Assessment of Demographic, Genetic, and Imaging Variables Associated With Brain Resilience and Cognitive Resilience to Pathological Tau in Patients With Alzheimer Disease

Ossenkoppele, Rik; Lyoo, Chul Hyoung; Jester-Broms, Jonas; Sudre, Carole H.; Cho, Hanna; Ryu, Young Hoon; Choi, Jae Yong; Smith, Ruben; Strandberg, Olof; Palmqvist, Sebastian; Kramer, Joel; Boxer, Adam L.; Gorno-Tempini, Maria L.; Miller, Bruce L.; La Joie, Renaud; Rabinovici, Gil D.; Hansson, Oskar

doi:10.1001/jamaneurol.2019.5154

Assessment of Demographic, Genetic, and Imaging Variables Associated With Brain Resilience and Cognitive Resilience to Pathological Tau in Patients With Alzheimer Disease

Journal Article · Fri May 01 00:00:00 EDT 2020 · JAMA Neurology

DOI:https://doi.org/10.1001/jamaneurol.2019.5154· OSTI ID:1629516

Ossenkoppele, Rik ^[1]; Lyoo, Chul Hyoung ^[2]; Jester-Broms, Jonas ^[3]; Sudre, Carole H. ^[4]; Cho, Hanna ^[5]; Ryu, Young Hoon ^[2]; Choi, Jae Yong ^[6]; Smith, Ruben ^[3]; Strandberg, Olof ^[3]; Palmqvist, Sebastian ^[3]; Kramer, Joel ^[7]; Boxer, Adam L. ^[7]; Gorno-Tempini, Maria L. ^[7]; Miller, Bruce L. ^[7]; La Joie, Renaud ^[7]; Rabinovici, Gil D. ^[8]; Hansson, Oskar ^[9]

Lund Univ. (Sweden). Clinical Memory Research Unit; Amsterdam Univ. Medical Center (Netherlands). Amsterdam Neuroscience. Dept. of Neurology. Alzheimer Center Amsterdam; DOE/OSTI
Yonsei Univ., Seoul (Korea, Republic of). College of Medicine. Gangnam Severance Hospital. Dept. of Neurology
Lund Univ. (Sweden). Clinical Memory Research Unit
King's College, London (United Kingdom). Biomedical Engineering and Imaging Sciences; Univ. College London (United Kingdom). Dept. of Neurodegenerative Disease. Dementia Research Centre; Univ. College London (United Kingdom). Dept. of Medical Physics. Centre for Medical Image Computing
Univ. College London (United Kingdom). Dept. of Neurodegenerative Disease. Dementia Research Centre
Yonsei Univ., Seoul (Korea, Republic of). College of Medicine. Gangnam Severance Hospital. Dept. of Neurology; Korea Inst. Radiological and Medical Sciences, Seoul (Korea, Republic of). Division of Applied RI
Univ. of California, San Francisco, CA (United States). Dept. of Neurology. Memory and Aging Center
Univ. of California, San Francisco, CA (United States). Dept. of Neurology. Memory and Aging Center; Univ. of California, San Francisco, CA (United States). Dept. of Radiology and Biomedical Imaging; Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Molecular Biophysics and Integrated Bioimaging Division
Lund Univ. (Sweden). Clinical Memory Research Unit; Skåne Univ. Hospital, Malmö (Sweden). Memory Clinic

