scholarly journals Early alteration of the locus coeruleus in phenotypic variants of Alzheimer’s disease

2019 ◽  
Vol 6 (7) ◽  
pp. 1345-1351 ◽  
Author(s):  
Pauline Olivieri ◽  
Julien Lagarde ◽  
Stéphane Lehericy ◽  
Romain Valabrègue ◽  
Adeline Michel ◽  
...  
Brain ◽  
2017 ◽  
Vol 140 (11) ◽  
pp. 3023-3038 ◽  
Author(s):  
Jacki M Rorabaugh ◽  
Termpanit Chalermpalanupap ◽  
Christian A Botz-Zapp ◽  
Vanessa M Fu ◽  
Natalie A Lembeck ◽  
...  

2021 ◽  
Author(s):  
Michael David ◽  
Paresh A. Malhotra

There is clear and early noradrenergic dysfunction in Alzheimer’s disease. This is likely secondary to pathological tau deposition in the locus coeruleus, the pontine nucleus that produces and releases noradrenaline, which occurs prior to involvement of cortical brain regions. Disruption of noradrenergic pathways affects cognition, especially attention, which impacts on memory and broader functioning in daily life. Additionally, it leads to the autonomic and neuropsychiatric symptoms that are frequently observed with disease progression.Despite the strong evidence of noradrenergic involvement in Alzheimer’s, there are no clear trial data supporting the clinical use of any noradrenergic treatments. Several approaches have been tried, including both proof-of-principle studies and randomised controlled trials, although most of the latter have been relatively small scale. Treatments have included drug therapies as well as stimulation modalities thought to modulate noradrenergic transmission. The lack of clear positive findings is likely secondary to limited capacity for gauging locus coeruleus integrity and noradrenergic dysfunction at an individual level. However, the recent development of several novel biomarkers holds potential and should allow quantification of dysfunction. This in turn may inform inclusion criteria and stratification for future trials. Imaging approaches in particular have improved greatly following the development of neuromelanin-sensitive sequences, enabling the use of structural MRI scans to estimate locus coeruleus integrity. Additionally, functional MRI and PET scanning have the potential to quantify network dysfunction. As well as neuroimaging, EEG and pupillometry techniques may prove useful in assessing noradrenergic tone and dynamic response to stimulation.Here we review the development of these biomarkers and discuss how they might augment clinical studies, particularly randomised trials, through stratification and identification of patients most likely to benefit from treatment. We outline the biomarkers with most potential, and how they hold promise as a means of transforming symptomatic therapy for people living with Alzheimer’s disease.


2019 ◽  
Vol 70 (2) ◽  
pp. 371-388 ◽  
Author(s):  
Sarah C. Kelly ◽  
Erin C. McKay ◽  
John S. Beck ◽  
Timothy J. Collier ◽  
Anne M. Dorrance ◽  
...  

2005 ◽  
Vol 492 (4) ◽  
pp. 469-476 ◽  
Author(s):  
Dwight C. German ◽  
Omar Nelson ◽  
Fen Liang ◽  
Chang-Lin Liang ◽  
Dora Games

2006 ◽  
Vol 14 (7S_Part_26) ◽  
pp. P1393-P1393
Author(s):  
Panos Theofilas ◽  
Alexander J. Ehrenberg ◽  
Helmut Heinsen ◽  
Lea Tenenholz Grinberg

Author(s):  
Tony James ◽  
Bartosz Kula ◽  
Seowon Choi ◽  
Shahzad S. Khan ◽  
Lane K. Bekar ◽  
...  

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