Browsing by Author "Jicha, Gregory A."

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    Aging-related tau astrogliopathy (ARTAG): harmonized evaluation strategy
    (Springer, 2016-01) Kovacs, Gabor G.; Ferrer, Isidro; Alafuzoff, Irina; Attems, Johannes; Budka, Herbert; Cairns, Nigel J.; Crary, John F.; Duyckaerts, Charles; Ghetti, Bernardino; Halliday, Glenda M.; Ironside, James W.; Love, Seth; Mackenzie, Ian R.; Munoz, David G.; Murray, Melissa E.; Nelson, Peter T.; Takahashi, Hitoshi; Trojanowski, John Q.; Ansorge, Olaf; Arzberger, Thomas; Baborie, Atik; Beach, Thomas G.; Bieniek, Kevin F.; Bigio, Eileen H.; Bodi, Istvan; Dugger, Brittany N.; Feany, Mel; Gelpi, Ellen; Gentleman, Stephen M.; Giaccone, Giorgio; Hatanpaa, Kimmo J.; Heale, Richard; Hof, Patrick R.; Hofer, Monika; Hortobágyi, Tibor; Jellinger, Kurt; Jicha, Gregory A.; Ince, Paul; Kofler, Julia; Kövari, Enikö; Kril, Jillian J.; Mann, David M.; Matej, Radoslav; McKee, Ann C.; McLean, Catriona; Milenkovic, Ivan; Montine, Thomas J.; Murayama, Shigeo; Lee, Edward B.; Rahimi, Jasmin; Rodriguez, Roberta D.; Rozemüller, Annemieke; Schneider, Julie A.; Schultz, Christian; Seeley, William; Seilhean, Danielle; Smith, Colin; Tagliavini, Fabrizio; Takao, Masaki; Thal, Dietmar Rudolf; Toledo, Jon B.; Tolnay, Markus; Troncoso, Juan C.; Vinters, Harry V.; Weis, Serge; Wharton, Stephen B.; White III, Charles L.; Wisniewski, Thomas; Woulfe, John M.; Yamada, Masahito; Dicks, Dennis W.; Department of Pathology and Laboratory Medicine, IU School of Medicine
    Pathological accumulation of abnormally phosphorylated tau protein in astrocytes is a frequent, but poorly characterized feature of the aging brain. Its etiology is uncertain, but its presence is sufficiently ubiquitous to merit further characterization and classification, which may stimulate clinicopathological studies and research into its pathobiology. This paper aims to harmonize evaluation and nomenclature of aging-related tau astrogliopathy (ARTAG), a term that refers to a morphological spectrum of astroglial pathology detected by tau immunohistochemistry, especially with phosphorylation-dependent and 4R isoform-specific antibodies. ARTAG occurs mainly, but not exclusively, in individuals over 60 years of age. Tau-immunoreactive astrocytes in ARTAG include thorn-shaped astrocytes at the glia limitans and in white matter, as well as solitary or clustered astrocytes with perinuclear cytoplasmic tau immunoreactivity that extends into the astroglial processes as fine fibrillar or granular immunopositivity, typically in gray matter. Various forms of ARTAG may coexist in the same brain and might reflect different pathogenic processes. Based on morphology and anatomical distribution, ARTAG can be distinguished from primary tauopathies, but may be concurrent with primary tauopathies or other disorders. We recommend four steps for evaluation of ARTAG: (1) identification of five types based on the location of either morphologies of tau astrogliopathy: subpial, subependymal, perivascular, white matter, gray matter; (2) documentation of the regional involvement: medial temporal lobe, lobar (frontal, parietal, occipital, lateral temporal), subcortical, brainstem; (3) documentation of the severity of tau astrogliopathy; and (4) description of subregional involvement. Some types of ARTAG may underlie neurological symptoms; however, the clinical significance of ARTAG is currently uncertain and awaits further studies. The goal of this proposal is to raise awareness of astroglial tau pathology in the aged brain, facilitating communication among neuropathologists and researchers, and informing interpretation of clinical biomarkers and imaging studies that focus on tau-related indicators.
