Plasma and cerebrospinal fluid levels of amyloid beta proteins 1-40 and 1-42 in Alzheimer disease.

BACKGROUND: In brains with AD, Abeta is a major component of diffuse plaques. Previous reports showed that CSF Abeta42 levels were lower in patients with AD than in controls. Although studies showed higher plasma Abeta42 levels in familial AD, a recent report has indicated that plasma Abeta42 levels were similar in a sporadic AD group and controls. However, no information is published on plasma Abeta40 and Abeta42 levels in relation to Apo E genotype or severity of dementia in sporadic AD. OBJECTIVE: To examine plasma and cerebrospinal fluid (CSF) levels of amyloid beta protein 1-40 (Abeta40) and 1-42 (Abeta42) levels in patients with probable Alzheimer disease (AD) and elderly nondemented control subjects in relation to the apolipoprotein E (Apo E) genotype and dementia severity. SETTING: Two university medical centers. PATIENTS AND METHODS: Levels of Abeta40 and Abeta42 were measured in plasma from 78 patients with AD and 61 controls and in CSF from 36 patients with AD and 29 controls by means of a sandwich enzyme-linked immunosorbent assay. RESULTS: Mean plasma Abeta40 levels were higher in the AD group than in controls (P = .005), but there was substantial overlap; Abeta42 levels were similar between the groups. Levels of Abeta40 and Abeta42 showed no association with sex or Mini-Mental State Examination scores. There was a significant relationship between age and Abeta40 level in controls but not in the AD group. Levels of Abeta40 were higher in patients with AD with the Apo E epsilon4 allele than in controls (P<.01). Cerebrospinal fluid Abeta40 levels were similar in the AD group and controls. However, Abeta42 levels were lower in the AD group than in controls (P<.001). The levels showed no association with severity of dementia. CONCLUSIONS: Although mean plasma Abeta40 levels are elevated in sporadic AD and influenced by Apo E genotype, measurement of plasma Abeta40 levels is not useful to support the clinical diagnosis of AD. Lower levels of CSF Abeta42 in the AD group are consistent with previous studies.

An endogenous retrovirus and exogenous scrapie in a mouse model of aging.

As we enter the post-genomic era, there is an increasing need for accurate methods of identifying host and pathogen factors that contribute to bacterial, viral and fungal disease. In addition, there is a requirement for fast and precise techniques to evaluate potential therapies for the prevention of infectious diseases. The development of useful and cost-effective model systems will be crucial in advancing our knowledge of all aspects of microbial pathogenesis. In this series, we will learn of animal models used to investigate diseases caused by a wide variety of pathogens, including HIV, Vibrio cholerae and Pseudomonas aeruginosa. A description of a model system specifically designed to study intracellular pathogens will be presented, as will a variety of the techniques currently used to exploit other useful models of infection. Additionally, a description of the mathematical models used to analyse the population biology of human onchocerciasis will be discussed. The series begins with an intriguing look at the possible connections between an endogenous retrovirus, the infectious agent of scrapie and accelerated senescence in a mouse model of early aging.

Increased levels of tau-like protein in patients with Down syndrome.

Tau-like protein levels from 40 Down syndrome (DS) persons (31-70 years old), 40 non-DS age-matched normal controls, 18 non-DS mentally retarded (MR) persons (26-91 years old), 25 probable Alzheimer disease (AD) patients (55-99 years old) and 24 non-demented elderly controls (54-79 years old) were measured using a sandwich enzyme linked immunosorbent assay. The levels were detected in 22 of 40 DS persons and were significantly higher in DS than any other group (P < 0.0001). There was no relationship between tau-like protein levels and age, gender or apolipoprotein E phenotypes in any of the five groups.

Increased plasma amyloid beta protein 1-42 levels in Down syndrome.

Amyloid beta protein 1-40 (A beta40) and A beta42 levels were quantitated in plasma from 43 persons with Down syndrome (DS; 26-68 years of age), 43 age-matched normal controls, and 19 non-DS mentally retarded (MR) persons (26-91 years of age) by using a sandwich enzyme linked immunosorbent assay. A beta40 levels were higher in DS and MR than controls, but were similar between DS and MR groups. A beta42 levels were higher in DS than controls or MR persons. The ratios of A beta42/A beta40 were higher in DS than controls or MR persons. The findings are consistent with those seen in DS brains.

Longer brainstem auditory evoked response latencies of individuals with fragile X syndrome related to sedation.

