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1.
Environ Adv ; 9: 1-13, 2022 Jul 28.
Article in English | MEDLINE | ID: mdl-36969089

ABSTRACT

Forest understory plant communities in the United States harbor most of the vegetation diversity of forests and are often sensitive to changes in climate and atmospheric deposition of nitrogen (N). As temperature increases from human-caused climate change and soils recover from long term atmospheric deposition of N and sulfur (S), it is unclear how these important ecosystem components will respond. We used the newly developed US-PROPS model - based on species response functions for over 1,500 species - to evaluate the potential impacts of atmospheric N deposition and climate change on species occurrence probability for a case study in the forested ecosystems of the Great Smoky Mountains National Park (GRSM), an iconic park in the southeastern United States. We evaluated six future scenarios from various combinations of two potential recoveries of soil pH (no change, +0.5 pH units) and three climate futures (no change, +1.5, +3.0 deg C). Species critical loads (CLs) of N deposition and projected responses for each scenario were determined. Critical loads were estimated to be low (< 2 kg N/ha/yr) to protect all species under current and expected future conditions across broad regions of GRSM and these CLs were exceeded at large spatial extents among scenarios. Northern hardwood, yellow pine, and chestnut oak forests were among the most N-sensitive vegetation map classes found within GRSM. Potential future air temperature conditions generally led to decreases in the maximum occurrence probability for species. Therefore, CLs were considered "unattainable" in these situations because the specified level of protection used for CL determination (i.e., maximum occurrence probability under ambient conditions) was not attainable. Although some species showed decreases in maximum occurrence probability with simulated increases in soil pH, most species were favored by increased pH. The importance of our study is rooted in the methodology described here for establishing regional CLs and for evaluating future conditions, which is transferable to other national parks in the U.S. and in Europe where the original PROPS model was developed.

2.
Renew Sustain Energy Rev ; 159: 1-16, 2022 May.
Article in English | MEDLINE | ID: mdl-37818487

ABSTRACT

Estimates of land use change (LUC) attributable to the U.S. Renewable Fuel Standard (RFS) are critical for evaluation of the program's impacts on air and water quality, biodiversity, and soil quality. To improve our understanding of the range of published estimates, we reviewed 29 studies published since 2008 attributing domestic LUC to the RFS, updating previous comparisons and adding a growing number of empirical approaches to estimating biofuel-induced LUC. To identify principal reasons underlying differences in reported effects, we documented key attributes of studies' methods including spatial extent, time period, baseline scenario, policy influence, and LUC definitions. Across computable general equilibrium (CGE) and partial equilibrium (PE) economic simulation model studies we found a range of 0.01-2.45 million acres of net cropland expansion per billion-gallon increase in biofuels. Empirical approaches reporting national-scale estimates fall within this range, reporting 0.38-0.66 million acres per billion-gallon increase. Empirical studies had a much smaller range of estimates and were closer to PE approaches than CGE. Studies generally did not represent all the potential drivers of biofuel production, and instead reported projections reflecting a combination of RFS impacts and other influences. Additional refinements to the modeling and empirical approaches reviewed in this study can further improve our understanding of the land use change driven by biofuels and the RFS Program.

3.
Philos Trans A Math Phys Eng Sci ; 378(2183): 20190317, 2020 Oct 30.
Article in English | MEDLINE | ID: mdl-32981433

ABSTRACT

Although awareness that air pollution can damage vegetation dates back at least to the 1600s, the processes and mechanisms of damage were not rigorously studied until the late twentieth century. In the UK following the Industrial Revolution, urban air quality became very poor, with highly phytotoxic SO2 and NO2 concentrations, and remained that way until the mid-twentieth century. Since then both air quality, and our understanding of pollutants and their impacts, have greatly improved. Air pollutants remain a threat to natural and managed ecosystems. Air pollution imparts impacts through four major threats to vegetation are discussed through in a series of case studies. Gas-phase effects by the primary emissions of SO2 and NO2 are discussed in the context of impacts on lichens in urban areas. The effects of wet and dry deposited acidity from sulfur and nitrogen compounds are considered with a particular focus on forest decline. Ecosystem eutrophication by nitrogen deposition focuses on heathland decline in the Netherlands, and ground-level ozone at phytotoxic concentrations is discussed by considering impacts on semi-natural vegetation. We find that, although air is getting cleaner, there is much room for additional improvement, especially for the effects of eutrophication on managed and natural ecosystems. This article is part of a discussion meeting issue 'Air quality, past present and future'.

