Translational Neurodegeneration

Substantia nigra pars compacta dopamine neuron loss and Lewy pathology, aggregates of -synuclein, characterize Parkinsons disease and Dementia with Lewy Bodies. Lewy pathology localizes to cortical neurons, and is found as Lewy neurites in the striatum, but its effects on excitatory synaptic function are just beginning to be understood. Corticostriatal projections regulate motor and cognitive behaviors impaired in these disorders. Here, -synuclein aggregation was induced in mouse M2 cortex, a vulnerable region in human disease. Early after initiation, aggregates localized to corticostriatal vesicular glutamate transporter 1 (vGLUT1)-positive terminals, with sparing of spiny projection neuron (SPN) soma, and dopamine terminals and neurons. Corticostriatal presynaptic aggregates significantly impaired glutamatergic transmission, without overt cortical neuron loss, and were associated with decreased synaptic density and volume. Thus, formation of presynaptic -synuclein aggregates impairs corticostriatal function without degeneration of cortical neurons or striatal dopamine terminals, suggesting pathologic -synuclein is sufficient for synaptic loss. Our findings also point to early synaptic dysfunction as a therapeutic target in Lewy body diseases.

Structured AbstractINTRODUCTION Tau pathology typically occurs in Alzheime[r]s disease (AD), however is also frequently present in Parkinso[n]s disease dementia (PDD) and Dementia with Lewy Bodies (DLB), yet its disease-specific signature is unclear. METHODSFive tau, amyloid-{beta}, -synuclein and neuronal markers were analysed across hippocampal subfields in non-demented controls (CTLs), AD, PDD and DLB using multiplex immunohistochemistry, single-tangle classification and confocal imaging. RESULTSAT8, pTau217, and GT38 were predominatly detected in AD, while pS422 was enriched in PDD and pS396 showed a region- and disease-specific pattern. DLB resembled AD in subregional tau distribution. Tau marker correlation were different comparing AD, PDD and CTL. Single-tangle analyses revealed disease-specific immunophenotypes but conserved mature intra-tangle epitope organisation. Distinct tau signatures were associated with inhibitory interneuron vulnerability, while regional tau co-occurrence with amyloid-{beta} and -synuclein remained conserved. DISCUSSIONDisease-specific tau signatures vary across hippocampal subregions and neuronal populations, implicating the contribution of regional and cell-specific factors beyond pathology burden.

Background Heparan sulfate (HS) and heparan sulfate proteoglycans (HSPGs) are components of the amyloid deposits in Alzheimers disease (AD) and other amyloidoses. HS and HSPGs are canonically thought to facilitate amyloid deposition by accelerating the aggregation of amyloidogenic proteins and impairing their clearance in a HS-dependent manner. Methods Leveraging insights from large-scale proteomic data, we focused on Syndecan-4 (Sdc4), the most increased transmembrane HSPG in the AD brain and in the brain of A{beta} amyloid depositing mice. We used proximity ligation assays (PLA) to evaluate the association of Sdc4 with A{beta} in situ and assessed the impacts of the Sdc4 ectodomain on A{beta} aggregation in vitro. Overexpression studies in cells, hiPSC-derived neurons, and mouse organotypic brain slice cultures (OBSCs) coupled with structure-function studies were used to investigate impacts on A{beta} production and APP processing. Finally, effects of overexpression of Sdc4 in vivo in the CRND8 amyloid deposition model were evaluated. Results Consistent with canonical roles, PLA demonstrated a spatial association of Sdc4 with amyloid deposits, and in vitro, the Sdc4 ectodomain accelerated A{beta} fibril formation in a HS-dependent manner. Unexpectedly, Sdc4 overexpression reduced A{beta} production in CHO cells, hiPSC-derived neurons, and OBSCs. These effects were accompanied by dramatic decreases in the levels of sAPP and C83 and increased immature APP in the cell. Sdc4 promoted altered APP localization into detergent resistant membrane domains and increased APP association with ATG5+/LC3+/Cathepsin D+ vesicles. Structure-function studies revealed that the transmembrane region mediates these effects in a glycosaminoglycan-independent manner. Sdc4 overexpression in the brain of APP mice significantly reduced amyloid deposition at an early age. Conclusions Sdc4 exerts paradoxical and mechanistically distinct effects that could impact AD pathogenesis differentially, potentially promoting A{beta} fibrillization extracellularly while suppressing APP processing and A{beta} production. Such data challenge the prevailing view that increased levels of HSPGs in AD are always pro-amyloidogenic and identify Sdc4 as a previously unrecognized regulator of amyloid homeostasis in AD.