Brainstem auditory evoked response latencies were studies in 75 males (13 with fragile X syndrome, 18 with mental retardation due to other causes, and 44 with no disability). Latency values were obtained for each ear for the positive deflections of waves I (P1), III (P3), and V (P5). Some individuals with mental retardation required sedation. Contrary to previous report, latencies obtained for individuals with fragile X did not differ from those obtained for persons without mental retardation. Persons receiving sedation, whether or not their retardation was due to fragile X, had longer latencies for wave P5 than persons who did not receive sedation. This effect of sedation may also explain the previously reported increased latencies for persons with fragile X.

Microencephaly in children congenitally infected with human immunodeficiency virus--a gross-anatomical morphometric study.

A quantitative technique involving serial sectioning and semiautomatic morphometric analysis was used to assess the severity of the reduction in size of the major brain structures in cerebral hemispheres of children congenitally infected with HIV-1. Cerebral hemispheres from 12 children (18-48 months of age) who died of AIDS were sectioned into 5-mm-thick serial slabs and photographed. The cross-sectional areas of grossly recognizable brain structures were digitized, and the volumes were calculated according to Cavalieri's principle. The results were compared with those of an identically processed group of control brains from non-AIDS children. Analysis of the brain weight showed that there was a significant reduction in supratentorial and infratentorial weight in the AIDS group. The results of the morphometric study revealed that the loss in brain mass was associated with a statistically significant reduction in the total volume of both hemispheres, the entire cortex, white matter, and basal ganglia. Detailed analysis of individual brain structures also showed a significant reduction in volume of all cortical regions and most of the subcortical gray matter (e.g., caudate nucleus, putamen, globus pallidus, claustrum, and thalamus). It appears that in the microencephaly observed as a frequent sequel in pediatric AIDS, the loss of brain tissue is global and includes an almost proportional loss of cortex, subcortical gray matter and white matter.

Normal ageing in adults with Down's syndrome: a longitudinal study.

The ubiquitous presence of the neuropathology of Alzheimer disease (AD) in individuals with Down's syndrome (DS) over 40 years of age suggests that this group of people will exhibit a high prevalence of dementia of the Alzheimer type (DAT) as they age. The present study indicates that there is a clear discrepancy between the presumed presence of AD neuropathology and the clinical expression of DAT among older people with DS. In the first 6 years of a longitudinal study, the present authors compared 91 adults (31-63 years of age) with DS and mild or moderate mental retardation to 64 adults (31-76 years of age) with other forms of mental retardation (MR) on yearly measures of mental status, short- and long-term memory, speeded psychomotor function, and visuospatial organization. The results indicated that, over repeated testing on the verbal long-term memory test, younger participants with DS showed small increases in their scores, while older participants with DS showed very slight decreases. Overall performance scores on this test and a speeded psychomotor task were poorer for both diagnostic groups in individuals aged 50 years and older. The magnitude and type of these selective changes in performance were consistent with performance profiles observed in older healthy adults without mental retardation on tests measuring similar cognitive functions. Only four out of the 91 people with DS in the present sample showed changes in functioning that have led to a diagnosis of possible DAT, and in these individuals, alternative causes of performance declines were concurrently present (e.g. thyroid dysfunction). These findings indicate that some age-associated changes in functioning are related to "normal' but probably precocious ageing among adults with DS. Furthermore, these findings suggest that adults with DS and mild or moderate mental retardation may be at lower risk for dementia during their fourth and fifth decades of life than previous studies have suggested.

Aberrant lateralization of brainstem auditory evoked responses by individuals with Down syndrome.

Brainstem auditory evoked response latencies were studied in 80 males (13 with Down syndrome, 23 with developmental disability due to other causes, and 44 with no disability). Latencies for waves P3 and P5 were shorter for the Down syndrome than for the other groups, though at P5, as compared to latencies for the nondisabled group, the difference was not significant. The pattern of left versus right ear responses in the Down syndrome group differed from those of the other groups. This finding was related to research noting decreased lateralization of and decreased ability at receptive and expressive language among people with Down syndrome. Some individuals required sedation. A lateralized effect of sedation was noted.

Immunoglobulin G subclasses in older persons with Down syndrome.