4.
Environ Pollut ; 262: 114351, 2020 Jul.
Article in English | MEDLINE | ID: mdl-32443221

ABSTRACT

Forest understory plant communities in the eastern United States are often diverse and are potentially sensitive to changes in climate and atmospheric inputs of nitrogen caused by air pollution. In recent years, empirical and processed-based mathematical models have been developed to investigate such changes in plant communities. In the study reported here, a robust set of understory vegetation response functions (expressed as version 2 of the Probability of Occurrence of Plant Species model for the United States [US-PROPS v2]) was developed based on observations of forest understory and grassland plant species presence/absence and associated abiotic characteristics derived from spatial datasets. Improvements to the US-PROPS model, relative to version 1, were mostly focused on inclusion of additional input data, development of custom species-level input datasets, and implementation of methods to address uncertainty. We investigated the application of US-PROPS v2 to evaluate the potential impacts of atmospheric nitrogen (N) and sulfur (S) deposition, and climate change on forest ecosystems at three forested sites located in New Hampshire, Virginia, and Tennessee in the eastern United States. Species-level N and S critical loads (CLs) were determined under ambient deposition at all three modeled sites. The lowest species-level CLs of N deposition at each site were between 2 and 11 kg N/ha/yr. Similarly, the lowest CLs of S deposition, based on the predicted soil pH response, were less than 2 kg S/ha/yr among the three sites. Critical load exceedance was found at all three model sites. The New Hampshire site included the largest percentage of species in exceedance. Simulated warming air temperature typically resulted in lower maximum occurrence probability, which contributed to lower CLs of N and S deposition. The US-PROPS v2 model, together with the PROPS-CLF model to derive CL functions, can be used to develop site-specific CLs for understory plants within broad regions of the United States. This study demonstrates that species-level CLs of N and S deposition are spatially variable according to the climate, light availability, and soil characteristics at a given location. Although the species niche models generally performed well in predicting occurrence probability, there remains uncertainty with respect to the accuracy of reported CLs. As such, the specific CLs reported here should be considered as preliminary estimates.


Subject(s)
Air Pollution , Climate Change , Ecosystem , Forests , Nitrogen/analysis , Tennessee , United States , Virginia
5.
Environ Pollut ; 234: 902-914, 2018 Mar.
Article in English | MEDLINE | ID: mdl-29253831

ABSTRACT

Changes in climate and atmospheric nitrogen (N) deposition caused pronounced changes in soil conditions and habitat suitability for many plant species over the latter half of the previous century. Such changes are expected to continue in the future with anticipated further changing air temperature and precipitation that will likely influence the effects of N deposition. To investigate the potential long-term impacts of atmospheric N deposition on hardwood forest ecosystems in the eastern United States in the context of climate change, application of the coupled biogeochemical and vegetation community model VSD+PROPS was explored at three sites in New Hampshire, Virginia, and Tennessee. This represents the first application of VSD+PROPS to forest ecosystems in the United States. Climate change and elevated (above mid-19th century) N deposition were simulated to be important factors for determining habitat suitability. Although simulation results suggested that the suitability of these forests to support the continued presence of their characteristic understory plant species might decline by the year 2100, low data availability for building vegetation response models with PROPS resulted in uncertain results at the extremes of simulated N deposition. Future PROPS model development in the United States should focus on inclusion of additional foundational data or alternate candidate predictor variables to reduce these uncertainties.


Subject(s)
Air Pollution/analysis , Climate Change , Trees/growth & development , Ecosystem , Forests , Models, Theoretical , Nitrogen/analysis , Nitrogen/metabolism , Soil/chemistry , Tennessee , United States , Virginia
6.
J Laryngol Otol ; 131(4): 298-302, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28027715

ABSTRACT

BACKGROUND: Histopathological anomalies of inner-ear structures in individuals with Down syndrome have been well documented; however, few studies have examined the radiological features. METHODS: A retrospective study was conducted of temporal bone computed tomography images in 38 individuals (75 ears) with Down syndrome to evaluate the prevalence of inner-ear abnormalities and assess vestibular aqueduct widths. RESULTS: Inner-ear anomalies were identified in 20 of the 38 individuals (52.6 per cent). Seven of the 75 temporal bones (9.3 per cent) were found to have higher than previously reported. A dilated internal auditory canal and vestibule were more common among the present study group, while prior studies have demonstrated internal auditory canal stenosis and decreased vestibule size. CONCLUSION: Down syndrome patients exhibit a high prevalence of dysplastic inner-ear features that confer substantial risk of sensorineural hearing loss. Computed tomography is a useful screening aid to detect inner-ear abnormalities, particularly enlarged vestibular aqueducts, which cause preventable sensorineural hearing loss in this population.


