Silvia Bagnoli (Italy)
University of Florence Department of Neuroscience, Psychology, Drug Research and Child HealthAuthor Of 3 Presentations
PLASMA NEUROFILAMENT LIGHT CHAIN AS A USEFUL BIOMARKER IN PRODROMAL PHASES OF ALZHEIMER’S DISEASE
- Deborah Leccese (Italy)
Abstract
Background and Aims:
One of the greatest challenges in Alzheimer’s disease (AD) is the discovery of new non-invasive, sensitive and specific biomarkers, which might be useful in prodromal phases like mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Neurofilament light chain (NfL), a component of neuronal cytoskeleton, is becoming increasingly notable in different neurological diseases including AD, as a valuable marker of neuronal damage. We aimed to assess quantitative differences in plasma NfL levels between SCD, MCI and AD patients investigating the role of NfL in the early stages of AD.
Methods:
We included 16 SCD, 19 MCI and 6 AD patients, who underwent clinical evaluation, neuropsychological assessment, Apolipoprotein E (ApoE) genotyping and plasma NfL analysis with SiMoA assay. Six SCD, 8 MCI, 6 AD patients underwent cerebrospinal fluid (CSF) biomarkers analysis (Aβ1-42, Aβ1-42/1-40, p-tau, t-tau dosage).
Results:
Plasma NfL levels were significantly increased in MCI (22,43 ± 12,74) when compared to SCD patients (12,69 ± 4,84) (p=0,001), but not to AD patients (22,38 ± 3,09). NfL levels were significantly correlated with p-tau (p=0,029) in SCD, with t-tau (p=0,047) and p-tau (p=0,028) in MCI, while no association with CSF biomarkers was found in AD patients.
Conclusions:
Plasma NfL levels increased in MCI compared to SCD, showing a correlation with tau pathology in SCD and MCI patients. Considering the correlation with p-tau, suggestive of AD, plasma NfL levels might be a useful biomarker of neurodegeneration in prodromal phases of AD.
GENDER DIFFERENCES IN COGNITIVE RESERVE: IMPLICATION FOR SUBJECTIVE COGNITIVE DECLINE IN WOMEN.
- Giulia Giacomucci (Italy)
Abstract
Background and Aims:
Subjective Cognitive Decline (SCD) is as a self-experienced decline in cognitive capacity with normal performance on standardized cognitive tests and has been shown to increase risk of Alzheimer’s Disease. The aim of our study was to evaluate factors influencing age at onset and severity of SCD.
Methods:
We included 381 SCD patients, who underwent clinical evaluation, neuropsychological assessment, evaluation of premorbid intelligence by the Test di Intelligenza Breve (TIB), evaluation of cognitive complaints by the Memory Assessment Clinics-Questionnaire (MAC-Q), and Apolipoprotein E (APOE) genotyping.
Results:
Proportion between women and men was significantly different (68.7%, 95% C.I. 63.9–73.4 vs 31.4%, 95% C.I. 26.6–36.0). Women were younger than men at onset of SCD and at the baseline visit (p=0.021), had lower years of education (p=0.007), lower TIB scores (p<0.001), and higher MAC-Q scores (p=0.012). TIB was directly associated with age at onset of SCD both in women and men, while years of education was inversely associated with age at onset only in women (Fig.1). Multivariate analysis showed that sex influences TIB independently from years of education (Fig.2). TIB was directly associated with MAC-Q in men.
Conclusions:
Sex interacts with premorbid intelligence and education level in influencing the age at onset and the severity of SCD. As the effect of education was different between men and women, we speculated that education might act as a minor contributor of cognitive reserve (CR) in women.
PREDICTIVE FACTORS OF PROGRESSION TO TOTAL LOSS OF LANGUAGE AND FUNCTIONAL AUTONOMY IN PRIMARY PROGRESSIVE APHASIA RELATED TO ALZHEIMER’S DISEASE
- Salvatore Mazzeo (Italy)
Abstract
Background and Aims:
Primary Progressive Aphasia (PPA) represents an atypical presentation of Alzheimer’s Disease (AD). Factors associated with different trajectories of linguistic and functional deficit progression have been poorly investigated. We aimed to identify prognostic factors of progression to total language loss (TLL) and loss of functional autonomy (LoFA) by multifactorial approach.
Methods:
23 consecutive patients diagnosed with Alzheimer-related PPA were included. All patients underwent neuropsychological evaluation, [18]F-Fludeoxyglucose-PET brain scan, CSF biomarkers measurement and Apolipoprotein E genotype analysis at baseline and underwent neurological follow-up every 6 months for a mean time of 2.42 years. All patients had positive amyloid-β biomarkers.
Results:
During follow-up, 11 patients progressed to TLL (TLL+). Greater impairment in Writing (p=0.017,Figure 1.A) and higher t-tau (p=0.028, Figure 2) were detected as risk factors for progression to TLL. A cut-off value of 955 pg/ml for t-tau was found to distinguish the two groups (accuracy=76.19%[95%C.I.=59.15%-93.23%]). TLL+ had hypometabolism in middle and superior temporal gyrus, paracentral lobule and precuneus (Figure 3.A), while TLL– had hypometabolism in inferior and middle temporal gyrus and fusiform gyrus (Figure 3.B). 12 patients progressed to LoFA (LoFA+). Impairment in Single-Word Comprehension influenced the risk of progression to LoFA (p=0.031,Figure 1.B). LoFA+ patients showed hypometabolism in left superior and middle temporal gyrus, left supramarginal gyrus, left postcentral gyrus and left fusiform gyrus while LoFA- patients had hypometabolism in left middle and inferior temporal gyrus and left fusiform gyrus.
Conclusions:
Linguistic features, t-tau and brain hypometabolic patterns could be considered as predictive factors for progression to TLL and LoFA in patients with Alzheimer-related PPA.