Heterozygous app a713t mutation carrier with inflammatoy amyloid angiopathy and family history of alzheimer´s disease: First case in Argentina

Aim: To report the case of a patient who suffered from cerebral amyloid angiopathy due to an autosomal dominant mutation in the APP gene Design/Methods: Medical record and neuroimaging revision. DNA extraction from the saliva sample. Sanger sequencing of the coding regions of the following: APP (NCBI RefSeq NM_000484.3), PSEN1 (NCBI RefSeq NM_000021.3) y PSEN2 (NCBI RefSeq NM_000447.2) Clinical case: A male patient of 71-year-old with a past medical history of recurrent lobar hemorrhagic strokes leading to major cognitive decline since the age of 65, prominent cerebral microangiopathy was present and worsened progressively. Patient´s mother had presenile Alzheimer`s disease. The patient developed partial nonconvulsive status epilepticus, no evidence of new strokes (ischemic or hemorrhagic) was found. Two weeks after seizures a new MRI unveiled right frontal meningeal enhancement. Lumbar puncture and cultures were normal. Inflammatory amyloid angiopathy was suspected. A course of IV methylprednisolone was administered followed by oral steroids with a slight improvement. The patient died four months after due to clinical complications. Post-mortem analysis confirmed a heterozygous mutation: c.2137G>A; p.Arg713Thr at exon 17 of the APP gene. Conclusion: The A713T mutation has been reported by groups of European researchers (British, Spanish and Italian) with variable phenotypes. This would be the first case detected in Argentina to our knowledge. It is notable the main manifestation in our case was the presence of recurrent hemorrhagic stroke, however, the antecedent of a pre-senile AD in a first-degree relative suggested the presence of genetic etiology. This mutation may be underdiagnosed. It would be advisable that a complete genogram must be performed in patients with cerebral amyloid angiopathy. The detection of these cases has implications for genetic counselling.Fil: Fernández Suárez, Marcos Nicolás. Centro de Neuropsiquiatría y Neurología de la Conducta; Argentina. Fundacion de Neurociencias del Alto Uruguay; ArgentinaFil: Brusco, Luis Ignacio. Alzheimer Argentina; Argentina. Alinearte Sa.; ArgentinaFil: Dalmasso, Maria Carolina. 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: Olivar, Natividad. Alzheimer Argentina; ArgentinaFil: Morelli, Laura. 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: Russo, Griselda. Centro de Neuropsiquiatría y Neurología de la Conducta; Argentina. Fundación de Neurociencias del Alto Uruguay; Argentin

Impairment of aversive episodic memories during COVID-19 Pandemic: The impact of emotional context on memory processes

The threatening context of the COVID-19 pandemic provided a unique settingto study the effects of negative psychological symptoms on memory processes. Episodic memory is an essential function of the human being related to the ability tostore and remember experiences and anticipate possible events in the future.Studying this function in this context is crucial to help understand what effects thepandemic will have on the formation of episodic memories. To study this, theformation of episodic memories was evaluated by free recall, recognition, andepisode order tasks for an aversive and neutral content. The results indicated thataversive episodic memory is impaired both in the free recall task and in therecognition task. Even the beneficial effect that emotional memory usually has for theepisodic order was undermined as there were no differences between the neutraland aversive condition. The present work adds to the evidence that indicates that thelevel of activation does not modify memory processes in a linear way, which also depends on the type of evocation that people are asked and the characteristics ofthe content to be encoded.Fil: León, Candela Sofía. Instituto Tecnológico de Buenos Aires; Argentina. Innocence Project Argentina; ArgentinaFil: Bonilla, Matías. Instituto Tecnológico de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Urreta Benitez, Facundo Antonio. Instituto Tecnológico de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Brusco, Luis Ignacio. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Wang, Jingyi. Beijing Normal University; China. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Forcato, Cecilia. Instituto Tecnológico de Buenos Aires; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Efficacy of melatonin in non-intensive care unit patients with COVID-19 pneumonia and sleep dysregulation