Subject(s)
Abnormalities, Multiple/diagnostic imaging , Down Syndrome/diagnostic imaging , Ear, Inner/diagnostic imaging , Hearing Loss, Sensorineural/diagnostic imaging , Tomography, X-Ray Computed , Vestibular Aqueduct/abnormalities , Abnormalities, Multiple/epidemiology , Adult , Down Syndrome/complications , Ear, Inner/abnormalities , Female , Hearing Loss, Sensorineural/congenital , Hearing Loss, Sensorineural/epidemiology , Humans , Male , Prevalence , Retrospective Studies , Temporal Bone/diagnostic imaging , Vestibular Aqueduct/diagnostic imaging , Young Adult
7.
Neurobiol Aging ; 32(3): 556.e13-23, 2011 Mar.
Article in English | MEDLINE | ID: mdl-21196064

ABSTRACT

The aim of this exploratory investigation was to determine if genetic variation within amyloid precursor protein (APP) or its processing enzymes correlates with APP cleavage product levels: APPα, APPß or Aß42, in cerebrospinal fluid (CSF) of cognitively normal subjects or Alzheimer's disease (AD) patients. Cognitively normal control subjects (n = 170) and AD patients (n = 92) were genotyped for 19 putative regulatory tagging SNPs within 9 genes (APP, ADAM10, BACE1, BACE2, PSEN1, PSEN2, PEN2, NCSTN and APH1B) involved in the APP processing pathway. SNP genotypes were tested for their association with CSF APPα, APPß, and Aß42, AD risk and age-at-onset while taking into account age, gender, race and APOE ε4. After adjusting for multiple comparisons, a significant association was found between ADAM10 SNP rs514049 and APPα levels. In controls, the rs514049 CC genotype had higher APPα levels than the CA, AA collapsed genotype, whereas the opposite effect was seen in AD patients. These results suggest that genetic variation within ADAM10, an APP processing gene, influences CSF APPα levels in an AD specific manner.


Subject(s)
ADAM Proteins/genetics , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/genetics , Amyloid Precursor Protein Secretases/genetics , Amyloid beta-Peptides/cerebrospinal fluid , Amyloid beta-Protein Precursor/cerebrospinal fluid , Membrane Proteins/genetics , Peptide Fragments/cerebrospinal fluid , Polymorphism, Single Nucleotide/genetics , ADAM10 Protein , Age of Onset , Aged , Aged, 80 and over , Amyloid Precursor Protein Secretases/cerebrospinal fluid , Amyloid beta-Protein Precursor/genetics , Apolipoprotein E4/genetics , Computational Biology , DNA Mutational Analysis/methods , Female , Gene Frequency , Genotype , Humans , Male , Middle Aged
8.
Neurology ; 75(23): 2079-86, 2010 Dec 07.
Article in English | MEDLINE | ID: mdl-21048198

ABSTRACT

OBJECTIVE: To identify antemortem CSF diagnostic biomarkers that can potentially distinguish between the 2 main causes of frontotemporal lobar degeneration (FTLD), i.e., FTLD with TDP-43 pathology (FTLD-TDP) and FTLD with tau pathology (FTLD-tau). METHODS: CSF samples were collected antemortem from 23 patients with FTLD with known pathology to form a autopsy cohort as part of a comparative biomarker study that additionally included 33 living cognitively normal subjects and 66 patients with autopsy-confirmed Alzheimer disease (AD). CSF samples were also collected from 80 living patients clinically diagnosed with frontotemporal dementia (FTD). Levels of 151 novel analytes were measured via a targeted multiplex panel enriched in neuropeptides, cytokines, and growth factors, along with levels of CSF biomarkers for AD. RESULTS: CSF levels of multiple analytes differed between FTLD-TDP and FTLD-tau, including Fas, neuropeptides (agouti-related peptide and adrenocorticotropic hormone), and chemokines (IL-23, IL-17). Classification by random forest analysis achieved high sensitivity for FTLD-TDP (86%) with modest specificity (78%) in the autopsy cohort. When the classification algorithm was applied to a living FTD cohort, semantic dementia was the phenotype with the highest predicted proportion of FTLD-TDP. When living patients with behavioral variant FTD were examined in detail, those predicted to have FTLD-TDP demonstrated neuropsychological differences vs those predicted to have FTLD-tau in a pattern consistent with previously reported trends in autopsy-confirmed cases. CONCLUSIONS: Clinical cases with FTLD-TDP and FTLD-tau pathology can be potentially identified antemortem by assaying levels of specific analytes that are well-known and readily measurable in CSF.


