Incremental value of biomarker combinations to predict progression of mild cognitive impairment to Alzheimer’s dementia

Background The progression of mild cognitive impairment (MCI) to Alzheimer’s disease (AD) dementia can be predicted by cognitive, neuroimaging, and cerebrospinal fluid (CSF) markers. Since most biomarkers reveal complementary information, a combination of biomarkers may increase the predictive power. We investigated which combination of the Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR)-sum-of-boxes, the word list delayed free recall from the Consortium to Establish a Registry of Dementia (CERAD) test battery, hippocampal volume (HCV), amyloid-beta1–42 (Aβ42), amyloid-beta1–40 (Aβ40) levels, the ratio of Aβ42/Aβ40, phosphorylated tau, and total tau (t-Tau) levels in the CSF best predicted a short-term conversion from MCI to AD dementia. Methods We used 115 complete datasets from MCI patients of the “Dementia Competence Network”, a German multicenter cohort study with annual follow-up up to 3 years. MCI was broadly defined to include amnestic and nonamnestic syndromes. Variables known to predict progression in MCI patients were selected a priori. Nine individual predictors were compared by receiver operating characteristic (ROC) curve analysis. ROC curves of the five best two-, three-, and four-parameter combinations were analyzed for significant superiority by a bootstrapping wrapper around a support vector machine with linear kernel. The incremental value of combinations was tested for statistical significance by comparing the specificities of the different classifiers at a given sensitivity of 85%. Results Out of 115 subjects, 28 (24.3%) with MCI progressed to AD dementia within a mean follow-up period of 25.5 months. At baseline, MCI-AD patients were no different from stable MCI in age and gender distribution, but had lower educational attainment. All single biomarkers were significantly different between the two groups at baseline. ROC curves of the individual predictors gave areas under the curve (AUC) between 0.66 and 0.77, and all single predictors were statistically superior to Aβ40. The AUC of the two-parameter combinations ranged from 0.77 to 0.81. The three-parameter combinations ranged from AUC 0.80–0.83, and the four- parameter combination from AUC 0.81–0.82. None of the predictor combinations was significantly superior to the two best single predictors (HCV and t-Tau). When maximizing the AUC differences by fixing sensitivity at 85%, the two- to four-parameter combinations were superior to HCV alone. Conclusion A combination of two biomarkers of neurodegeneration (e.g., HCV and t-Tau) is not superior over the single parameters in identifying patients with MCI who are most likely to progress to AD dementia, although there is a gradual increase in the statistical measures across increasing biomarker combinations. This may have implications for clinical diagnosis and for selecting subjects for participation in clinical trials

Detection, control and mitigation system for secure vehicular communication

The increase in the safety and privacy of automated vehicle drivers against hazardous cyber-attacks will lead to a considerable reduction in the number of global deaths and injuries. In this sense, the European Commission has focused attention on the security of communications in high-risk systems when receiving a cyber-attack such as automated vehicles. The project SerIoT comes up as an possible solution, providing a useful open and reference framework for real-time monitoring of the traffic exchanged through heterogeneous IoT platforms. This system is capable of recognize suspicious patterns, evaluate them and finally take mitigate actions. The paper presents a use case of the SerIoT project related to rerouting tests in vehicular communication. The goal is to ensure secure and reliable communication among Connected Intelligent Transportation Systems (C-ITS) components (vehicles, infrastructures, etc) using the SerIoT's system capabilities to detect and mitigate possible network attacks. Therefore, fleet management and smart intersection scenarios were chosen, where vehicles equipped with On Board Units (OBU) interact with each other and Road Side Units (RSU) to accomplish an optimal flow of traffic. These equipments use the SerIoT systems to deal with cyber-attacks such as Denial of Service (DoS). Tests have been validated in different scenarios under threats situations. It shows the great performance of the SerIoT system taking the corresponding actions to ensure a continuous and safety traffic flow

SUCLG2 identified as both a determinator of CSF Aβ1-42 levels and an attenuator of cognitive decline in Alzheimer's disease

Cerebrospinal fluid amyloid-beta 1-42 (Aβ1-42) and phosphorylated Tau at position 181 (pTau181) are biomarkers of Alzheimer's disease (AD). We performed an analysis and meta-analysis of genome-wide association study data on Aβ1-42 and pTau181 in AD dementia patients followed by independent replication. An association was found between Aβ1-42 level and a single-nucleotide polymorphism in SUCLG2 (rs62256378) (P = 2.5×10−12). An interaction between APOE genotype and rs62256378 was detected (P = 9.5 × 10−5), with the strongest effect being observed in APOE-ε4 noncarriers. Clinically, rs62256378 was associated with rate of cognitive decline in AD dementia patients (P = 3.1 × 10−3). Functional microglia experiments showed that SUCLG2 was involved in clearance of Aβ1-4

