Publications by authors named "Liana G. Apostolova"

Background: Although previous studies have shown that cognitive decline in Alzheimer's disease (AD) is associated with various risk factors, they primarily focused on late-onset AD (LOAD).

Objective: We aim to evaluate the differential impact of risk factors on the cognitive decline between early-onset AD (EOAD, onset < 65 years) and LOAD (onset 65 years) and explore the longitudinal effect of Apolipoprotein E allele 4 ( ε4) on cortical atrophy in both cohorts.

Methods: Using data from 212 EOAD and 1101 LOAD participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI), we conducted multivariable mixed-effect models to evaluate the impact of ε4, education, hypertension, diabetes, dyslipidemia, and body mass index on cognitive performance.

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Objective: Social connectedness is a modifiable lifestyle factor that delays age-related cognitive decline. Using cross-sectional, longitudinal, and experimental approaches, we examined whether theory of mind - inferring what others think or feel - is a potential mechanism underlying this relationship.

Methods: In Study 1, 305 community-dwelling older adults participating in two different, but related, studies completed comprehensive measures of general cognition, theory of mind, and personal social networks.

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Introduction: Early-onset Alzheimer's disease (EOAD) manifests prior to the age of 65, and affects 4%-8% of patients with Alzheimer's disease (AD). The current analyses sought to examine longitudinal cognitive trajectories of participants with early-onset dementia.

Methods: Data from 307 cognitively normal (CN) volunteer participants and those with amyloid-positive EOAD or amyloid-negative cognitive impairment (EOnonAD) were compared.

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Introduction: Early-onset Alzheimer's disease (EOAD) and late-onset Alzheimer's disease (LOAD) share similar amyloid etiology, but evidence from smaller-scale studies suggests that they manifest differently clinically. Current analyses sought to contrast the cognitive profiles of EOAD and LOAD.

Methods: Z-score cognitive-domain composites for 311 amyloid-positive sporadic EOAD and 314 amyloid-positive LOAD participants were calculated from baseline data from age-appropriate control cohorts.

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Article Synopsis
  • The study investigates the genetic factors contributing to Alzheimer's disease by analyzing tau deposition through a genome-wide association study involving 3,046 participants.
  • It identifies the CYP1B1-RMDN2 locus as significantly linked to tau levels, with the variant rs2113389 explaining 4.3% of tau variation, while also correlating with cognitive decline.
  • Findings suggest a connection between CYP1B1 expression and tau deposition, offering potential new avenues for Alzheimer's treatment and understanding its genetic basis.
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Article Synopsis
  • Alzheimer's disease (AD) begins years before noticeable symptoms, making early detection crucial, as individuals with high amyloid levels can still be cognitively normal, indicating that amyloid alone isn't a sufficient risk marker.
  • A new risk score was created by combining amyloid imaging and genetic data to assess risk for cognitive decline in patients with mild cognitive impairment (MCI), yielding better correlation with cognitive scores than traditional amyloid measures.
  • This innovative risk score showed strong effectiveness in identifying different risk levels among subgroups of MCI patients, potentially enhancing early AD risk assessment and benefiting clinical trials.
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Background: Practice effects (PE) are traditionally considered improvements in performance observed resulting from repeated exposure to test materials across multiple testing sessions. While PE are commonly observed for memory tests, this effect has only been considered in summary total scores. The current objective was to consider PE in summary total scores, individual learning trials, and learning slopes.

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Background: Incidence of cognitive impairment and its consequences have not been fully examined in heart failure (HF).

Objective: The aim of this study was to examine associations of HF with cognitive decline, frequencies and risks of, and time-to-develop mild cognitive impairment (MCI) or dementia during 15-year follow-up.

Methods: For this retrospective cohort study, data were retrieved from the National Alzheimer's Coordinating Center.