Subject(s)
Biomarkers/cerebrospinal fluid , DNA-Binding Proteins/metabolism , Frontotemporal Lobar Degeneration/cerebrospinal fluid , Tauopathies/cerebrospinal fluid , Adrenocorticotropic Hormone/cerebrospinal fluid , Aged , Alzheimer Disease/cerebrospinal fluid , Cohort Studies , Female , Frontotemporal Lobar Degeneration/complications , Humans , Interleukin-17/cerebrospinal fluid , Male , Mental Status Schedule , Middle Aged , Neuropsychological Tests , Statistics, Nonparametric , Tauopathies/complications
9.
Proc Natl Acad Sci U S A ; 106(29): 12145-50, 2009 Jul 21.
Article in English | MEDLINE | ID: mdl-19581601

ABSTRACT

A number of distinct beta-amyloid (Abeta) variants or multimers have been implicated in Alzheimer's disease (AD), and antibodies recognizing such peptides are in clinical trials. Humans have natural Abeta-specific antibodies, but their diversity, abundance, and function in the general population remain largely unknown. Here, we demonstrate with peptide microarrays the presence of natural antibodies against known toxic Abeta and amyloidogenic non-Abeta species in plasma samples and cerebrospinal fluid of AD patients and healthy controls aged 21-89 years. Antibody reactivity was most prominent against oligomeric assemblies of Abeta and pyroglutamate or oxidized residues, and IgGs specific for oligomeric preparations of Abeta1-42 in particular declined with age and advancing AD. Most individuals showed unexpected antibody reactivities against peptides unique to autosomal dominant forms of dementia (mutant Abeta, ABri, ADan) and IgGs isolated from plasma of AD patients or healthy controls protected primary neurons from Abeta toxicity. Aged vervets showed similar patterns of plasma IgG antibodies against amyloid peptides, and after immunization with Abeta the monkeys developed high titers not only against Abeta peptides but also against ABri and ADan peptides. Our findings support the concept of conformation-specific, cross-reactive antibodies that may protect against amyloidogenic toxic peptides. If a therapeutic benefit of Abeta antibodies can be confirmed in AD patients, stimulating the production of such neuroprotective antibodies or passively administering them to the elderly population may provide a preventive measure toward AD.


Subject(s)
Aging/immunology , Alzheimer Disease/immunology , Amyloid beta-Peptides/chemistry , Amyloid beta-Peptides/immunology , Antibodies/immunology , Neuroprotective Agents/immunology , Peptides/immunology , Aging/drug effects , Alzheimer Disease/blood , Alzheimer Disease/complications , Alzheimer Disease/pathology , Amyloid beta-Peptides/toxicity , Animals , Antibodies/blood , Antibodies/cerebrospinal fluid , Cytoprotection/drug effects , Dementia/complications , Dementia/immunology , Disease Progression , Genes, Dominant , Immunization , Immunoglobulin G/blood , Mice , Molecular Weight , Neurons/cytology , Neurons/drug effects , Peptides/chemistry , Primates/immunology , Protein Processing, Post-Translational/drug effects , Protein Structure, Quaternary
10.
AJNR Am J Neuroradiol ; 30(5): 978-84, 2009 May.
Article in English | MEDLINE | ID: mdl-19213826

ABSTRACT

BACKGROUND AND PURPOSE: There is significant interest in the development of novel noninvasive techniques for the diagnosis of Alzheimer disease (AD) and tracking its progression. Because MR imaging has detected alterations in sodium levels that correlate with cell death in stroke, we hypothesized that there would be alterations of sodium levels in the brains of patients with AD, related to AD cell death. MATERIALS AND METHODS: A total of 10 volunteers (5 with mild AD and 5 healthy control subjects) were scanned with a 20-minute sodium (23Na) MR imaging protocol on a 3T clinical scanner. RESULTS: After normalizing the signal intensity from the medial temporal lobes corresponding to the hippocampus with the ventricular signal intensity, we were able to detect a 7.5% signal intensity increase in the brains of patients with AD (AD group, 68.25% +/- 3.4% vs control group, 60.75% +/- 2.9%; P < .01). This signal intensity enhancement inversely correlated with hippocampal volume (AD group, 3.22 +/- 0.50 cm3 vs control group, 3.91 +/- 0.45 cm3; r2 = 0.50). CONCLUSIONS: This finding suggests that sodium imaging may be a clinically useful tool to detect the neuropathologic changes associated with AD.