Background: Late-onset Alzheimer's disease (LOAD) comprises more than 95% of all AD cases. Transgenic, overexpression animal models have off target side effects, do not effectively produce the heterogeneity observed clinically in LOAD patients, and are therefore not best suited for preclinical therapeutic development. The Model Organism Development and Evaluation for Late-onset Alzheimer's Disease (MODEL-AD) Consortium was established to develop novel mouse strains to model human-relevant genetic and environmental risk factors for LOAD. Methylenetetrahydrofolate reductase (MTHFR) is an enzyme in the folate/methionine pathway. Variants in the MTHFR gene, notably 677C>T, are associated with ADRD, and we have previously shown the Mthfr677C>T mouse model phenocopies humans carrying the variant and develop cerebrovascular deficits. Methods: To examine the contributions of Mthfr677C>T in the context of late-onset Alzheimer's disease (LOAD), MODEL-AD created a novel mouse strain on the C57BL/6J (B6) background that was homozygous for Mthfr677C>T, in combination with humanized Abeta;, APOEe4, and Trem2*R47H (referred to as LOAD2.Mthfr677C>T). Mice were assessed over multiple ages for disease-relevant phenotypes. Regular behavior measurements and biometric samples were collected longitudinally to 24 months of age. Blood and brain tissue were collected for transcriptomics, proteomics, human disease correlation, and neuropathology. Results: Despite lacking hallmark pathologies such as amyloid deposition and significant neuroinflammation, compared to LOAD2 controls, LOAD2.Mthfr677C>T mice showed transcriptional and proteomic signatures in the brain that relate to the cerebrovasculature, myelination, and synaptic biology, similar to those seen in human LOAD patients. Conclusions: These data further support the use of the LOAD2.Mthfr677C>T mouse model to study aspects of ADRD such as cerebrovascular compromise.

Alzheimers Disease (AD) and related dementias (AD/RDs) impact cortical motor and sensory biology whereas the precise changes to these systems, and their clinical relevance, remain under debate. We hypothesized that cortical representations of complex and simple movements are differently altered during disease progression in 5XFAD mice, a well-established model of AD. Motor cortex somatotopy was determined in 5XFAD and Wild-Type Control (WT Control) mice at 6 and 12 months (mos.) of age using long-duration intracortical microstimulation (LD-ICMS) to systematically identify cortical sites evoking complex and simple forelimb movements. At 6 mos. of age, 5XFAD mice exhibited a significant expansion of motor cortical sites representing simple movements, specifically Elbow Flexion (p=0.0004) and Wrist Flexion (p=0.024). The over-sized territory for Elbow Flexion significantly distinguished 5XFAD from WT mice (Receiver Operating Characteristic [ROC] area under the curve [AUC]= 0.94, p= 0.0009) whereas discriminative performance of Wrist Flexion was a non-significant trend (AUC=0.75, p=0.059). By 12 mos. of age, motor cortex organization was markedly reorganized in 5XFAD mice, with significantly fewer cortical sites evoking complex Advance movement (p<0.0001) as well as simple Shoulder (p=0.0001), Elbow Extension (p=0.024), and Wrist Extension (p=0.003) movements. The number of sites for simple Wrist Flexion was significantly increased (p=0.011) in 12 mo. old 5XFAD mice. At 12 mos., territory size of several of these movement zones highly distinguished 5XFAD from WT mice, including Advance (AUC= 0.96, p= 0.0005), Shoulder (AUC= 0.97, p= 0.0004), Elbow Extension (AUC=0.78, p=0.034), Wrist Extension (AUC=0.85, p= 0.0082), and Wrist Flexion (AUC=0.80, p= 0.023). These findings demonstrate progressive, age-dependent remodeling of motor cortex somatotopy in 5XFAD mice, characterized by early expansion of specific simple movement cortical sites followed by deterioration of both complex and simple motor cortical maps as disease advances. Motor cortex somatotopic remodeling may provide a sensitive biomarker of AD/RDs progression.