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Brain inflammation, with an increased density of microglia and macrophages, is an important component of Alzheimer's disease and a potential therapeutic target. However, it is incompletely characterized, particularly in patients whose disease begins before the age of 65 years and, thus, have few co-pathologies. Inflammation has been usefully imaged with translocator protein (TSPO) PET, but most inflammation PET tracers cannot image subjects with a low-binder TSPO rs6971 genotype.

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Introduction: We examined the burden of neuropsychiatric symptoms (NPSs) in early-onset (EO) and late-onset (LO) Alzheimer's disease (AD) and adjusted for age effects via the inclusion of cognitively unimpaired (CU) individuals.

Methods: Cross-sectional data from 2940 EOAD, 8665 LOAD, and 8775 age-stratified CU individuals (early-CU, n = 2433; late-CU, n = 6342) from the National Alzheimer's Coordinating Center database were included. Fisher's exact tests compared EOAD and LOAD on the presence and severity of NPSs.

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Alzheimer's disease (AD) is a complex, progressive primary neurodegenerative disease. Since pivotal genetic studies in 1993, the ε4 allele of the apolipoprotein E gene (APOE ε4) has remained the strongest single genome-wide associated risk variant in AD. Scientific advances in APOE biology, AD pathophysiology and ApoE-targeted therapies have brought APOE to the forefront of research, with potential translation into routine AD clinical care.

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Behavioral neurology & neuropsychiatry (BNNP) is a field that seeks to understand brain-behavior relationships, including fundamental brain organization principles and the many ways that brain structures and connectivity can be disrupted, leading to abnormalities of behavior, cognition, emotion, perception, and social cognition. In North America, BNNP has existed as an integrated subspecialty through the United Council for Neurologic Subspecialties since 2006. Nonetheless, the number of behavioral neurologists across academic medical centers and community settings is not keeping pace with increasing clinical and research demand.

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Background: Early-onset dementia (EOD, onset age < 65) and late-onset dementia (LOD, onset age ≥ 65) exhibit distinct features. Understanding the risk factors for dementia development and mortality in EOD and LOD respectively is crucial for personalized care. While risk factors are known for LOD development and mortality, their impact on EOD remains unclear.

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Amyloid-β (Aβ) and tau proteins accumulate within distinct neuronal systems in Alzheimer's disease (AD). Although it is not clear why certain brain regions are more vulnerable to Aβ and tau pathologies than others, gene expression may play a role. We study the association between brain-wide gene expression profiles and regional vulnerability to Aβ (gene-to-Aβ associations) and tau (gene-to-tau associations) pathologies by leveraging two large independent AD cohorts.

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The BrainAGE method is used to estimate biological brain age using structural neuroimaging. However, the stability of the model across different scan parameters and races/ethnicities has not been thoroughly investigated. Estimated brain age was compared within- and across- MRI field strength and across voxel sizes.

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Frontotemporal lobar degeneration (FTLD) causes frontotemporal dementia (FTD), the most common form of dementia after Alzheimer's disease, and is often also associated with motor disorders. The pathological hallmarks of FTLD are neuronal inclusions of specific, abnormally assembled proteins. In the majority of cases the inclusions contain amyloid filament assemblies of TAR DNA-binding protein 43 (TDP-43) or tau, with distinct filament structures characterizing different FTLD subtypes.

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Introduction: Social connectedness is associated with slower cognitive decline among older adults. Recent research suggests that distinct aspects of social networks may have differential effects on cognitive resilience, but few studies analyze brain structure.

Methods: This study includes 117 cognitively impaired and 59 unimpaired older adults.

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Understanding the interrelationships of brain function as measured by resting-state magnetic resonance imaging and neuropsychological/behavioral measures in Alzheimer's disease is key for advancement of neuroimaging analysis methods in clinical research. The edge time-series framework recently developed in the field of network neuroscience, in combination with other network science methods, allows for investigations of brain-behavior relationships that are not possible with conventional functional connectivity methods. Data from the Indiana Alzheimer's Disease Research Center sample (53 cognitively normal control, 47 subjective cognitive decline, 32 mild cognitive impairment, and 20 Alzheimer's disease participants) were used to investigate relationships between functional connectivity components, each derived from a subset of time points based on co-fluctuation of regional signals, and measures of domain-specific neuropsychological functions.