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    Alzheimer's disease and inflammatory biomarkers positively correlate in plasma in the UK‐ADRC cohort
    (Wiley, 2024) Foley, Kate E.; Winder, Zachary; Sudduth, Tiffany L.; Martin, Barbara J.; Nelson, Peter T.; Jicha, Gregory A.; Harp, Jordan P.; Weekman, Erica M.; Wilcock, Donna M.; Neurology, School of Medicine
    Introduction: Protein-based plasma assays provide hope for improving accessibility and specificity of molecular diagnostics to diagnose dementia. Methods: Plasma was obtained from participants (N = 837) in our community-based University of Kentucky Alzheimer's Disease Research Center cohort. We evaluated six Alzheimer's disease (AD)- and neurodegeneration-related (Aβ40, Aβ42, Aβ42/40, p-tau181, total tau, and NfLight) and five inflammatory biomarkers (TNF𝛼, IL6, IL8, IL10, and GFAP) using the SIMOA-based protein assay platform. Statistics were performed to assess correlations. Results: Our large cohort reflects previous plasma biomarker findings. Relationships between biomarkers to understand AD-inflammatory biomarker correlations showed significant associations between AD and inflammatory biomarkers suggesting peripheral inflammatory interactions with increasing AD pathology. Biomarker associations parsed out by clinical diagnosis (normal, MCI, and dementia) reveal changes in strength of the correlations across the cognitive continuum. Discussion: Unique AD-inflammatory biomarker correlations in a community-based cohort reveal a new avenue for utilizing plasma-based biomarkers in the assessment of AD and related dementias. Highlights: Large community cohorts studying sex, age, and APOE genotype effects on biomarkers are few. It is unknown how biomarker-biomarker associations vary through aging and dementia. Six AD (Aβ40, Aβ42, Aβ42/40, p-tau181, total tau, and NfLight) and five inflammatory biomarkers (TNFα, IL6, IL8, IL10, and GFAP) were used to examine associations between biomarkers. Plasma biomarkers suggesting increasing cerebral AD pathology corresponded to increases in peripheral inflammatory markers, both pro-inflammatory and anti-inflammatory. Strength of correlations, between pairs of classic AD and inflammatory plasma biomarker, changes throughout cognitive progression to dementia.
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    Associations of Future Cognitive Decline with Sexual Satisfaction among Married Older Adults
    (Taylor & Francis, 2021) Smith, Allison G.; Bardach, Shoshana H.; Barber, Justin M.; Williams, Andrea; Rhodus, Elizabeth K.; Parsons, Kelly K.; Jicha, Gregory A.; Psychiatry, School of Medicine
    Objectives: This study sought to explore changes in longitudinal cognitive status in relation to baseline measures of intimacy and sexuality in cognitively intact, married older adults. Methods: Baseline intimacy and sexuality survey data from 155, cognitively intact, married, older adults were collected using a novel survey instrument that explored the domains of: 1) romance with one's partner, 2) sexual satisfaction, 3) beliefs about sexuality, and 4) social support and emotional intimacy. These data were analyzed in relation to change in cognitive status over a 10-year follow-up period using binary logistic regression modeling. Exploratory factor analysis was used to assess the shared variance of survey items attributable to intimacy and sexuality without specification of an a priori hypothesis regarding the association of intimacy and sexuality with future change in cognitive status. Results: Over the 10-year study period, 33.5% (n = 52) of individuals developed cognitive impairment. Participants with greater sexual satisfaction scores at baseline were statistically less likely to convert from cognitively intact to mild cognitive impairment or dementia in the future (p = .01). The domains of romance with one's partner, beliefs about sexuality, and social support/emotional intimacy were not predictive of future longitudinal changes in cognitive status. Conclusions: Sexual satisfaction is associated with longitudinal cognitive outcomes in cognitively intact, married, older adults. Clinical implications: Clinicians should routinely assess for sexual satisfaction among older adults and refer to appropriate providers, such as couples or sex therapists, when appropriate.
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    Clinical criteria for limbic-predominant age-related TDP-43 encephalopathy
    (Wiley, 2025) Wolk, David A.; Nelson, Peter T.; Apostolova, Liana; Arfanakis, Konstantinos; Boyle, Patricia A.; Carlsson, Cynthia M.; Corriveau-Lecavalier, Nick; Dacks, Penny; Dickerson, Bradford C.; Domoto-Reilly, Kimiko; Dugger, Brittany N.; Edelmayer, Rebecca; Fardo, David W.; Grothe, Michel J.; Hohman, Timothy J.; Irwin, David J.; Jicha, Gregory A.; Jones, David T.; Kawas, Claudia H.; Lee, Edward B.; Lincoln, Karen; Maestre, Gladys E.; Mormino, Elizabeth C.; Onyike, Chiadi U.; Petersen, Ronald C.; Rabinovici, Gil D.; Rademakers, Rosa; Raman, Rema; Rascovsky, Katya; Rissman, Robert A.; Rogalski, Emily; Scheltens, Philip; Sperling, Reisa A.; Yang, Hyun-Sik; Yu, Lei; Zetterberg, Henrik; Schneider, Julie A.; Neurology, School of Medicine
    Limbic predominant age-related TDP-43 encephalopathy neuropathologic change (LATE-NC) is highly prevalent in late life and a common co-pathology with Alzheimer's disease neuropathologic change (ADNC). LATE-NC is a slowly progressive, amnestic clinical syndrome. Alternatively, when present with ADNC, LATE-NC is associated with a more rapid course. With the emergence of anti-amyloid therapeutics, discrimination of LATE-NC from ADNC is critical and will lead to greater clinical recognition of amnestic patients without ADNC. Furthermore, co-pathology with LATE-NC may influence outcomes of these therapeutics. Thus there is a need to identify patients during life with likely LATE-NC. We propose criteria for clinical diagnosis of LATE as an initial framework for further validation. In the context of progressive memory loss and substantial hippocampal atrophy, criteria are laid out for probable (amyloid negative) or possible LATE (amyloid biomarkers are unavailable or when amyloid is present, but hippocampal neurodegeneration is out of proportion to expected pure ADNC). HIGHLIGHTS: Limbic-predominant age-related TDP-43 encephalopathy (LATE) is a highly prevalent driver of neuropathologic memory loss in late life. LATE neuropathologic change (LATE-NC) is a common co-pathology with Alzheimer's disease neuropathologic change (ADNC) and may influence outcomes with emerging disease-modifying medicines. We provide initial clinical criteria for diagnosing LATE during life either when LATE-NC is the likely primary driver of symptoms or when observed in conjunction with AD. Definitions of possible and probable LATE are provided.