Importance: Better understanding is needed of the degree to which individuals tolerate Alzheimer disease (AD)-like pathological tau with respect to brain structure (brain resilience) and cognition (cognitive resilience). Objective: To examine the demographic (age, sex, and educational level), genetic (APOE-ε4 status), and neuroimaging (white matter hyperintensities and cortical thickness) factors associated with interindividual differences in brain and cognitive resilience to tau positron emission tomography (PET) load and to changes in global cognition over time. Design, setting, an participants: In this cross-sectional, longitudinal study, tau PET was performed from June 1, 2014, to November 30, 2017, and global cognition monitored for a mean [SD] interval of 2.0 [1.8] years at 3 dementia centers in South Korea, Sweden, and the United States. The study included amyloid-β-positive participants with mild cognitive impairment or AD dementia. Data analysis was performed from October 26, 2018, to December 11, 2019. Exposures: Standard dementia screening, cognitive testing, brain magnetic resonance imaging, amyloid-β PET and cerebrospinal fluid analysis, and flortaucipir (tau) labeled with fluor-18 (18F) PET. Main outcomes and measures: Separate linear regression models were performed between whole cortex [18F]flortaucipir uptake and cortical thickness, and standardized residuals were used to obtain a measure of brain resilience. The same procedure was performed for whole cortex [18F]flortaucipir uptake vs Mini-Mental State Examination (MMSE) as a measure of cognitive resilience. Bivariate and multivariable linear regression models were conducted with age, sex, educational level, APOE-ε4 status, white matter hyperintensity volumes, and cortical thickness as independent variables and brain and cognitive resilience measures as dependent variables. Linear mixed models were performed to examine whether changes in MMSE scores over time differed as a function of a combined brain and cognitive resilience variable. Results: A total of 260 participants (145 [55.8%] female; mean [SD] age, 69.2 [9.5] years; mean [SD] MMSE score, 21.9 [5.5]) were included in the study. In multivariable models, women (standardized β = -0.15, P = .02) and young patients (standardized β = -0.20, P = .006) had greater brain resilience to pathological tau. Higher educational level (standardized β = 0.23, P < .001) and global cortical thickness (standardized β = 0.23, P < .001) were associated with greater cognitive resilience to pathological tau. Linear mixed models indicated a significant interaction of brain resilience × cognitive resilience × time on MMSE (β [SE] = -0.235 [0.111], P = .03), with steepest slopes for individuals with both low brain and cognitive resilience. Conclusions and relevance: Results of this study suggest that women and young patients with AD have relative preservation of brain structure when exposed to neocortical pathological tau. Interindividual differences in resilience to pathological tau may be important to disease progression because participants with both low brain and cognitive resilience had the most rapid cognitive decline over time.

View Accepted Manuscript (DOE)

Research Organization:: Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

Sponsoring Organization:: USDOE Office of Science (SC), Biological and Environmental Research (BER). Biological Systems Science Division

Grant/Contract Number:: AC02-05CH11231

OSTI ID:: 1629516

Journal Information:: JAMA Neurology, Journal Name: JAMA Neurology Journal Issue: 5 Vol. 77; ISSN 2168-6149

Publisher:: American Medical AssociationCopyright Statement

Country of Publication:: United States

Language:: English

References (60)