Chronic Wasting Disease (CWD) is a fatal transmissible spongiform encephalopathy (TSE) that is confined to cervids (deer, moose, elk, and reindeer) but shares key properties with human neurodegenerative conditions such as Alzheimers, Parkinsons, Huntingtons disease and frontal-temporal dementia. CWD and other TSEs are caused by the misfolded prion protein (PrP). Although the identification of diagnostic and prognostic biomarkers at all stages of disease progression is becoming exceedingly critical as CWD continues to increase in prevalence, accurate antemortem testing techniques are extremely limited. This study made use of cervidized transgenic mice (mice carrying the cervid PrP) that recapitulate CWD in various disease stages and investigated the utility of neurological biomarkers and neurobehavioral manifestations for CWD detection. Neurofilament light chain (NFL), glial fibrillary acidic protein (GFAP), and total Tau (t-Tau) were assessed under the hypothesis that combined biomarker signatures might more reliably reflect CWD-related neurodegeneration and disease progression. Analyses at 90, 132, 174, and 230 days post-CWD inoculation show distinct biomarker elevation, with all three biomarkers significantly elevated in the CWD animals by 132 days post-inoculation. To our knowledge, this is the first demonstration that these three plasma biomarkers are useful not only for detecting CWD, but also for identifying it at early antemortem stages of disease. Novel phenotypes were also revealed by comprehensive phenotypic profiling, including rigid tail elevation, increased grip strength, and impaired coordination, to lend further support to plasma biomarker data indicating neurologic impairment associated with brain pathology. Ultimately, the goal is to improve antemortem, non-invasive CWD detection methods to enable earlier detection and assist with disease management.

BackgroundNeuromelanin (NM) is a pigment that progressively accumulates with age in catecholaminergic neurons, particularly in the substantia nigra, ventral tegmental area, and locus coeruleus. These neuronal populations are especially vulnerable to degeneration in Parkinsons disease (PD). Elevated intracellular NM levels have been linked to neurodegeneration and PD-like phenotypes in experimental models. However, the molecular mechanisms underlying NM-induced pathology remain poorly understood, as human studies cannot disentangle the specific effects of NM accumulation from those of normal aging. MethodsWe performed transcriptomic microarray analysis on laser-captured catecholaminergic neurons and regions (substantia nigra, ventral tegmental area, locus coeruleus) from NM-producing transgenic mice (tgNM) and NM-free wild-type controls across different ages, and compared them to data from postmortem human brain tissue. One of the molecular targets identified, GPNMB, was validated in mouse and human tissue, and functionally tested in vivo. ResultsWe identified region- and age-dependent transcriptional changes associated with progressive NM accumulation. NM consistently upregulated neuroinflammatory pathways with enrichment of disease-associated microglial genes, while downregulating transcription, translation, and mitochondrial functions. Locus coeruleus exhibited the earliest and strongest transcriptional alterations, whereas substantia nigra and ventral tegmental area showed a later-onset, age-progressive transcriptional dysfunction. Neuron-specific analyses revealed that many changes originated within NM-containing neurons rather than being solely glial-driven. NM-driven transcriptional profiles in mice strongly correlated with postmortem data from PD patients, underscoring their translational relevance. Among molecular targets, the glycoprotein GPNMB was consistently upregulated in NM-containing neurons and validated at RNA and protein levels in both NM-producing transgenic mice and human PD brains. Functional experiments demonstrated that GPNMB overexpression attenuated NM-linked dopaminergic neurodegeneration and improved motor performance in mice. ConclusionThis study provides a comprehensive in vivo characterization of NM-specific transcriptomic changes in catecholaminergic neurons, showing that NM accumulation drives neuroinflammatory and neurodegenerative programs. Our results support that the neuroinflammatory changes observed in tgNM mice and in human PD represent early pathological events that precede overt neurodegeneration. The disease-associated gene GPNMB emerged as a conserved NM-induced factor with protective properties, highlighting its potential as a therapeutic target in PD and aging-related neurodegeneration.