The association of sleep disruption with a higher vulnerability to COVID-19 infection is asubject of major clinical importance. In patients with pneumonia associated with COVID-19admitted to non-intensive care unit (NICU) several factors, like the disrupting influence ofrespiratory distress, medication, greater stress due to social isolation, and lack of appropriateexposure to environmental light can be instrumental to disrupt sleep / wake cycle. Thetherapeutic potential of melatonin to counteract the consequences of COVID-19 infection hasbeen advocated. Because of its wide-ranging effects as an antioxidant, anti-inflammatory, andimmunomodulatory compound, melatonin could be unique in impairing the consequences ofSARS-CoV-2 infection. Melatonin is also an effective chronobiotic agent to reverse the circadiandisruption of social isolation and to control delirium in severely affected patients. Properlyadministered, melatonin may restore the optimal circadian pattern of the sleep-wake cycle andimprove clinical condition in pneumonia associated with COVID-19 patients. The present reviewarticle discusses the importance of maintaining normal sleep and circadian rhythmicity in NICUpatients and provides preliminary data suggesting the efficacy of melatonin (9 mg/day) to reducelength of stay of pneumonia patients associated with COVID-19 in NICU.Fil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Cruz, Pablo. No especifíca;Fil: Cangas, Alicia. No especifíca;Fil: González Rojas, Carmen. No especifíca;Fil: Vigo, Daniel Eduardo. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; ArgentinaFil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; Argentin

One-week sleep hygiene education improves episodic memory in young but not in older adults during social isolation

Memory formation is a dynamic process that comprises different phases, such as encoding, consolidation and retrieval. It could be altered by several factors such as sleep quality, anxiety, and depression levels. In the last years, due to COVID-19 pandemic, there was a reduction in sleep quality, an increase in anxiety and depressive symptoms as well as an impairment in emotional episodic memory encoding, especially in young adults. Taking into account the profound impact of sleep quality in daily life a series of rules has been developed that are conducive to consistently achieving good sleep, known as sleep hygiene education. These interventions have been shown to be effective in improving sleep quality and duration and reducing depressive and anxiety symptoms. Here we propose the implementation of a brief sleep hygiene education to improve sleep quality and memory performance as well as to diminish anxiety and depressive scores. For that, participants were divided into two groups: Sleep hygiene education and control group. After that, they were evaluated for anxiety, depression, and sleep quality levels and trained on an episodic memory task. They were tested immediately after (short-term test) and also 1 week later (long-term test). This procedure was also performed before the sleep hygiene education and was taken as baseline level. We found that episodic memory performance for young adults improved for the SHE group after intervention but not for older adults, and no improvements in emotional variables were observed. Despite not observing a significant effect of the intervention for young and older adults regarding the sleep quality scores, we consider that there may be an improvement in sleep physiology that is not subjectively perceived, but would also have a positive impact on memory processes. These results show that even a sleep hygiene education of 1 week could improve cognition in young adults when acute memory and sleep impairment occurs, in this case, due to the isolation by COVID-19 pandemic. However, we suggest that longer interventions should be implemented for older adults who already experience a natural decline in cognitive processes such as episodic memory formation

El proceso cognitivo de la toma de decisiones en la enfermedad de Alzheimer

El objetivo de este trabajo es describir, desde la neuropsicología, el proceso de Toma de Decisiones (TD) en sujetos que padecen la Enfermedad de Alzheimer (EA). Para ello, se estableció una comparación del desempeño en TD de 40 sujetos con diagnóstico de enfermedad de Alzheimer con el desempeño de un grupo control de 40 sujetos sin diagnóstico de enfermedad neurológica y /o psiquiátrica, pareados por NSEC. El desempeño en la TD se evaluó con la tarea de Game Dice Task (GDT) ?Tarea del Juego de los Dados de Brand?. También se aplicaron otras pruebas y tareas de evaluación cognitiva para determinar la relación de la TD con otras Funciones Ejecutivas (FE). Los resultados permitieron establecer que el proceso de TD se deteriora desde los comienzos de la enfermedad, evidenciando que el desempeño de los sujetos con EA es significativamente inferior al de los sujetos sanos, con un porcentaje mayor de respuestas de riesgo y aumento significativo de los tiempos de respuesta. También se observó deterioro en todas las funciones ejecutivas evaluadas. El trabajo provee evidencia empírica que soporta la idea de que la TD se encuentra estrechamente relacionada a las demás FE.The purpose of this study is to describe the impairment in the decision making (DM) process in subjects with diagnosis of Alzheimer’s disease (AD). The DM performance was assessed on 40 subjects diagnosed with AD and then compared against 40 control subjects with no neurological or psychiatric disease. The DM was evaluated using the Game Dice Task developed by Brand. Subjects were also administered other cognitive assessment tests in order to determine the relationship between the DM with other executive functions. The results show that the DM process seems to be impaired in patients with AD from the early stages of the disease. The results also show that the DM performance of the subjects with diagnosis of AD seems to be very inferior when compared to that of healthy subjects. DM assessment show that subjects with AD take more risky answers and have a longer reaction time to make the decision than those with no neurological disease. It was also observed that all executives functions seem to be deteriorated as well. This research shows empiric evidence about the relationship between DM and executive functions.Fil: Malm Morgan, María Rita. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Neurociencia Cognitiva. Fundación Favaloro. Instituto de Neurociencia Cognitiva; ArgentinaFil: Urquijo, Sebastian. Universidad Nacional de Mar del Plata. Facultad de Psicología. Centro de Investigación en Procesos Básicos, Metodologías y Educación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata; ArgentinaFil: Lopez, Fernanda. No especifíca;Fil: Licitra, Mariela. No especifíca;Fil: Comesaña, Ana. Universidad Nacional de Mar del Plata. Facultad de Psicología. Centro de Investigación en Procesos Básicos, Metodologías y Educación; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata; ArgentinaFil: Rodriguez, Marisa. No especifíca;Fil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Admixture mapping implicates 13q33.3 as ancestry-of-origin locus for Alzheimer disease in Hispanic and Latino populations