The Relationships Between Age, Sex, and the Incidence of Dementia and Alzheimer Disease Gao, Sujuan; Hendrie, Hugh C.; Hall, Kathleen S. Archives of General Psychiatry, Vol. 55, Issue 9 https://doi.org/10.1001/archpsyc.55.9.809	journal	September 1998
Prevalence of Cerebral Amyloid Pathology in Persons Without Dementia: A Meta-analysis Jansen, Willemijn J.; Ossenkoppele, Rik; Knol, Dirk L. JAMA, Vol. 313, Issue 19 https://doi.org/10.1001/jama.2015.4668	journal	May 2015
Level of education mitigates the impact of tau pathology on neuronal function Hoenig, Merle C.; Bischof, Gérard N. European Journal of Nuclear Medicine and Molecular Imaging, Vol. 46, Issue 9 https://doi.org/10.1007/s00259-019-04342-3	journal	June 2019
Vulnerable Neural Systems and the Borderland of Brain Aging and Neurodegeneration Jagust, William Neuron, Vol. 77, Issue 2 https://doi.org/10.1016/j.neuron.2013.01.002	journal	January 2013
PET Imaging of Tau Deposition in the Aging Human Brain Schöll, Michael; Lockhart, Samuel N.; Schonhaut, Daniel R. Neuron, Vol. 89, Issue 5 https://doi.org/10.1016/j.neuron.2016.01.028	journal	March 2016
Memory aging and brain maintenance Nyberg, Lars; Lövdén, Martin; Riklund, Katrine Trends in Cognitive Sciences, Vol. 16, Issue 5 https://doi.org/10.1016/j.tics.2012.04.005	journal	May 2012
Early-onset versus late-onset Alzheimer's disease: the case of the missing APOE ɛ4 allele van der Flier, Wiesje M.; Pijnenburg, Yolande AL; Fox, Nick C. The Lancet Neurology, Vol. 10, Issue 3 https://doi.org/10.1016/s1474-4422(10)70306-9	journal	March 2011
Neuroimaging correlates of pathologically defined subtypes of Alzheimer's disease: a case-control study Whitwell, Jennifer L.; Dickson, Dennis W.; Murray, Melissa E. The Lancet Neurology, Vol. 11, Issue 10 https://doi.org/10.1016/s1474-4422(12)70200-4	journal	October 2012
Tau pathology and neurodegeneration Spillantini, Maria Grazia; Goedert, Michel The Lancet Neurology, Vol. 12, Issue 6 https://doi.org/10.1016/s1474-4422(13)70090-5	journal	June 2013
Tau pathology and neurodegeneration contribute to cognitive impairment in Alzheimer’s disease Bejanin, Alexandre; Schonhaut, Daniel R.; La Joie, Renaud Brain, Vol. 140, Issue 12 https://doi.org/10.1093/brain/awx243	journal	October 2017
Bayesian Model Selection for Pathological Neuroimaging Data Applied to White Matter Lesion Segmentation Sudre, Carole H.; Cardoso, M. Jorge; Bouvy, Willem H. IEEE Transactions on Medical Imaging, Vol. 34, Issue 10 https://doi.org/10.1109/tmi.2015.2419072	journal	October 2015
Greater tau load and reduced cortical thickness in APOE ε4-negative Alzheimer’s disease: a cohort study Mattsson, Niklas; Ossenkoppele, Rik; Smith, Ruben Alzheimer's Research & Therapy, Vol. 10, Issue 1 https://doi.org/10.1186/s13195-018-0403-x	journal	August 2018
Is intracranial volume a suitable proxy for brain reserve? van Loenhoud, Anna Catharina; Groot, Colin; Vogel, Jacob William Alzheimer's Research & Therapy, Vol. 10, Issue 1 https://doi.org/10.1186/s13195-018-0408-5	journal	September 2018
Asymptomatic Alzheimer disease Hohman, Timothy J.; McLaren, Donald G.; Mormino, Elizabeth C. Neurology, Vol. 87, Issue 23 https://doi.org/10.1212/wnl.0000000000003397	journal	November 2016
Discriminative Accuracy of [ ¹⁸ F]flortaucipir Positron Emission Tomography for Alzheimer Disease vs Other Neurodegenerative Disorders Ossenkoppele, Rik; Rabinovici, Gil D.; Smith, Ruben JAMA, Vol. 320, Issue 11 https://doi.org/10.1001/jama.2018.12917	journal	September 2018