IgG subclasses were measured in sera from 33 persons with Down syndrome (DS) (mean age 55 +/- 7 years) and 33 age- and sex-matched control individuals using a mouse monoclonal antibody based sandwich enzyme linked immunosorbent assay. Significantly higher levels of IgG1 and IgG3 and lower levels of IgG2 and IgG4 subclasses were found in the DS group compared to the control individuals. The higher levels of IgG1 and IgG3 subclasses found in DS persons were consistent with those seen in patients with autoimmune diseases and chronic viral infections; the lower levels of IgG2 and IgG4 subclasses were consistent with those seen in patients with recurrent infections. Our findings are similar to those reported in children with DS. We speculate that the subclass levels may have little or no relationship to the development of brain lesions typical of Alzheimer disease in older persons with DS. There were no significant differences between the levels of IgG subclasses of persons with DS showing signs of dementia of the Alzheimer type compared to those without such manifestations.

Increased levels of beta 2-microglobulin, soluble interleukin-2 receptor, and soluble CD8 in patients with subacute sclerosing panencephalitis.

We measured beta 2-microglobulin (beta 2-M), soluble interleukin-2 receptor (sIL-2R), and soluble CD8 (sCD8) antigen levels in paired cerebrospinal fluid (CSF) and sera from patients with subacute sclerosing panencephalitis (SSPE), multiple sclerosis (MS), and other neurological diseases (OND) using enzyme-linked immunosorbent assay. beta 2-M was significantly increased in CSF of the SSPE group compared to the MS or the OND group. Similarly, beta 2-M in the MS versus OND group was significantly increased in CSF. Although serum levels of beta 2-M were similar in the three groups, the CSF/serum ratios were higher in SSPE versus the MS group and in the MS versus the OND group. Levels of sIL-2R and sCD8 were higher in SSPE CSF than OND CSF; however, there were no differences between levels in SSPE and MS CSF. The levels of sIL-2R were increased in SSPE sera compared to those of MS or the OND group, whereas levels of sCD8 in serum from the three groups were similar. The findings of increased CSF/serum ratio of beta 2-M and higher levels of serum sIL-2R and CSF sCD8 in SSPE patients are consistent with those seen in patients with acute and chronic viral infections. When the levels between the initial and follow-up CSF and serum samples from SSPE patients were compared, the data showed that CSF levels of sCD8 elevated during periods of clinical worsening and decreased during clinical improvement. In contrast, serum beta 2-M decreased during periods of worsening and increased during improvement. The measurement of serum beta 2-M and CSF sCD8 may be useful in SSPE patients as markers to monitor disease activity.

The Fra(X) syndrome: neurological, electrophysiological, and neuropathological abnormalities.

We have evaluated 62 fragile X syndrome [fra(X)] individuals (55 males and 7 females) with different degrees of developmental disabilities that were clinically non-progressive and non-focal in character. The mean age for the 55 males was 23.1 years +/- 14.3 SD with a range of 2-70: for the 7 females, the mean age was 15.7 years +/- 3.5 SD with a range of 10-20 years. Mental retardation (MR) was found in 53 males (8/53 [15.1%] mild, 26/53 [49.1%] moderate, 14/53 [26.4%] severe, and 5/53 [9.4%] profound). Learning disabilities were found in 2/55 (3.6%) of males. One of the 7 females had mild and one had moderate MR: the other 5 were learning disabled. Autistic stigmata were present in 10/62 (16%) of the patients. Only 14/62 (23%) had a history of seizures, all of which were controlled with anticonvulsants. In 36/62 cases, an electroencephalogram (EEG) was performed. We compared these data with that of others. Brain stem auditory evoked response (BAER) was performed in 12 cases. Abnormalities were found in only 5/12. Neuroimaging and computerized cranial transaxial tomography (CT scan) were performed on 21/62 (34%) of the patients. Only 8 of these 21 (38%) studies were abnormal. One patient died; neuropathological studies showed mild brain atrophy, with light microscopic and ultrastructural abnormalities. Rapid Golgi dendritic spine patterns showed that the proximal apical segments were abnormally developed. Very thin, long tortuous spines with prominent terminal heads and irregular dilatations were present. Marked reductions in the length of the synapses, as determined on EPTA-postfixed tissue where noted.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain growth in Down syndrome subjects 15 to 22 weeks of gestational age and birth to 60 months.

