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Browsing by Author "Silverman, Wayne"
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Item A pathway linking pulse pressure to dementia in adults with Down syndrome(Oxford University Press, 2024-05-09) Rizvi, Batool; Lao, Patrick J.; Sathishkumar, Mithra; Taylor, Lisa; Queder, Nazek; McMillan, Liv; Edwards, Natalie C.; Keator, David B.; Doran, Eric; Hom, Christy; Nguyen, Dana; Rosas, H. Diana; Lai, Florence; Schupf, Nicole; Gutierrez, Jose; Silverman, Wayne; Lott, Ira T.; Mapstone, Mark; Wilcock, Donna M.; Head, Elizabeth; Yassa, Michael A.; Brickman, Adam M.; Neurology, School of MedicineAdults with Down syndrome are less likely to have hypertension than neurotypical adults. However, whether blood pressure measures are associated with brain health and clinical outcomes in this population has not been studied in detail. Here, we assessed whether pulse pressure is associated with markers of cerebrovascular disease and is linked to a diagnosis of dementia in adults with Down syndrome via structural imaging markers of cerebrovascular disease and atrophy. The study included participants with Down syndrome from the Alzheimer’s Disease - Down Syndrome study (n = 195, age = 50.6 ± 7.2 years, 44% women, 18% diagnosed with dementia). Higher pulse pressure was associated with greater global, parietal and occipital white matter hyperintensity volume but not with enlarged perivascular spaces, microbleeds or infarcts. Using a structural equation model, we found that pulse pressure was associated with greater white matter hyperintensity volume, which in turn was related to increased neurodegeneration, and subsequent dementia diagnosis. Pulse pressure is an important determinant of brain health and clinical outcomes in individuals with Down syndrome despite the low likelihood of frank hypertension.Item Plasma Total-Tau and Neurofilament Light Chain as Diagnostic Biomarkers of Alzheimer's Disease Dementia and Mild Cognitive Impairment in Adults with Down Syndrome(IOS Press, 2021) Petersen, Melissa E.; Rafii, Michael S.; Zhang, Fan; Hall, James; Julovich, David; Ances, Beau M.; Schupf, Nicole; Krinsky-McHale, Sharon J.; Mapstone, Mark; Silverman, Wayne; Lott, Ira; Klunk, William; Head, Elizabeth; Christian, Brad; Foroud, Tatiana; Lai, Florence; Rosas, H. Diana; Zaman, Shahid; Wang, Mei-Cheng; Tycko, Benjamin; Lee, Joseph H.; Handen, Benjamin; Hartley, Sigan; Fortea, Juan; O’Bryant, Sid; Alzheimer’s Biomarker Consortium – Down Syndrome (ABC-DS); Medical and Molecular Genetics, School of MedicineBackground: The need for diagnostic biomarkers of cognitive decline is particularly important among aging adults with Down syndrome (DS). Growing empirical support has identified the utility of plasma derived biomarkers among neurotypical adults with mild cognitive impairment (MCI) and Alzheimer's disease (AD); however, the application of such biomarkers has been limited among the DS population. Objective: This study aimed to investigate the cross-sectional diagnostic performance of plasma neurofilament light chain (Nf-L) and total-tau, individually and in combination among a cohort of DS adults. Methods: Plasma samples were analyzed from n = 305 (n = 225 cognitively stable (CS); n = 44 MCI-DS; n = 36 DS-AD) participants enrolled in the Alzheimer's Biomarker Consortium -Down Syndrome. Results: In distinguishing DS-AD participants from CS, Nf-L alone produced an AUC of 90%, total-tau alone reached 74%, and combined reached an AUC of 86%. When age and gender were included, AUC increased to 93%. Higher values of Nf-L, total-tau, and age were all shown to be associated with increased risk for DS-AD. When distinguishing MCI-DS participants from CS, Nf-L alone produced an AUC of 65%, while total-tau alone reached 56%. A combined model with Nf-L, total-tau, age, and gender produced an AUC of 87%. Both higher values in age and total-tau were found to increase risk for MCI-DS; Nf-L levels were not associated with increased risk for MCI-DS. Conclusion: Advanced assay techniques make total-tau and particularly Nf-L useful biomarkers of both AD pathology and clinical status in DS and have the potential to serve as outcome measures in clinical trials for future disease-modifying drugs.