Subject(s)
Alzheimer Disease/metabolism , Alzheimer Disease/pathology , Brain/metabolism , Brain/pathology , Magnetic Resonance Imaging/methods , Magnetic Resonance Spectroscopy/methods , Sodium/analysis , Aged , Biomarkers/analysis , Female , Humans , Male , Middle Aged , Pilot Projects , Tissue Distribution
11.
Neuroimage ; 41(4): 1220-7, 2008 Jul 15.
Article in English | MEDLINE | ID: mdl-18474436

ABSTRACT

The purpose of this study is to determine the diagnostic accuracy of MRI-based high-dimensional pattern classification in differentiating between patients with Alzheimer's disease (AD), Frontotemporal Dementia (FTD), and healthy controls, on an individual patient basis. MRI scans of 37 patients with AD and 37 age-matched cognitively normal elderly individuals, as well as 12 patients with FTD and 12 age-matched cognitively normal elderly individuals, were analyzed using voxel-based analysis and high-dimensional pattern classification. Diagnostic sensitivity and specificity of spatial patterns of regional brain atrophy found to be characteristic of AD and FTD were determined via cross-validation and via split-sample methods. Complex spatial patterns of relatively reduced brain volumes were identified, including temporal, orbitofrontal, parietal and cingulate regions, which were predominantly characteristic of either AD or FTD. These patterns provided 100% diagnostic accuracy, when used to separate AD or FTD from healthy controls. The ability to correctly distinguish AD from FTD averaged 84.3%. All estimates of diagnostic accuracy were determined via cross-validation. In conclusion, AD- and FTD-specific patterns of brain atrophy can be detected with high accuracy using high-dimensional pattern classification of MRI scans obtained in a typical clinical setting.


Subject(s)
Alzheimer Disease/diagnosis , Dementia/diagnosis , Magnetic Resonance Imaging , Age of Onset , Aged , Alzheimer Disease/pathology , Cross-Sectional Studies , Dementia/pathology , Female , Hippocampus/pathology , Humans , Image Processing, Computer-Assisted , Male , Neuropsychological Tests , ROC Curve , Reproducibility of Results
12.
Neurology ; 70(19 Pt 2): 1827-35, 2008 May 06.
Article in English | MEDLINE | ID: mdl-18458217

ABSTRACT

OBJECTIVE: To evaluate the diagnostic value of CSF biomarkers in patients with known pathology due to frontotemporal lobar degeneration (FTLD). BACKGROUND: It is important to distinguish FTLD from other neurodegenerative diseases like Alzheimer disease (AD), but this may be difficult clinically because of atypical presentations. METHODS: Patients with FTLD (n = 30) and AD (n = 19) were identified at autopsy or on the basis of genetic testing at University of Pennsylvania and Erasmus University Medical Center. CSF was obtained during a diagnostic lumbar puncture and was analyzed using assays for total tau and amyloid-beta 1-42 (A beta(42)). Patients also were assessed with a brief neuropsychological battery. RESULTS: CSF total tau level and the ratio of CSF total tau to A beta(42) (tau/A beta(42)) were significantly lower in FTLD than in AD. Receiver operating characteristic curve analyses confirmed that the CSF tau/A beta(42) ratio is sensitive and specific at discriminating between FTLD and AD, and is more successful at this than CSF total tau alone. Although some neuropsychological measures are significantly different in autopsy-proven FTLD and AD, combining these neuropsychological measures with CSF biomarkers did not improve the ability to distinguish FTLD from AD. CONCLUSIONS: The ratio of CSF tau/A beta(42) is a sensitive and specific biomarker at discriminating frontotemporal lobar degeneration from Alzheimer disease in patients with known pathology.


Subject(s)
Amyloid beta-Peptides/cerebrospinal fluid , Brain/metabolism , Brain/pathology , Dementia/cerebrospinal fluid , Dementia/pathology , Peptide Fragments/cerebrospinal fluid , tau Proteins/cerebrospinal fluid , Aged , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/diagnosis , Alzheimer Disease/physiopathology , Amyloid beta-Peptides/analysis , Biomarkers/analysis , Biomarkers/cerebrospinal fluid , Brain/physiopathology , Dementia/physiopathology , Diagnosis, Differential , Disease Progression , Female , Humans , Male , Middle Aged , Neurofibrillary Tangles , Neuropsychological Tests , Peptide Fragments/analysis , Plaque, Amyloid/metabolism , Plaque, Amyloid/pathology , Predictive Value of Tests , Prognosis , tau Proteins/analysis
13.
Neurosignals ; 16(1): 11-8, 2008.
Article in English | MEDLINE | ID: mdl-18097155

ABSTRACT

The increasing prevalence of Alzheimer's disease and the devastating consequences of late-life dementia motivates the drive to develop diagnostic biomarkers to reliably identify the pathology associated with this disorder. Strategies to accomplish this include the detection of altered levels of tau and amyloid in cerebrospinal fluid, the use of structural MRI to identify disease-specific patterns of regional atrophy and MRI T(1)rho to detect disease-related macromolecular protein aggregation, and the direct imaging of amyloid deposits using positron emission tomography and single photon emission computerized tomography. Success will facilitate the ability to reliably diagnose Alzheimer's disease while the symptoms of brain failure are mild and may provide objective measures of disease-modifying treatment efficacy.


