Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease

Abstract Objective Within Lewy body spectrum disorders (LBSD) with α‐synuclein pathology (αSyn), concomitant Alzheimer's disease (AD) pathology is common and is predictive of clinical outcomes, including cognitive impairment and decline. Plasma phosphorylated tau 181 (p‐tau181) is sensitive to...

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Main Authors: Katheryn A. Q. Cousins, David J. Irwin, Alice Chen‐Plotkin, Leslie M. Shaw, Sanaz Arezoumandan, Edward B. Lee, David A. Wolk, Daniel Weintraub, Meredith Spindler, Andres Deik, Murray Grossman, Thomas F. Tropea
Format: Article
Language:English
Published: Wiley 2023-05-01
Series:Annals of Clinical and Translational Neurology
Online Access:https://doi.org/10.1002/acn3.51768
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author Katheryn A. Q. Cousins
David J. Irwin
Alice Chen‐Plotkin
Leslie M. Shaw
Sanaz Arezoumandan
Edward B. Lee
David A. Wolk
Daniel Weintraub
Meredith Spindler
Andres Deik
Murray Grossman
Thomas F. Tropea
author_facet Katheryn A. Q. Cousins
David J. Irwin
Alice Chen‐Plotkin
Leslie M. Shaw
Sanaz Arezoumandan
Edward B. Lee
David A. Wolk
Daniel Weintraub
Meredith Spindler
Andres Deik
Murray Grossman
Thomas F. Tropea
author_sort Katheryn A. Q. Cousins
collection DOAJ
description Abstract Objective Within Lewy body spectrum disorders (LBSD) with α‐synuclein pathology (αSyn), concomitant Alzheimer's disease (AD) pathology is common and is predictive of clinical outcomes, including cognitive impairment and decline. Plasma phosphorylated tau 181 (p‐tau181) is sensitive to AD neuropathologic change (ADNC) in clinical AD, and plasma glial fibrillary acidic protein (GFAP) is associated with the presence of β‐amyloid plaques. While these plasma biomarkers are well tested in clinical and pathological AD, their diagnostic and prognostic performance for concomitant AD in LBSD is unknown. Methods In autopsy‐confirmed αSyn‐positive LBSD, we tested how plasma p‐tau181 and GFAP differed across αSyn with concomitant ADNC (αSyn+AD; n = 19) and αSyn without AD (αSyn; n = 30). Severity of burden was scored on a semiquantitative scale for several pathologies (e.g., β‐amyloid and tau), and scores were averaged across sampled brainstem, limbic, and neocortical regions. Results Linear models showed that plasma GFAP was significantly higher in αSyn+AD compared to αSyn (β = 0.31, 95% CI = 0.065–0.56, and P = 0.015), after covarying for age at plasma, plasma‐to‐death interval, and sex; plasma p‐tau181 was not (P = 0.37). Next, linear models tested associations of AD pathological features with both plasma analytes, covarying for plasma‐to‐death, age at plasma, and sex. GFAP was significantly associated with brain β‐amyloid (β = 15, 95% CI = 6.1–25, and P = 0.0018) and tau burden (β = 12, 95% CI = 2.5–22, and P = 0.015); plasma p‐tau181 was not associated with either (both P > 0.34). Interpretation Findings indicate that plasma GFAP may be sensitive to concomitant AD pathology in LBSD, especially accumulation of β‐amyloid plaques.
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spelling doaj.art-be506e0f18724aafa19268390fc0a2852023-05-16T15:39:13ZengWileyAnnals of Clinical and Translational Neurology2328-95032023-05-0110580281310.1002/acn3.51768Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body diseaseKatheryn A. Q. Cousins0David J. Irwin1Alice Chen‐Plotkin2Leslie M. Shaw3Sanaz Arezoumandan4Edward B. Lee5David A. Wolk6Daniel Weintraub7Meredith Spindler8Andres Deik9Murray Grossman10Thomas F. Tropea11Department of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Psychiatry University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USADepartment of Neurology Perelman School of Medicine Philadelphia Pennsylvania USAAbstract Objective Within Lewy body spectrum disorders (LBSD) with α‐synuclein pathology (αSyn), concomitant Alzheimer's disease (AD) pathology is common and is predictive of clinical outcomes, including cognitive impairment and decline. Plasma phosphorylated tau 181 (p‐tau181) is sensitive to AD neuropathologic change (ADNC) in clinical AD, and plasma glial fibrillary acidic protein (GFAP) is associated with the presence of β‐amyloid plaques. While these plasma biomarkers are well tested in clinical and pathological AD, their diagnostic and prognostic performance for concomitant AD in LBSD is unknown. Methods In autopsy‐confirmed αSyn‐positive LBSD, we tested how plasma p‐tau181 and GFAP differed across αSyn with concomitant ADNC (αSyn+AD; n = 19) and αSyn without AD (αSyn; n = 30). Severity of burden was scored on a semiquantitative scale for several pathologies (e.g., β‐amyloid and tau), and scores were averaged across sampled brainstem, limbic, and neocortical regions. Results Linear models showed that plasma GFAP was significantly higher in αSyn+AD compared to αSyn (β = 0.31, 95% CI = 0.065–0.56, and P = 0.015), after covarying for age at plasma, plasma‐to‐death interval, and sex; plasma p‐tau181 was not (P = 0.37). Next, linear models tested associations of AD pathological features with both plasma analytes, covarying for plasma‐to‐death, age at plasma, and sex. GFAP was significantly associated with brain β‐amyloid (β = 15, 95% CI = 6.1–25, and P = 0.0018) and tau burden (β = 12, 95% CI = 2.5–22, and P = 0.015); plasma p‐tau181 was not associated with either (both P > 0.34). Interpretation Findings indicate that plasma GFAP may be sensitive to concomitant AD pathology in LBSD, especially accumulation of β‐amyloid plaques.https://doi.org/10.1002/acn3.51768
spellingShingle Katheryn A. Q. Cousins
David J. Irwin
Alice Chen‐Plotkin
Leslie M. Shaw
Sanaz Arezoumandan
Edward B. Lee
David A. Wolk
Daniel Weintraub
Meredith Spindler
Andres Deik
Murray Grossman
Thomas F. Tropea
Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
Annals of Clinical and Translational Neurology
title Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
title_full Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
title_fullStr Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
title_full_unstemmed Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
title_short Plasma GFAP associates with secondary Alzheimer's pathology in Lewy body disease
title_sort plasma gfap associates with secondary alzheimer s pathology in lewy body disease
url https://doi.org/10.1002/acn3.51768
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