Alzheimer disease (AD) is the most common form of senile dementia, with high incidence late in life in many populations including Caribbean Hispanic (CH) populations. Such admixed populations, descended from more than one ancestral population, can present challenges for genetic studies, including limited sample sizes and unique analytical constraints. Therefore, CH populations and other admixed populations have not been well represented in studies of AD, and much of the genetic variation contributing to AD risk in these populations remains unknown. Here, we conduct genome-wide analysis of AD in multiplex CH families from the Alzheimer Disease Sequencing Project (ADSP). We developed, validated, and applied an implementation of a logistic mixed model for admixture mapping with binary traits that leverages genetic ancestry to identify ancestry-of-origin loci contributing to AD. We identified three loci on chromosome 13q33.3 associated with reduced risk of AD, where associations were driven by Native American (NAM) ancestry. This AD admixture mapping signal spans the FAM155A, ABHD13, TNFSF13B, LIG4, and MYO16 genes and was supported by evidence for association in an independent sample from the Alzheimer's Genetics in Argentina—Alzheimer Argentina consortium (AGA-ALZAR) study with considerable NAM ancestry. We also provide evidence of NAM haplotypes and key variants within 13q33.3 that segregate with AD in the ADSP whole-genome sequencing data. Interestingly, the widely used genome-wide association study approach failed to identify associations in this region. Our findings underscore the potential of leveraging genetic ancestry diversity in recently admixed populations to improve genetic mapping, in this case for AD-relevant loci.Fil: Horimoto, Andrea R.V.R.. University of Washington; Estados UnidosFil: Boyken, Lisa A.. University of Washington; Estados UnidosFil: Blue, Elizabeth E.. University of Washington; Estados Unidos. Brotman Baty Institute for Precision Medicine; Estados UnidosFil: Grinde, Kelsey E.. University of Washington; Estados Unidos. Macalester College; Estados UnidosFil: Nafikov, Rafael A.. University of Washington; Estados UnidosFil: Sohi, Harkirat K.. University of Washington; Estados UnidosFil: Nato, Alejandro Q.. University of Washington; Estados Unidos. Marshall University; Estados UnidosFil: Bis, Joshua C.. University of Washington; Estados UnidosFil: Brusco, Luis Ignacio. Universidad de Buenos Aires. Facultad de Medicina; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Morelli, Laura. 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: Ramirez, Alfredo Jose. University Of Cologne; Alemania. Universitat Bonn; Alemania. German Center for Neurodegenerative Diseases; Alemania. University Of Texas Health Science Center At San Antonio (ut Health San Antonio) ; University Of Texas At San Antonio; . 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: Dalmasso, Maria Carolina. 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; Argentina. University Of Cologne; AlemaniaFil: Temple, Seth. University of Washington; Estados UnidosFil: Satizabal, Claudia. University Of Texas Health Science Center At San Antonio (ut Health San Antonio) ; University Of Texas At San Antonio; . University of Texas at San Antonio; Estados UnidosFil: Browning, Sharon R.. University of Washington; Estados UnidosFil: Seshadri, Sudha. University Of Texas Health Science Center At San Antonio (ut Health San Antonio) ; University Of Texas At San Antonio; . University of Texas at San Antonio; Estados UnidosFil: Wijsman, Ellen M.. University of Washington; Estados UnidosFil: Thornton, Timothy A.. University of Washington; Estados Unido

