed worst baseline performance for most cognitive outcomes and compared to the AD+LB− group faster global cognitive decline and more cortical hypometabolism, particularly in posterior brain regions. Neuropathological examination (n = 61) showed high sensitivity (26/27, 96.3%) and specificity (27/28, 96.4%) of the SAA-test. We showed that co-existing LB-positivity exacerbates cognitive decline and cortical brain hypometabolism in AD. In vivo LB pathology detection could enhance prognostic evaluations in clinical practice and could have implications for clinical AD trial design.

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type
Contribution to journal
publication status
published
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in
Nature Communications
volume
15
issue
1
article number
8061
publisher
Nature Publishing Group
external identifiers
  • scopus:85204002289
  • pmid:39277604
ISSN
2041-1723
DOI
10.1038/s41467-024-52299-1
language
English
LU publication?
yes
id
186bf00c-804f-4e5d-aeea-fc902f385924
date added to LUP
2024-11-12 11:59:58
date last changed
2025-06-11 05:04:26
@article{186bf00c-804f-4e5d-aeea-fc902f385924,
  abstract     = {{<p>Identifying concomitant Lewy body (LB) pathology through seed amplification assays (SAA) might enhance the diagnostic and prognostic work-up of Alzheimer’s disease (AD) in clinical practice and trials. This study examined whether LB pathology exacerbates AD-related disease progression in 795 cognitively impaired individuals (Mild Cognitive Impairment and dementia) from the longitudinal multi-center observational ADNI cohort. Participants were on average 75 years of age (SD = 7.89), 40.8% were female, 184 (23.1%) had no biomarker evidence of AD/LB pathology, 39 (4.9%) had isolated LB pathology (AD-LB+), 395 (49.7%) had only AD pathology (AD+LB-), and 177 (22.3%) had both pathologies (AD+LB+). The AD+LB+ group showed worst baseline performance for most cognitive outcomes and compared to the AD+LB− group faster global cognitive decline and more cortical hypometabolism, particularly in posterior brain regions. Neuropathological examination (n = 61) showed high sensitivity (26/27, 96.3%) and specificity (27/28, 96.4%) of the SAA-test. We showed that co-existing LB-positivity exacerbates cognitive decline and cortical brain hypometabolism in AD. In vivo LB pathology detection could enhance prognostic evaluations in clinical practice and could have implications for clinical AD trial design.</p>}},
  author       = {{Collij, Lyduine E. and Mastenbroek, Sophie E. and Mattsson-Carlgren, Niklas and Strandberg, Olof and Smith, Ruben and Janelidze, Shorena and Palmqvist, Sebastian and Ossenkoppele, Rik and Hansson, Oskar}},
  issn         = {{2041-1723}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Nature Communications}},
  title        = {{Lewy body pathology exacerbates brain hypometabolism and cognitive decline in Alzheimer’s disease}},
  url          = {{http://dx.doi.org/10.1038/s41467-024-52299-1}},
  doi          = {{10.1038/s41467-024-52299-1}},
  volume       = {{15}},
  year         = {{2024}},
}