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    Frontal Memory‐related Brainwaves Differentially Correlate with AD and Astrocyte Plasma Biomarkers
    (Wiley, 2025-01-09) Jiang, Yang; Wu, Xian; Katsumata, Yuriko; Clark, Maria F.; Foley, Kate E.; Wang, Baoxi; Sudduth, Tiffany L.; Wilcock, Donna M.; Jicha, Gregory A.; Norris, Christopher M.; Neurology, School of Medicine
    Background: We currently lack in the dementia field accurate, noninvasive, quick, and affordable screening tools for brain dysfunctions associated with early subtle risk of mild cognitive impairment (MCI). Our Kentucky aging cohort demonstrates that asymptomatic older individuals with MCI‐like frontal memory‐related brainwave patterns convert to MCI within a short 5‐year period, as opposed to individuals with NC‐like patterns (1) that remain normal 10 years later (2). Astrocyte reactivity influences amyloid‐β effects on tau pathology in preclinical Alzheimer’s disease (3). Leveraging blood‐based AD and astrocyte biomarkers and the cognitive electroencephalogram (EEG) signatures (4), we test the hypothesis that predictive frontal memory‐related EEG changes correlate with preclinical and early AD plasma biomarkers. Method: 34 (19 women) older volunteers with or without MCI, average age 79 (SD 8.53) years old, from a longitudinal cohort followed by University of Kentucky ADRC participated. Each participant’s EEG was recorded (64‐ or 14‐channels) during a working memory (modified delayed match‐to‐sample) task. Principal component analysis (PCA) was performed on 64‐channel EEG data to create PC scores (PC1 & PC2). For multiple linear regression of EEG PC scores on multiple neurodegenerative plasma biomarkers including Aβ42/40, pTau181, total Tau, and GFAP (Astrocyte reactivity), we adjusted age, sex, education, and gap years between collection dates. Result: The 61% of variance in frontal signals can be explained by PC1 in normal cognition (NC) and MCI individuals, and PC2 counts for 35% of variance (Figure 1). The decreased brainwaves (MCI‐like) seen in left frontal sites significantly correlate with increased pTau181, GFAP, and PC2 (Figure 2). Curiously, right frontal EEG relations with pTau181, GFAP showed the opposite trend. Bilateral frontal signals showed negative correlations with Aβ42/40 and positive correlations with total Tau. Conclusion: Our results indicate that GFAP & pTau181 trend in similar asymmetry ways with frontal cognitive brainwaves, but Aβ42/40 & total Tau correlate to a different component of frontal EEG. That is, distinct cognitive brainwaves correlate with astrocyte reactivity differentially that influence pathologies of beta‐amyloid accumulations and Tau development. Cognitive pathophysiological signatures and AD–Astrocyte plasma biomarkers have great potential for predicting subtle cognitive decline and specific dementia risk in healthy normal individuals.