Association of Apolipoprotein E ɛ4, Educational Level, and Sex With Tau Deposition and Tau-Mediated Metabolic Dysfunction in Older Adults Ramanan, Vijay K.; Castillo, Anna M.; Knopman, David S. JAMA Network Open, Vol. 2, Issue 10 https://doi.org/10.1001/jamanetworkopen.2019.13909	journal	October 2019
Sex-Specific Association of Apolipoprotein E With Cerebrospinal Fluid Levels of Tau Hohman, Timothy J.; Dumitrescu, Logan; Barnes, Lisa L. JAMA Neurology, Vol. 75, Issue 8 https://doi.org/10.1001/jamaneurol.2018.0821	journal	August 2018
Sex Differences in the Association of Global Amyloid and Regional Tau Deposition Measured by Positron Emission Tomography in Clinically Normal Older Adults Buckley, Rachel F.; Mormino, Elizabeth C.; Rabin, Jennifer S. JAMA Neurology, Vol. 76, Issue 5 https://doi.org/10.1001/jamaneurol.2018.4693	journal	May 2019
Cognitive resilience in clinical and preclinical Alzheimer’s disease: the Association of Amyloid and Tau Burden on cognitive performance Rentz, Dorene M.; Mormino, Elizabeth C.; Papp, Kathryn V. Brain Imaging and Behavior, Vol. 11, Issue 2 https://doi.org/10.1007/s11682-016-9640-4	journal	October 2016
Early-onset versus late-onset Alzheimer's disease: the case of the missing APOE ɛ4 allele van der Flier, Wiesje M.; Pijnenburg, Yolande AL; Fox, Nick C. The Lancet Neurology, Vol. 10, Issue 3 https://doi.org/10.1016/S1474-4422(10)70306-9	journal	March 2011
Cognitive reserve in ageing and Alzheimer's disease Stern, Yaakov The Lancet Neurology, Vol. 11, Issue 11 https://doi.org/10.1016/S1474-4422(12)70191-6	journal	November 2012
Neuroimaging correlates of pathologically defined subtypes of Alzheimer's disease: a case-control study Whitwell, Jennifer L.; Dickson, Dennis W.; Murray, Melissa E. The Lancet Neurology, Vol. 11, Issue 10 https://doi.org/10.1016/S1474-4422(12)70200-4	journal	October 2012
Tau pathology and neurodegeneration Spillantini, Maria Grazia; Goedert, Michel The Lancet Neurology, Vol. 12, Issue 6 https://doi.org/10.1016/S1474-4422(13)70090-5	journal	June 2013
Age-specific and sex-specific prevalence of cerebral β-amyloidosis, tauopathy, and neurodegeneration in cognitively unimpaired individuals aged 50–95 years: a cross-sectional study Jack, Clifford R.; Wiste, Heather J.; Weigand, Stephen D. The Lancet Neurology, Vol. 16, Issue 6 https://doi.org/10.1016/S1474-4422(17)30077-7	journal	June 2017
Understanding the Odd Science of Aging Kirkwood, Thomas B. L. Cell, Vol. 120, Issue 4 https://doi.org/10.1016/j.cell.2005.01.027	journal	February 2005
The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer's disease McKhann, Guy M.; Knopman, David S.; Chertkow, Howard Alzheimer's & Dementia, Vol. 7, Issue 3 https://doi.org/10.1016/j.jalz.2011.03.005	journal	May 2011
The diagnosis of mild cognitive impairment due to Alzheimer's disease: Recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease Albert, Marilyn S.; DeKosky, Steven T.; Dickson, Dennis Alzheimer's & Dementia, Vol. 7, Issue 3 https://doi.org/10.1016/j.jalz.2011.03.008	journal	April 2011
Whitepaper: Defining and investigating cognitive reserve, brain reserve, and brain maintenance Stern, Yaakov; Arenaza‐Urquijo, Eider M.; Bartrés‐Faz, David Alzheimer's & Dementia, Vol. 16, Issue 9 https://doi.org/10.1016/j.jalz.2018.07.219	journal	January 2020
Biomarkers for tau pathology Schöll, Michael; Maass, Anne; Mattsson, Niklas Molecular and Cellular Neuroscience, Vol. 97 https://doi.org/10.1016/j.mcn.2018.12.001	journal	June 2019
Tau pathology and cognitive reserve in Alzheimer's disease Hoenig, Merle Christine; Bischof, Gérard Nisal; Hammes, Jochen Neurobiology of Aging, Vol. 57 https://doi.org/10.1016/j.neurobiolaging.2017.05.004	journal	September 2017