Insulin resistance is increasingly recognized as a metabolic factor associated with Alzheimers disease (AD); however, its relevance to hippocampal structural changes--a key pathological feature of AD--across disease stages is not fully understood. To address this issue, we investigated the relationship between insulin resistance, hippocampal gray matter volume, and cognitive performance using data from the Alzheimers Disease Neuroimaging Initiative (ADNI), a large-scale neuroimaging dataset. Insulin resistance was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and its relationship with brain structure and cognitive performance was evaluated across diagnostic groups. In the mild cognitive impairment (MCI) group, higher insulin resistance was associated with larger anterior hippocampal gray matter volume, whereas in the AD group this association was reversed in direction. Furthermore, in the MCI group, anterior hippocampal gray matter volume was also positively associated with higher Mini-Mental State Examination (MMSE) scores, and an exploratory mediation analysis suggested a significant indirect association linking HOMA-IR, anterior hippocampal volume, and cognitive performance through anterior hippocampal volume. These findings suggest that the relationship between insulin resistance and AD-related brain changes differs across diagnostic groups, highlighting the importance of considering metabolic alterations in relation to disease status.

Complement-mediated neuroinflammation has been implicated in Alzheimer's disease (AD), but its role during the pre-symptomatic phase of the disease remains unclear. In the PREVENT-AD cohort of cognitively unimpaired individuals at increased familial risk of AD, we investigated whether CSF complement proteins relate to early AD pathology and synaptic dysfunction, then assessed our results' reproducibility across the clinical AD spectrum. Baseline CSF C1q, C3, C3b, and Factor H were measured in relation to CSF AD biomarkers, synaptic proteins, cognition, MRI volumetry, and amyloid and tau PET. Key findings were then examined in 708 participants from ADNI spanning cognitively normal, mild cognitive impairment (MCI), and dementia stages of AD. In PREVENT-AD, C1q was positively associated with CSF P-tau181, T-tau, and multiple synaptic markers including ADAM23, GAP43, SNAP25, and SYT1. Factor H showed similarly strong positive associations with P-tau181, T-tau, ADAM22, ADAM23, GAP43, and SYT1. By contrast, C3 showed minimal associations, while C3b displayed weaker positive relationships with P-tau181, T-tau, ADAM22, and ADAM23. Complement proteins were not robustly associated with amyloid or tau PET, and only C1q related to lower global cognitive performance. In ADNI, C1q emerged as the most consistent analyte, showing positive associations with tau, neurofilament light, and synaptic markers across all diagnostic groups. C3 exhibited predominantly negative associations, whereas C3b and Factor H showed stage-dependent relationships, particularly with evident neurodegeneration and synaptic injury in symptomatic individuals. These findings identify complement dysregulation, especially involving C1q, as an early correlate of tau-linked synaptic pathology, and support a role for complement activation in the AD molecular cascade.

Previous observations in preclinical and clinical studies indicate a beneficial effect of insulin-like growth factor 1 (IGF-1) in different neurological illnesses, including Alzheimers disease (AD). AD is the most important neurodegenerative disease in the world and despite previous intensive research and the recent approval of putative disease-modifying therapies, available treatments provide only modest clinical benefit and do not halt disease progression. Consequently, there remains a pressing need to develop novel therapeutic strategies for AD. Since resistance to IGF-1 may be involved in development of AD, as it regulates cognition and amyloid {beta} (A{beta}) metabolism, we recently developed a small molecule IGF-1 sensitizer, AIK3a305, that crosses the blood brain barrier (BBB) and exerts modulatory actions in the brain. Using a mouse model of familial AD, the APP/PS1 mouse, we administered them AIK3a305 for 3 months. Treatment started at 12 months of age, when the disease is already well established, and cognitive deterioration readily measurable. One month after starting daily intraperitoneal injections of AIK3a305, mice showed normal cognitive performance in the Y maze, a measure of working memory that enables daily life activities. After 3 months, cognition remained fully preserved, mood-associated disturbances such as anxiety, were corrected, and brain A{beta} levels significantly ameliorated. AIK3a305 may therefore be a promising novel therapeutic strategy for AD patients.