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    Synergistic effects of plasma S100b levels and MRI‐based water exchange rate across the blood‐brain‐barrier on memory performance among older adults
    (Wiley, 2025-01-09) Pappas, Colleen; Zachariou, Valentinos; Bauer, Christopher E.; Sudduth, Tiffany L.; Wilcock, Donna M.; Jicha, Gregory A.; Hartz, Anika M. S.; Shao, Xingfeng; Wang, Danny J. J.; Gold, Brian T.; Neurology, School of Medicine
    Background: Non‐invasive biofluid and MRI measures of blood‐brain‐barrier (BBB) dysfunction may aid early detection of cerebral small vessel disease (cSVD). Plasma markers of astrocytic function and injury, such as S100 calcium‐binding protein B (S100b), have gained increased attention in relation to BBB integrity and cognition. Here we explored the inter‐relationships between plasma S100b levels, an MRI measure of water exchange rate across the BBB (kw), and cognitive performance among older adults. Method: The participant sample consisted of 74 older adults without dementia recruited from the University of Kentucky Sanders Brown Center on Aging. Relationships between S100b and cognition (memory, executive function) and MRI‐based BBB water exchange rate were tested. Plasma S100b levels (pg/mL) were measured using Meso Scale Discovery R‐PLEX assay at the University of Kentucky’s CCTS Biomarker Analysis Lab. Composite scores were created for memory and executive function. A diffusion‐prepared arterial spin labeling (DP‐ASL) MRI sequence was used to estimate water exchange rate across the BBB (expressed as kw). All data (S100b, cognition, MRI) were collected within 1 year of each other. Multiple linear regression models examined the impact of plasma S100b on memory, executive function, and kw. Covariates included age, gender, and education (for cognition models only). Additionally, kw was tested as moderator of the S100b‐cognition relationships using the PROCESS macro. Result: A negative relationship was observed between S100b and memory, where higher S100b levels were associated with poorer memory performance. A similar relationship was not observed with executive function. S100b was also not associated with kw. However, there was an interaction between S100b levels and kw in the parietal lobe on memory performance such that participants with both lower parietal kw and higher S100b showed the poorest memory performance. Conclusion: Our results indicate that S100b levels are negatively associated with memory performance, but not MRI‐based BBB kw. However, higher S100b levels coupled with lower MRI‐based water exchange rate further contributed to the strong negative effects observed for memory performance. This suggests that plasma S100b and BBB kw may be different proxies of BBB function and may have synergistic negative effects on cognition.
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    The Effect of Sex‐Differences on the Relationship Between White Matter Hyperintensity, Cerebrovascular Reactivity, and Fluid Biomarkers
    (Wiley, 2025-01-09) Bahrani, Ahmed A.; Jiang, Yang; Powell, David K.; Katsumata, Yuriko; Nahvi, Azadeh; Lee, Tiffany; Gold, Brian T.; Goldstein, Larry B.; Wilcock, Donna M.; Jicha, Gregory A.; Nelson, Peter T.; Norris, Christopher M.; Neurology, School of Medicine
    Background: Alzheimer’s disease (AD) and vascular cognitive impairment and dementia (VCID) are the predominant types of dementia in older adults, associated with memory loss and cognitive deficits. White matter hyperintensities (WMH) are linked to both AD and VCID. Astrocytes play a crucial role in WM integrity, encompassing functions like neuroinflammation, oxidative stress, and Aβ clearance. Poorly reactive astrocytes could lead to implications, like WMH or vascular damage. This study aims to explore sex‐differences effect on the correlation between fluid biomarkers, WMH, and cerebrovascular reactivity (CVR). Method: Twenty‐seven participants (mean age 76.8±6.4 years, Female=15) preliminary data were collected from UK‐ADRC/MarkVCID cohorts. A correlation test was employed to examine sex‐differences based on the correlation of fluid inflammatory (GFAP, IL6, IL8, IL10), angiogenic (TDP‐43, and PlGF) biomarkers, and Aβ40 and 42, to global and regional CVR and WMH. Results: We observed several sex‐differences: the female group showed a significant correlation between WMH at occipital lobe and IL6 (P=0.031), IL10 (P=0.036), and GFAP (P=0.037), while male group only showed a significant correlation between Aβ42 and WMH at the occipital lobe (P=0.039). CVR data of the female group exhibited a correlation at the parietal lobe (right‐hemisphere) and IL8 (P=0.037) and Aβ40 (P=0.038) and between Aβ40 and CVR temporal lobe (right‐hemisphere, P=0.021). The male group showed a significant correlation between IL6 and CVR at the occipital lobe (left‐hemisphere, P=0.012. Generally, the female group showed higher mean values for all biomarkers except for IL10 and PIGF, but only significant at GFAP and TDP43. Additionally, the correlation test adjusted for age and sex showed that TDP‐43 had a significant correlation with WMH in the temporal (P=0.041), occipital (P=0.024), and parietal (P=0.024) lobes, while GFAP displayed a significant correlation only with WMH in the frontal lobe (P=0.013). Conclusions: Despite the small sample size, which warrants expansion in future studies, we observed interesting findings of sex‐differences in specific brain regions in relation to fluid biomarkers. These biomarkers may arise, in part, from reactive astrocytes, commonly found near many brain lesions, including WM pathology. Further studies are needed to gain deeper insight into astrocyte activities in diseases associated with WMH and CVR, like AD.