Gender difference analysis of cortical thickness in healthy young adults with surface-based methods Im, Kiho; Lee, Jong-Min; Lee, Junki NeuroImage, Vol. 31, Issue 1 https://doi.org/10.1016/j.neuroimage.2005.11.042	journal	May 2006
Mapping the effect of APOE ε4 on gray matter loss in Alzheimer's disease in vivo Pievani, M.; Rasser, P. E.; Galluzzi, S. NeuroImage, Vol. 45, Issue 4 https://doi.org/10.1016/j.neuroimage.2009.01.009	journal	May 2009
Comparison of multiple tau-PET measures as biomarkers in aging and Alzheimer's disease Maass, Anne; Landau, Susan; Baker, Suzanne L. NeuroImage, Vol. 157 https://doi.org/10.1016/j.neuroimage.2017.05.058	journal	August 2017
White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities Alber, Jessica; Alladi, Suvarna; Bae, Hee‐Joon Alzheimer's & Dementia: Translational Research & Clinical Interventions, Vol. 5, Issue 1 https://doi.org/10.1016/j.trci.2019.02.001	journal	January 2019
Protective actions of sex steroid hormones in Alzheimer’s disease Pike, Christian J.; Carroll, Jenna C.; Rosario, Emily R. Frontiers in Neuroendocrinology, Vol. 30, Issue 2 https://doi.org/10.1016/j.yfrne.2009.04.015	journal	July 2009
Nature and implications of sex differences in AD pathology Babapour Mofrad, Rosha; van der Flier, Wiesje M. Nature Reviews Neurology, Vol. 15, Issue 1 https://doi.org/10.1038/s41582-018-0115-7	journal	December 2018
Gene expression changes in the course of normal brain aging are sexually dimorphic Berchtold, Nicole C.; Cribbs, David H.; Coleman, Paul D. Proceedings of the National Academy of Sciences, Vol. 105, Issue 40 https://doi.org/10.1073/pnas.0806883105	journal	October 2008
Distinct patterns of brain activity in young carriers of the APOE -ε4 allele Filippini, Nicola; MacIntosh, Bradley J.; Hough, Morgan G. Proceedings of the National Academy of Sciences, Vol. 106, Issue 17 https://doi.org/10.1073/pnas.0811879106	journal	April 2009
Apolipoprotein E (APOE) genotype has dissociable effects on memory and attentional–executive network function in Alzheimer’s disease Wolk, David A.; Dickerson, Bradford C.; Weiner, Michael Proceedings of the National Academy of Sciences, Vol. 107, Issue 22 https://doi.org/10.1073/pnas.1001412107	journal	May 2010
Functional brain abnormalities in young adults at genetic risk for late-onset Alzheimer's dementia Reiman, E. M.; Chen, K.; Alexander, G. E. Proceedings of the National Academy of Sciences, Vol. 101, Issue 1 https://doi.org/10.1073/pnas.2635903100	journal	December 2003
Tau PET patterns mirror clinical and neuroanatomical variability in Alzheimer’s disease Ossenkoppele, Rik; Schonhaut, Daniel R.; Schöll, Michael Brain, Vol. 139, Issue 5 https://doi.org/10.1093/brain/aww027	journal	March 2016
Distinct 18F-AV-1451 tau PET retention patterns in early- and late-onset Alzheimer’s disease Schöll, Michael; Ossenkoppele, Rik; Strandberg, Olof Brain, Vol. 140, Issue 9 https://doi.org/10.1093/brain/awx171	journal	July 2017
Longitudinal tau PET in ageing and Alzheimer’s disease Jack, Clifford R.; Wiste, Heather J.; Schwarz, Christopher G. Brain, Vol. 141, Issue 5 https://doi.org/10.1093/brain/awy059	journal	March 2018
A multicentre longitudinal study of flortaucipir (18F) in normal ageing, mild cognitive impairment and Alzheimer’s disease dementia Pontecorvo, Michael J.; Devous, Michael D.; Kennedy, Ian Brain, Vol. 142, Issue 6 https://doi.org/10.1093/brain/awz090	journal	April 2019
Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report Nelson, Peter T.; Dickson, Dennis W.; Trojanowski, John Q. Brain, Vol. 142, Issue 6 https://doi.org/10.1093/brain/awz099	journal	April 2019