We have found similarities of skull shape, brain growth and brain maturation in 17 DS and 10 non-DS (control) fetuses, ages 15-22 weeks of gestational age (Group A), and differences in 101 DS and 80 non-DS cases, from birth to 60 months (Group B). Postnatally, the gross neuropathological differences between DS and control brains are more distinct after 3-5 months of age. The anterior posterior diameter fronto-occipital length of the brain hemispheres is shortened and that is secondary to reduction of frontal lobe growth. Also flattening of occipital poles, narrowing of the superior temporal gyruses and generalized retardation of brain growth were common findings. Standard morphometric methods indicate changes from birth [Wisniewski et al. 1984, 1986, 1990]. The cerebral cortex of the DS cases had a 20-50% reduction of neurons since birth, mainly in the granular layers [Wisniewski et al. 1984, 1986, 1990]. Changes in brain weight with age were greater in the non-DS than in the DS cases, and greater in males than in females. CHD and GI malformations were associated with less brain weight in both DS and non-DS cases. We suggest that the prenatal retardation of neurogenesis begins after 22 weeks' gestational age. The postnatal retardation of brain growth is secondary to pre- and postnatal abnormalities in synaptogenesis.

Brainstem auditory-evoked responses with and without sedation in autism and Down's syndrome.

Brainstem auditory-evoked responses (BAER) were obtained from 46 control, 16 Down's syndrome, and 48 autistic male subjects. Six Down's syndrome and 37 autistic subjects were tested with sedation. Sedated and unsedated Down's syndrome subjects displayed shorter absolute and interpeak latencies for early components of the BAER whereas the sedated autistic group showed longer latencies for the middle and late components. The prolongation of latencies in the sedated autistic group was unrelated to age or intellectual level. Although individuals requiring sedation may have a higher probability of neurological impairment, an effect of sedation on the BAER cannot be ruled out.

Study of spindle microtubule reassembly in cells from Alzheimer and Down syndrome patients following exposure to colcemid.

Numerous intraneuronal neurofibrillary tangles and senile (neuritic) plaques are the two characteristic lesions in Alzheimer disease (AD) and adult Down syndrome (DS). Evidence indicates that microtubule assembly is impaired in AD. We studied spindle microtubule repolymerization rates in EBV-transformed lymphoblasts from AD, DS, and control individuals after colcemid exposure. The distinctive arrangement of microtubules in spindle and its size make this structure an obvious choice for study. Recovery trends in the three patient groups differed significantly; in particular, the controls showed an earlier appearance of intact spindle microtubules than AD. Other researchers found similar results using AD fibroblasts. The results from the DS cells were inconsistent and difficult to interpret. It is unclear how the AD microtubules differ from controls, or whether a relationship exists between the altered microtubule repolymerization kinetics observed in this study and the presence of neurofibrillary tangles in AD patients. A difference in repolymerization rates can be the basis for a diagnostic test for AD if it can be verified.

Differences in antiepileptic drug efficacy in hippocampally kindled normal and microcephalic rats.

The difference in antiepileptic drug efficacy was investigated in two groups of animals: 5 normal and 4 microcephalic rats. The latter were produced by a single i.p. injection of 30 mg/kg methylazoxymethanol acetate in the mother on the 15th day of gestation. Hippocampal kindling was performed to a seizure criterion in all animals followed by testing of the antiepileptic drugs vs placebo. Besides carbamazepine (CBZ), two new anticonvulsants were tested: (E)-2-[(alpha-amino)phenylmethylene]-benzo-[b]-thiophene-3(2H)-one (AF-CX 921) and its metabolite (E)-2-[alpha-amino)phenylmethylene]-benzo-[b]-thiophene-3(2H)-one- 1- oxide (AF-CX 1325). Frequency of occurrence and duration of afterdischarges and seizures were statistically examined. The duration of early afterdischarges (AD1) tended to be shorter in microcephalic than in normal animals in control and placebo periods. In contrast, during treatment with the antiepileptic drugs, AD1 durations were longer in microcephalic than in normal animals. This suggests that the drugs inhibited AD1 to a lesser extent in the microcephalics. Two other characteristics of EEG epileptic activity, focal spiking (FS) and late afterdischarges (AD2) also varied in the two groups. Both were significantly lower in occurrence in the microcephalic rats independent of treatment. Three types of behavioral manifestations were also examined: convulsive seizures (CS), epileptic behavior (EB) and quiet states (Q). The two groups of animals responded differently to the drugs with respect to Q and CS. In the microcephalics, AFCX 1325 and AFCX 921 were superior to CBZ, which in turn, was superior to placebo.(ABSTRACT TRUNCATED AT 250 WORDS)

Factors related to adaptive behavior changes among profoundly mentally retarded, physically disabled persons.