Subject(s)
Alzheimer Disease/diagnosis , Alzheimer Disease/metabolism , Biomarkers/metabolism , Early Diagnosis , Humans
14.
Neurology ; 70(7): 521-7, 2008 Feb 12.
Article in English | MEDLINE | ID: mdl-17914064

ABSTRACT

BACKGROUND: Mutations in the LRRK2 gene are an important cause of familial and nonfamilial parkinsonism. Despite pleomorphic pathology, LRRK2 mutations are believed to manifest clinically as typical Parkinson disease (PD). However, most genetic screens have been limited to PD clinic populations. OBJECTIVE: To clinically characterize LRRK2 mutations in cases recruited from a spectrum of neurodegenerative diseases. METHODS: We screened for the common G2019S mutation and several additional previously reported LRRK2 mutations in 434 individuals. A total of 254 patients recruited from neurodegenerative disease clinics and 180 neurodegenerative disease autopsy cases from the University of Pennsylvania brain bank were evaluated. RESULTS: Eight cases were found to harbor a LRRK2 mutation. Among patients with a mutation, two presented with cognitive deficits leading to clinical diagnoses of corticobasal syndrome and primary progressive aphasia. CONCLUSION: The clinical presentation of LRRK2-associated neurodegenerative disease may be more heterogeneous than previously assumed.


Subject(s)
Aphasia, Primary Progressive/genetics , Brain/pathology , Genetic Predisposition to Disease/genetics , Heredodegenerative Disorders, Nervous System/genetics , Mutation/genetics , Protein Serine-Threonine Kinases/genetics , Adult , Aged , Aged, 80 and over , Aphasia, Primary Progressive/pathology , Aphasia, Primary Progressive/physiopathology , Brain/physiopathology , DNA Mutational Analysis , Female , Genetic Markers/genetics , Genetic Testing , Genotype , Heredodegenerative Disorders, Nervous System/pathology , Heredodegenerative Disorders, Nervous System/physiopathology , Humans , Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 , Male , Middle Aged , Phenotype , Predictive Value of Tests
15.
J Neurol Neurosurg Psychiatry ; 79(2): 126-9, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17615171

ABSTRACT

OBJECTIVE: To examine the clinical and pathological factors associated with survival in autopsy-confirmed frontotemporal lobar degeneration (FTLD). METHODS: The final analysis cohort included 71 patients with pathologically proven FTLD, excluding patients with clinical motor neuron disease (MND), evaluated at the University of Pennsylvania or at the University of California, San Francisco. We assessed clinical and demographic features; cognitive functioning at presentation; genetic markers of disease; and graded anatomical distribution of tau, ubiquitin and amyloid pathology. RESULTS: The tau-negative group (n = 35) had a median survival time of 96 months (95% CI: 72-114 months), whereas the tau-positive group (n = 36) had a median survival time of 72 months (95% CI: 60-84 months). Patients with tau-positive pathology across all brain regions had shorter survival than those with tau-negative pathology in univariate Cox regression analyses (Hazard ratio of dying = 2.003, 95% CI = 1.209-3.318, p = 0.007). CONCLUSIONS: Tau-positive pathology represents a significant risk to survival in FTLD, whereas tau-negative pathology is associated with a longer survival time when clinical MND is excluded.


Subject(s)
Dementia/mortality , Adult , Aged , Aged, 80 and over , Alzheimer Disease/genetics , Alzheimer Disease/mortality , Alzheimer Disease/pathology , Basal Ganglia/pathology , Brain/pathology , Cohort Studies , Dementia/genetics , Dementia/pathology , Diagnosis, Differential , Disease Progression , Educational Status , Female , Frontal Lobe/pathology , Genetic Predisposition to Disease/genetics , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Proportional Hazards Models , Risk Factors , Survival Rate , Tauopathies/genetics , Tauopathies/mortality , Tauopathies/pathology , Temporal Lobe/pathology
16.
Neurology ; 68(16): 1274-83, 2007 Apr 17.
Article in English | MEDLINE | ID: mdl-17438218

ABSTRACT

OBJECTIVE: To investigate the clinical features of autopsy-proven corticobasal degeneration (CBD). METHODS: We evaluated symptoms, signs, and neuropsychological deficits longitudinally in 15 patients with autopsy-proven CBD and related these observations directly to the neuroanatomic distribution of disease. RESULTS: At presentation, a specific pattern of cognitive impairment was evident, whereas an extrapyramidal motor abnormality was present in less than half of the patients. Follow-up examination revealed persistent impairment of apraxia and executive functioning, worsening language performance, and preserved memory. The motor disorder emerged and worsened as the condition progressed. Statistical analysis associated cognitive deficits with tau-immunoreactive pathology that is significantly more prominent in frontal and parietal cortices and the basal ganglia than temporal neocortex and the hippocampus. CONCLUSION: The clinical diagnosis of corticobasal degeneration should depend on a specific pattern of impaired cognition as well as an extrapyramidal motor disorder, reflecting the neuroanatomic distribution of disease in frontal and parietal cortices and the basal ganglia.