Genome-wide meta-analysis for Alzheimer's disease cerebrospinal fluid biomarkers

Amyloid-beta 42 (A beta 42) and phosphorylated tau (pTau) levels in cerebrospinal fluid (CSF) reflect core features of the pathogenesis of Alzheimer's disease (AD) more directly than clinical diagnosis. Initiated by the European Alzheimer & Dementia Biobank (EADB), the largest collaborative effort on genetics underlying CSF biomarkers was established, including 31 cohorts with a total of 13,116 individuals (discovery n = 8074; replication n = 5042 individuals). Besides the APOE locus, novel associations with two other well-established AD risk loci were observed; CR1 was shown a locus for A beta 42 and BIN1 for pTau. GMNC and C16orf95 were further identified as loci for pTau, of which the latter is novel. Clustering methods exploring the influence of all known AD risk loci on the CSF protein levels, revealed 4 biological categories suggesting multiple A beta 42 and pTau related biological pathways involved in the etiology of AD. In functional follow-up analyses, GMNC and C16orf95 both associated with lateral ventricular volume, implying an overlap in genetic etiology for tau levels and brain ventricular volume.Peer reviewe

Matrix metalloproteinase 10 is linked to the risk of progression to dementia of the Alzheimer's type

Alzheimer's disease has a long asymptomatic phase that offers a substantial time window for intervention. Using this window of opportunity will require early diagnostic and prognostic biomarkers to detect Alzheimer's disease pathology at predementia stages, thus allowing identification of patients who will most probably progress to dementia of the Alzheimer's type and benefit from specific disease-modifying therapies. Consequently, we searched for CSF proteins associated with disease progression along with the clinical disease staging. We measured the levels of 184 proteins in CSF samples from 556 subjective cognitive decline and mild cognitive impairment patients from three independent memory clinic longitudinal studies (Spanish ACE, n = 410; German DCN, n = 93; German Mannheim, n = 53). We evaluated the association between protein levels and clinical stage, and the effect of protein levels on the progression from mild cognitive impairment to dementia of the Alzheimer's type. Mild cognitive impairment subjects with increased CSF level of matrix metalloproteinase 10 (MMP-10) showed a higher probability of progressing to dementia of the Alzheimer's type and a faster cognitive decline. CSF MMP-10 increased the prediction accuracy of CSF amyloid-β 42 (Aβ42), phospho-Tau 181 (P-Tau181) and total tau (T-Tau) for conversion to dementia of the Alzheimer's type. Including MMP-10 to the [A/T/(N)] scheme improved considerably the prognostic value in mild cognitive impairment patients with abnormal Aβ42, but normal P-Tau181 and T-Tau, and in mild cognitive impairment patients with abnormal Aβ42, P-Tau181 and T-Tau. MMP-10 was correlated with age in subjects with normal Aβ42, P-Tau181 and T-Tau levels. Our findings support the use of CSF MMP-10 as a prognostic marker for dementia of the Alzheimer's type and its inclusion in the [A/T/(N)] scheme to incorporate pathologic aspects beyond amyloid and tau. CSF level of MMP-10 may reflect ageing and neuroinflammation.Fil: Martino Adami, Pamela Victoria. University Of Cologne; Alemania. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigaciones Bioquímicas de Buenos Aires. Fundación Instituto Leloir. Instituto de Investigaciones Bioquímicas de Buenos Aires; ArgentinaFil: Orellana, Adelina. Instituto de Salud Carlos III; España. International University of Catalonia; EspañaFil: García, Pablo. International University of Catalonia; España. Instituto de Salud Carlos III; EspañaFil: Kleineidam, Luca. University Of Cologne; AlemaniaFil: Alarcón Martín, Emilio. International University of Catalonia; EspañaFil: Montrreal, Laura. International University of Catalonia; EspañaFil: Aguilera, Nuria. International University of Catalonia; EspañaFil: Espinosa, Ana. Fundació Ace; EspañaFil: Abdelnour, Carla. Fundació Ace; EspañaFil: Rosende Roca, Maitee. Fundació Ace; EspañaFil: Pablo Tartari, Juan. Fundació Ace; EspañaFil: Vargas, Liliana. Fundació Ace; EspañaFil: Mauleón, Ana. Fundació Ace; EspañaFil: Esteban De Antonio, Ester. Fundació Ace; EspañaFil: López Cuevas, Rogelio. Fundació Ace; EspañaFil: Dalmasso, Maria Carolina. University Of Cologne; Alemania. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Campos Martin, Rafael. University Of Cologne; AlemaniaFil: Parveen, Kayenat. University Of Cologne; AlemaniaFil: Andrade Fuentes, Victor M. University Of Cologne; AlemaniaFil: Amin, Najaf. University of Oxford; Reino UnidoFil: Ahmad, Shahzad. Erasmus MC; Países BajosFil: Ikram, M. Arfan. Erasmus MC; Países BajosFil: Lewczuk, Piotr. Universitat Erlangen-Nuremberg; AlemaniaFil: Kornhuber, Johannes. Universitat Erlangen-Nuremberg; AlemaniaFil: Peters, Oliver. University Hospital Of Białystok; PoloniaFil: Frölich, Lutz. Ruprecht Karls Universitat Heidelberg.; AlemaniaFil: Rüther, Eckart. Universität Göttingen; AlemaniaFil: Wiltfang, Jens. Universität Göttingen; AlemaniaFil: Tarraga, Lluis. Fundació Ace; EspañaFil: Boada, Merce. Fundació Ace; Españ