Changes in adaptive competence over a 1-year period of profoundly mentally retarded, physically disabled persons living in a moderately sized residential facility or in small community programs were examined. No evidence was found to indicate that habilitative growth was greater for residents in the small community programs. Indeed, residents of the moderately sized facility showed evidence of skill acquisition whereas community residents declined slightly in adaptive skill. Within community programs, presence of a relevant goal was positively related to change in independent living skills, and clients with musculoskeletal impairments tended to regress in motor and eating skills. These data suggest that client characteristics and habilitative program content are significant predictors of client growth, and size of the residence is probably not as important for delivery of effective services.

State-dependent variations in brainstem auditory evoked responses in human subjects.

BAERs from 16 subjects during 3 sessions varied in the latency or amplitude of some components depending upon level of arousal as indicated by EEG patterns. There was a general tendency for activation to produce the fastest responses with the largest amplitudes and for drowsiness to produce the slowest responses with the smallest amplitudes. The latency of P2 was significantly prolonged during drowsiness, relative to those during relaxation or activation. For right-ear stimulation, P5 latency was longest during drowsiness, and shortest during activation while for left-ear stimulation the shortest latency occurred during relaxation. The amplitudes of Wave II and Wave VII were significantly smaller during drowsiness than during activation. Although the differences were below the level of clinical significance, the data indicate a modification in the characteristics of brainstem transmission as a function of concurrent activity in other brain areas.

Preclinical changes in weight of scrapie-infected mice as a function of scrapie agent-mouse strain combination.

Several inbred strains of mice were injected with different scrapie agents and their total body weight was monitored throughout the incubation period. As a control, mice were injected with normal mouse brain homogenate. For most combinations of scrapie agent and mouse strain, weights during the preclinical phase were similar to or lower than the average weight of controls. For some combinations there was a significant increase in weight (compared to controls) during the latter part of the preclinical phase of disease. The effect was dependent on both agent and mouse strain, i.e., in some cases a mouse strain showed the increase with one scrapie agent but not another and some scrapie agents caused the increase in one inbred strain of mouse but not in another strain. The increase in weight was due to accumulations of fat rather than a generalized increase in weight of various organs. With one mouse strain (SJL), there was increased vacuolation seen in the hypothalamus of mice injected with scrapie agents that showed the increase in weight compared to the lesion intensity with an agent which did not cause the weight increase.

Structure of the Minnesota Developmental Programming System Behavioral Scales, Alternate Form C.

The Minnesota Developmental Programming System Behavioral Scales, Alternate Form C, designed to assess adaptive behavior of profoundly developmentally disabled individuals, was evaluated using data from 3,487 individuals. Relative difficulty within each of four 20-item subscales (Gross Motor, Eating, Environmental Integration, and Language/Communication) deviated slightly from the original instrument description. Factor analyses with orthogonal rotation revealed six factors with high loadings on, respectively: (a) difficult items from all subscales, (b) items from both Gross Motor and Eating subscales, (c) items from both Environmental Integration and Language/Communication subscales, and (d) items within each individual subscale except Language/Communication. Oblique rotation suggested two factors for each subscale, one loading on easier items and one loading on more difficult items. Factor patterns after oblique rotation were similar for four age groups ranging from young children (less than 5 years) to adults (over 30 years). Factor analyses of items within each subscale showed predominance of a single factor and no strong evidence of subscale multidimensionality. These results, in large part, confirmed the original Form C description.

Reaction time and psychophysiological activity.

Disjunctive reaction times (RT) involving two interstimulus intervals were obtained from 10 subjects during 4 sessions while recording heart period, skin conductance, and EEG. Multiple regression analysis indicated complex relationships between RT and skin conductance and heart period which varied with session level. The relationship of RT and skin conductance was predominantly linear but positive when level of skin conductance was low and negative when high. Heart period showed a predominantly curvilinear trend which also varied with level during the session. Fastest RTs tended to occur with long heart periods in short heart period sessions and vice versa. Fast RTs were also accompanied by relatively low EEG power before and after stimulation and by higher EEG frequency after the stimulus. The pattern of findings did not fully accord with the expectations of activation theory, and the proportion of RT variance accounted for was small. It is suggested that activation may vary to maintain a constant level of motor performance. Faster RT may occur under relaxed conditions and high arousal, and concentrated attentiveness may be an attempt to compensate for boredom or distraction.