Subject(s)
Brain/physiopathology , Cognition Disorders/diagnosis , Movement Disorders/diagnosis , Neurodegenerative Diseases/diagnosis , Tauopathies/diagnosis , Age of Onset , Aged , Apraxias/diagnosis , Apraxias/etiology , Apraxias/physiopathology , Basal Ganglia Diseases/diagnosis , Basal Ganglia Diseases/etiology , Basal Ganglia Diseases/physiopathology , Brain/pathology , Cognition Disorders/etiology , Cognition Disorders/physiopathology , Disease Progression , Female , Humans , Language Disorders/diagnosis , Language Disorders/etiology , Language Disorders/physiopathology , Longitudinal Studies , Male , Middle Aged , Movement Disorders/etiology , Movement Disorders/physiopathology , Neural Pathways/pathology , Neural Pathways/physiopathology , Neurodegenerative Diseases/physiopathology , Neurodegenerative Diseases/psychology , Neurofibrillary Tangles/metabolism , Neurofibrillary Tangles/pathology , Neurologic Examination , Neuropsychological Tests , Predictive Value of Tests , Registries , Tauopathies/physiopathology , Tauopathies/psychology , tau Proteins/metabolism
17.
Neurobiol Aging ; 27(3): 394-401, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16125823

ABSTRACT

The diagnosis of Alzheimer's disease (AD) in patients with mild cognitive impairment (MCI) is limited because it is based on non-specific behavioral and neuroimaging findings. The lesions of Alzheimer's disease: amyloid beta (Abeta) deposits, tau pathology and cellular oxidative damage, affect the hippocampus in the earlier stages causing memory impairment. In a 2-year longitudinal study of MCI patients and normal controls, we examined the hypothesis that cerebrospinal fluid (CSF) markers for these pathological features improve the diagnostic accuracy over memory and magnetic resonance imaging (MRI)-hippocampal volume evaluations. Relative to control, MCI patients showed decreased memory and hippocampal volumes and elevated CSF levels of hyperphosphorylated tau and isoprostane. These two CSF measures consistently improved the diagnostic accuracy over the memory measures and the isoprostane measure incremented the accuracy of the hippocampal volume achieving overall diagnostic accuracies of about 90%. Among MCI patients, over 2 years, longitudinal hippocampal volume losses were closely associated with increasing hyperphosphorylated tau and decreasing amyloid beta-42 levels. These results demonstrate that CSF biomarkers for AD contribute to the characterization of MCI.


Subject(s)
Alzheimer Disease/diagnosis , Amyloid beta-Peptides/cerebrospinal fluid , Cognition Disorders/diagnosis , Hippocampus/pathology , Isoprostanes/cerebrospinal fluid , Magnetic Resonance Imaging/methods , tau Proteins/cerebrospinal fluid , Aged , Alzheimer Disease/cerebrospinal fluid , Alzheimer Disease/complications , Biomarkers/cerebrospinal fluid , Cognition Disorders/cerebrospinal fluid , Cognition Disorders/etiology , Female , Humans , Image Enhancement/methods , Longitudinal Studies , Male , Middle Aged , Reproducibility of Results , Sensitivity and Specificity
18.
Int J Tuberc Lung Dis ; 9(9): 964-9, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16158888

ABSTRACT

SETTING: New York City (NYC). OBJECTIVES: To examine the extent to which prior tuberculosis (TB) treatment, length of residence in the United States and other factors are associated with the occurrence of drug resistance among non-US-born persons in NYC. DESIGN: Cases were non-US-born persons diagnosed with TB in NYC from 1998-1999 and from 2001-2002, with an initial Mycobacterium tuberculosis isolate resistant to any first-line anti-tuberculosis drug. Controls were randomly selected from non-US-born persons whose isolates were susceptible to all first-line anti-tuberculosis drugs. RESULTS: Overall, cases with multidrug-resistant (MDR) TB were more likely to have had prior TB treatment; other drug resistance was not associated with prior TB treatment. In a multivariate model, the relationship between MDR-TB and prior treatment remained significant for non-US-born persons regardless of length of time in the U.S. CONCLUSIONS: The findings underscore the utility of monitoring trends in drug resistance among the non-US-born by time in the US and prior treatment to determine where or when drug resistance may be occurring.