Which resources help young people to prevent and overcome mental distress in deprived urban areas in Latin America? A protocol for a prospective cohort study

Introduction Improving the mental health of young people is a global public health priority. In Latin America, young people living in deprived urban areas face various risk factors for mental distress. However, most either do not develop mental distress in the form of depression and anxiety, or recover within a year without treatment from mental health services. This research programme seeks to identify the personal and social resources that help young people to prevent and recover from mental distress. Methods and analysis A cross-sectional study will compare personal and social resources used by 1020 young people (aged 15-16 and 20-24 years) with symptoms of depression and/or anxiety and 1020 without. A longitudinal cohort study will follow-up young people with mental distress after 6 months and 1 year and compare resource use in those who do and do not recover. An experience sampling method study will intensively assess activities, experiences and mental distress in subgroups over short time periods. Finally, we will develop case studies highlighting existing initiatives that effectively support young people to prevent and recover from mental distress. The analysis will assess differences between young people with and without distress at baseline using t-tests and χ 2 tests. Within the groups with mental distress, multivariate logistic regression analyses using a random effects model will assess the relationship between predictor variables and recovery. Ethics and dissemination Ethics approvals are received from Ethics Committee in Biomedical Research, Faculty of Medicine, University of Buenos Aires; Faculty of Medicine-Research and Ethics Committee of the Pontificia Universidad Javeriana, Bogotá; Institutional Ethics Committee of Research of the Universidad Peruana Cayetano Heredia and Queen Mary Ethics of Research Committee. Dissemination will include arts-based methods and target different audiences such as national stakeholders, researchers from different disciplines and the general public. Trial registration number ISRCTN72241383

New insights into the genetic etiology of Alzheimer's disease and related dementias

Characterization of the genetic landscape of Alzheimer's disease (AD) and related dementias (ADD) provides a unique opportunity for a better understanding of the associated pathophysiological processes. We performed a two-stage genome-wide association study totaling 111,326 clinically diagnosed/'proxy' AD cases and 677,663 controls. We found 75 risk loci, of which 42 were new at the time of analysis. Pathway enrichment analyses confirmed the involvement of amyloid/tau pathways and highlighted microglia implication. Gene prioritization in the new loci identified 31 genes that were suggestive of new genetically associated processes, including the tumor necrosis factor alpha pathway through the linear ubiquitin chain assembly complex. We also built a new genetic risk score associated with the risk of future AD/dementia or progression from mild cognitive impairment to AD/dementia. The improvement in prediction led to a 1.6- to 1.9-fold increase in AD risk from the lowest to the highest decile, in addition to effects of age and the APOE ε4 allele

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Multiancestry analysis of the HLA locus in Alzheimer’s and Parkinson’s diseases uncovers a shared adaptive immune response mediated by HLA-DRB1*04 subtypes

Across multiancestry groups, we analyzed Human Leukocyte Antigen (HLA) associations in over 176,000 individuals with Parkinson’s disease (PD) and Alzheimer’s disease (AD) versus controls. We demonstrate that the two diseases share the same protective association at the HLA locus. HLA-specific fine-mapping showed that hierarchical protective effects of HLA-DRB1*04 subtypes best accounted for the association, strongest with HLA-DRB1*04:04 and HLA-DRB1*04:07, and intermediary with HLA-DRB1*04:01 and HLA-DRB1*04:03. The same signal was associated with decreased neurofibrillary tangles in postmortem brains and was associated with reduced tau levels in cerebrospinal fluid and to a lower extent with increased Aβ42. Protective HLA-DRB1*04 subtypes strongly bound the aggregation-prone tau PHF6 sequence, however only when acetylated at a lysine (K311), a common posttranslational modification central to tau aggregation. An HLA-DRB1*04-mediated adaptive immune response decreases PD and AD risks, potentially by acting against tau, offering the possibility of therapeutic avenues