White matter hyperintensities: relationship to amyloid and tau burden Graff-Radford, Jonathan; Arenaza-Urquijo, Eider M.; Knopman, David S. Brain, Vol. 142, Issue 8 https://doi.org/10.1093/brain/awz162	journal	June 2019
Sex Differences in Cortical Thickness Mapped in 176 Healthy Individuals between 7 and 87 Years of Age Sowell, E. R.; Peterson, B. S.; Kan, E. Cerebral Cortex, Vol. 17, Issue 7 https://doi.org/10.1093/cercor/bhl066	journal	August 2006
Sex Differences in the Adult Human Brain: Evidence from 5216 UK Biobank Participants Ritchie, Stuart J.; Cox, Simon R.; Shen, Xueyi Cerebral Cortex, Vol. 28, Issue 8 https://doi.org/10.1093/cercor/bhy109	journal	May 2018
How to Select, Calculate, and Interpret Effect Sizes Durlak, J. A. Journal of Pediatric Psychology, Vol. 34, Issue 9 https://doi.org/10.1093/jpepsy/jsp004	journal	February 2009
Correlation of Alzheimer Disease Neuropathologic Changes With Cognitive Status: A Review of the Literature Nelson, Peter T.; Alafuzoff, Irina; Bigio, Eileen H. Journal of Neuropathology & Experimental Neurology, Vol. 71, Issue 5 https://doi.org/10.1097/NEN.0b013e31825018f7	journal	May 2012
Bayesian Model Selection for Pathological Neuroimaging Data Applied to White Matter Lesion Segmentation Sudre, Carole H.; Cardoso, M. Jorge; Bouvy, Willem H. IEEE Transactions on Medical Imaging, Vol. 34, Issue 10 https://doi.org/10.1109/TMI.2015.2419072	journal	October 2015
Accelerated aging‐related transcriptome changes in the female prefrontal cortex Yuan, Yuan; Chen, Yi‐Ping Phoebe; Boyd‐Kirkup, Jerome Aging Cell, Vol. 11, Issue 5 https://doi.org/10.1111/j.1474-9726.2012.00859.x	journal	August 2012
Size of the treatment effect on cognition of cholinesterase inhibition in Alzheimer's disease Rockwood, K. Journal of Neurology, Neurosurgery & Psychiatry, Vol. 75, Issue 5 https://doi.org/10.1136/jnnp.2003.029074	journal	May 2004
Donepezil treatment in severe Alzheimer's disease: a pooled analysis of three clinical trials Winblad, Bengt; Black, Sandra E.; Homma, Akira Current Medical Research and Opinion, Vol. 25, Issue 11 https://doi.org/10.1185/03007990903236731	journal	September 2009
Asymptomatic Alzheimer disease Hohman, Timothy J.; McLaren, Donald G.; Mormino, Elizabeth C. Neurology, Vol. 87, Issue 23 https://doi.org/10.1212/WNL.0000000000003397	journal	November 2016
Differential effects of cognitive reserve and brain reserve on cognition in Alzheimer disease Groot, Colin; van Loenhoud, Anna C.; Barkhof, Frederik Neurology, Vol. 90, Issue 2 https://doi.org/10.1212/WNL.0000000000004802	journal	December 2017
Resistance vs resilience to Alzheimer disease Arenaza-Urquijo, Eider M.; Vemuri, Prashanthi Neurology, Vol. 90, Issue 15 https://doi.org/10.1212/WNL.0000000000005303	journal	March 2018
Cognitive reserve and clinical progression in Alzheimer disease van Loenhoud, Anna Catharina; van der Flier, Wiesje Maria; Wink, Alle Meije Neurology, Vol. 93, Issue 4 https://doi.org/10.1212/WNL.0000000000007821	journal	July 2019
Left frontal connectivity attenuates the adverse effect of entorhinal tau pathology on memory Neitzel, Julia; Franzmeier, Nicolai; Rubinski, Anna Neurology, Vol. 93, Issue 4 https://doi.org/10.1212/WNL.0000000000007822	journal	June 2019
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: Guidelines for Reporting Observational Studies von Elm, Erik; Altman, Douglas G.; Egger, Matthias PLoS Medicine, Vol. 4, Issue 10 https://doi.org/10.1371/journal.pmed.0040296	journal	October 2007

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