SUCLG2 identified as both a determinator of CSF Aβ1–42 levels and an attenuator of cognitive decline in Alzheimer's disease

Cerebrospinal fluid amyloid-beta 1–42 (Aβ1–42) and phosphorylated Tau at position 181 (pTau181) are biomarkers of Alzheimer's disease (AD). We performed an analysis and meta-analysis of genome-wide association study data on Aβ1–42 and pTau181 in AD dementia patients followed by independent replication. An association was found between Aβ1–42 level and a single-nucleotide polymorphism in SUCLG2 (rs62256378) (P = 2.5×10−12). An interaction between APOE genotype and rs62256378 was detected (P = 9.5 × 10−5), with the strongest effect being observed in APOE-ε4 noncarriers. Clinically, rs62256378 was associated with rate of cognitive decline in AD dementia patients (P = 3.1 × 10−3). Functional microglia experiments showed that SUCLG2 was involved in clearance of Aβ1–42

Matrix metalloproteinase 10 is linked to the risk of progression to dementia of the Alzheimer's type

Alzheimer's disease has a long asymptomatic phase that offers a substantial time window for intervention. Using this window of opportunity will require early diagnostic and prognostic biomarkers to detect Alzheimer's disease pathology at predementia stages, thus allowing identification of patients who will most probably progress to dementia of the Alzheimer's type and benefit from specific disease-modifying therapies. Consequently, we searched for CSF proteins associated with disease progression along with the clinical disease staging. We measured the levels of 184 proteins in CSF samples from 556 subjective cognitive decline and mild cognitive impairment patients from three independent memory clinic longitudinal studies (Spanish ACE, n = 410; German DCN, n = 93; German Mannheim, n = 53). We evaluated the association between protein levels and clinical stage, and the effect of protein levels on the progression from mild cognitive impairment to dementia of the Alzheimer's type. Mild cognitive impairment subjects with increased CSF level of matrix metalloproteinase 10 (MMP-10) showed a higher probability of progressing to dementia of the Alzheimer's type and a faster cognitive decline. CSF MMP-10 increased the prediction accuracy of CSF amyloid-β 42 (Aβ42), phospho-Tau 181 (P-Tau181) and total tau (T-Tau) for conversion to dementia of the Alzheimer's type. Including MMP-10 to the [A/T/(N)] scheme improved considerably the prognostic value in mild cognitive impairment patients with abnormal Aβ42, but normal P-Tau181 and T-Tau, and in mild cognitive impairment patients with abnormal Aβ42, P-Tau181 and T-Tau. MMP-10 was correlated with age in subjects with normal Aβ42, P-Tau181 and T-Tau levels. Our findings support the use of CSF MMP-10 as a prognostic marker for dementia of the Alzheimer's type and its inclusion in the [A/T/(N)] scheme to incorporate pathologic aspects beyond amyloid and tau. CSF level of MMP-10 may reflect ageing and neuroinflammation