Subject(s)
Emigration and Immigration , Tuberculosis, Multidrug-Resistant/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Antitubercular Agents/therapeutic use , Case-Control Studies , Emigration and Immigration/statistics & numerical data , Female , Humans , Male , Middle Aged , Multivariate Analysis , New York City/epidemiology , Risk Factors
19.
Neurology ; 65(3): 397-403, 2005 Aug 09.
Article in English | MEDLINE | ID: mdl-16087904

ABSTRACT

OBJECTIVE: To compare survival and rates of cognitive and functional decline in patients with autopsy-confirmed frontotemporal dementia (FTD) and Alzheimer disease (AD) in a large multicenter study. BACKGROUND: Despite advances in the clinical characterization of FTD, little is known about its rate of progression. Characterizing survival and rate of decline in FTD is important because it can provide prognostic guidelines and benchmarks to use in the evaluation of disease-modifying drugs. METHODS: Seventy patients with FTD and 70 patients with AD who were followed by seven Alzheimer disease research centers until confirmation of diagnosis at autopsy were matched for overall age, education, and Mini-Mental State Examination (MMSE) score at initial evaluation. Survival and rates of cognitive and functional decline were compared. RESULTS: Patients with FTD had significantly shorter survival from initial evaluation to death than patients with AD (FTD = 4.2 years, AD = 6.0 years; log-rank test = 5.17, p < 0.05), and they declined significantly faster over one year on the MMSE (mean annual rate of change: -6.7 points for FTD vs -2.3 points for AD). A significantly greater proportion of patients with FTD were impaired in basic activities of daily living (ADLs) at initial evaluation, and lost the capacity for independent or minimally-assisted ADLs over the subsequent year. CONCLUSIONS: The results are consistent with shorter survival and faster rates of cognitive and functional decline in patients with frontotemporal dementia (FTD) compared to those with Alzheimer disease (AD). This suggests that FTD follows a more malignant disease course than AD once dementia is clinically recognized.


Subject(s)
Alzheimer Disease/physiopathology , Cognition Disorders/physiopathology , Dementia/physiopathology , Activities of Daily Living , Adult , Age Factors , Age of Onset , Aged , Aged, 80 and over , Alzheimer Disease/pathology , Alzheimer Disease/psychology , Cognition Disorders/pathology , Cognition Disorders/psychology , Dementia/pathology , Dementia/psychology , Disease Progression , Educational Status , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Prospective Studies , Sex Distribution , Survival Rate/trends
20.
Neurology ; 61(4): 475-8, 2003 Aug 26.
Article in English | MEDLINE | ID: mdl-12939420

ABSTRACT

OBJECTIVE: To quantify the isoprostane 8,12-iso-iPF2alpha-VI in brain tissues obtained from patients with AD, patients with frontotemporal dementia (FTD), and controls. BACKGROUND: Enhanced brain oxidative stress with secondary damage to cellular macromolecules may play a role in the pathogenesis of AD and FTD. The isoprostane 8,12-iso-iPF2alpha-VI is a specific and sensitive marker of in vivo lipid peroxidation and is increased in AD. METHODS: Levels of this isoprostane were determined by gas chromatography/negative ion chemical ionization mass spectrometry. RESULTS: Levels of 8,12-iso-iPF2alpha-VI were markedly elevated in both frontal and temporal cortex of AD brains compared to the corresponding areas of FTD and controls. No significant difference in brain 8,12-iso-iPF2alpha-VI levels for any regions considered was observed between FTD and controls. CONCLUSIONS: Lipid peroxidation is a feature of AD, but not FTD. The generation of 8,12-iso-iPF(2alpha)-VI in the brain is not a general or final common pathway of neurodegeneration, but may be relatively specific for disease processes in AD and not FTD.


Subject(s)
Alzheimer Disease/metabolism , Brain Chemistry , Dementia/metabolism , Dinoprost/analogs & derivatives , Dinoprost/analysis , Lipid Peroxidation , Aged , Aged, 80 and over , Alzheimer Disease/pathology , Biomarkers , Dementia/classification , Dementia/pathology , Female , Gas Chromatography-Mass Spectrometry , Humans , Male , Middle Aged , Nerve Degeneration , Oxidative Stress , Parkinson Disease/genetics , Parkinson Disease/metabolism , Parkinson Disease/pathology , Pick Disease of the Brain/metabolism , Pick Disease of the Brain/pathology , Supranuclear Palsy, Progressive/metabolism , Supranuclear Palsy, Progressive/pathology
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