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Understanding the interrelationships of brain function as measured by resting-state magnetic resonance imaging and neuropsychological/behavioral measures in Alzheimer's disease is key for advancement of neuroimaging analysis methods in clinical research. The edge time-series framework recently developed in the field of network neuroscience, in combination with other network science methods, allows for investigations of brain-behavior relationships that are not possible with conventional functional connectivity methods. Data from the Indiana Alzheimer's Disease Research Center sample (53 cognitively normal control, 47 subjective cognitive decline, 32 mild cognitive impairment, and 20 Alzheimer's disease participants) were used to investigate relationships between functional connectivity components, each derived from a subset of time points based on co-fluctuation of regional signals, and measures of domain-specific neuropsychological functions.

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Article Synopsis
  • Researchers developed an MRI-based signature to identify brain atrophy linked to sporadic early-onset Alzheimer's disease (EOAD) using two patient samples, one small (n=25) and another larger (n=211).
  • The study found consistent atrophy patterns in specific brain regions, like the caudal lateral temporal cortex and inferior parietal lobule, while the medial temporal lobe was relatively spared.
  • The EOAD-signature atrophy correlates with cognitive impairment severity, suggesting it's a reliable biomarker for Alzheimer’s-related neurodegeneration in clinical trials.
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Article Synopsis
  • The LEADS study focuses on understanding the genetic causes of early-onset Alzheimer's Disease (EOAD), specifically in individuals aged 40-64, by screening for known pathogenic variants.
  • *Whole exome sequencing of 299 participants found pathogenic variants in 1.35% of EOAD cases and 6.58% of early-onset non-Alzheimer's disease cases, but no gene showed a significant enrichment for rare functional variants.
  • *The findings suggest that LEADS may include new genetic variants related to early-onset cognitive impairment, making it an important resource for ongoing Alzheimer's research.*
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Background: Utilization of NIA-AA Research Framework requires dichotomization of tau pathology. However, due to the novelty of tau-PET imaging, there is no consensus on methods to categorize scans into "positive" or "negative" (T+ or T-). In response, some tau topographical pathologic staging schemes have been developed.

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Article Synopsis
  • The study focuses on analyzing baseline amyloid-beta and tau-PET scans in participants with early-onset Alzheimer's disease (EOAD) to improve diagnostic understanding.* -
  • Out of the 321 cognitively impaired participants, 75.7% were classified as having EOAD based on amyloid-PET, with 95.1% of them also showing elevated tau-PET signals, particularly in younger and female subjects.* -
  • The findings highlight the significance of using these biomarkers for more accurate EOAD diagnoses and suggest potential implications for treatment strategies based on tau-PET levels.*
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Objective: Learning slopes represent serial acquisition of information during list-learning tasks. Although several calculations for learning slopes exist, the Learning Ratio (LR) has recently demonstrated the highest sensitivity toward changes in cognition and Alzheimer's disease (AD) biomarkers. However, investigation of learning slopes in cognitively unimpaired individuals with subjective memory concerns (SMC) has been limited.

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Article Synopsis
  • The study examines the Rey Auditory Verbal Learning Test (RAVLT) as a tool for assessing memory impairment in early-onset Alzheimer's disease (EOAD), focusing on the effects of amyloid presence and diagnostic syndrome.
  • RAVLT recordings from 303 participants were analyzed, revealing that amyloid-positive individuals showed significant differences in memory performance compared to amyloid-negative individuals, including effects on raw scores and timing measures.
  • The findings suggest that RAVLT is sensitive to variations in memory impairment linked to amyloid and syndrome types in EOAD, highlighting the need for further research to understand the predictive capabilities of these memory scores.
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