Dopaminergic neurons in the substantia nigra pars compacta are key targets of -synuclein pathology and neurodegeneration in Parkinson's disease (PD). It is thought that pathological accumulation of -synuclein significantly contributes to nigral neuronal dysfunction and ensuing neuronal demise. In this study, we further assessed this possibility and interrogated the role of -synuclein burden in compromising neuronal function and altering physiological neuronal pathways. In particular, we focused on nigral mitochondrial impairment and disruption of circadian regulatory pathways triggered by sustained -synuclein expression. Using an in vivo AAV-mediated model, we show that -synuclein accumulation over a period of 12 weeks is associated with mitochondrial complex I and IV deficits and leads to dopaminergic cell loss. Proximity ligation assays revealed association of both total and phosphorylated -synuclein with mitochondrial proteins at a time (between 4 and 12 weeks) that paralleled the development of mitochondrial dysfunction. Spatial transcriptomic analysis of the substantia nigra identified coordinated alterations in genes involved in mitochondrial, metabolic, and circadian pathways, including increased expression of circadian-associated genes such as Nr1d1, Nr1d2, Cry2, Arntl2, and Csnk1e. At the protein level, -synuclein overexpression was associated with a differential shift in cryptochrome protein expression, characterized by reduced CRY1 and increased CRY2. Data provide evidence of a specific window of time during which sustained -synuclein burden results in direct -synuclein-mitochondria interactions and nigral mitochondrial damage. During the same time period, a specific remodeling of molecular clock components occurs, providing a potential new mechanism contributing to metabolic and mitochondrial dysregulations and, ultimately, neuronal injury and degeneration.

Different conformations, or strains, of -synuclein (-syn) aggregates are believed to be responsible for the distinct seeding propensities, propagation profiles, and clinical presentations in Lewy body diseases (LBD) and multiple system atrophy (MSA). While biochemical properties and strain differences of insoluble deposits have been extensively characterized, the understanding of what influence soluble -syn species may have on these processes is limited to a small number of studies focusing on complex mixtures of soluble species or on a single - synucleinopathy. Given that soluble oligomers are considered highly pathologically relevant, we isolated and characterized the biochemical, seeding, and toxicity properties of size-fractionated soluble -syn species from MSA and LBD brains, comparing them to species from control brains without known neurological disease (Ctrl). We observed that levels of differently sized oligomers phosphorylated at Ser129, as well as soluble large oligomers (>450 kDa), were increased in LBD compared to both MSA and Ctrl brains. Nevertheless, species derived from MSA brain exhibited seeding activity across the spectrum of -syn species (oligomers, monomers, and truncated forms) in the seed amplification assay, whereas only oligomeric species (>150 kDa) from LBD cases were seeding-prone. In the HEK293 -syn (A53T)-YFP biosensor line, as well as in murine primary neurons, only large oligomers (>450 kDa) from MSA cases induced seeding and aggregation of -syn. Taken together, our study suggests that soluble -syn species derived from MSA and LBD brains show different biochemical, aggregation and seeding patterns, presumably due to strain variations of the respective oligomers. Our findings provide novel insight into the pathogenesis of different -synucleinopathies, which may guide us in the development of targeted therapeutics.

Alzheimer's disease (AD) lacks effective therapies despite extensive efforts targeting amyloid {beta} (A{beta}) and its precursor processing. Synapse loss is the strongest correlate of cognitive decline, driven partly by A{beta} oligomers (A{beta}Os), which bind multiple synaptic membrane proteins including the synaptic organizer neurexin and disrupt synaptic integrity and function. The protein sorting receptor SorCS1 blocks interactions between A{beta}Os and {beta}-isoforms of neurexins ({beta}-Nrxns), but its therapeutic relevance in vivo remains unclear. Using 5xFAD mice, which overproduce A{beta}Os, combined with forebrain specific neuronal SorCS1 overexpression, we show that SorCS1 preserves working memory, synaptic integrity, and basal excitatory transmission without altering amyloid deposition, in part by restoring synaptic {beta}-Nrxn expression. SorCS1 also reduces tau hyperphosphorylation in 5xFAD synaptosomes and binds the tau kinase GSK3{beta}. These results identify SorCS1 as an AD resilience promoting factor that maintains synaptic connectivity and attenuates tau pathology, revealing a therapeutic strategy that operates independently of amyloid reduction.

Parkinson disease (PD) affects more than 1.1 million individuals in the United States and around 12 million worldwide. Although Genome Wide Association Studies (GWAS) have substantially advanced our understanding of PD genetic architecture, the regulatory mechanisms linking PD risk loci to disease-relevant gene expression remain incompletely characterized, limiting our ability to infer disease mechanisms from genetic associations. Here, we integrated disease-state parietal cortex transcriptomics with the International Parkinsons Disease Genomics Consortium (iPDGC) locus prioritization to refine PD gene nomination and identify biologically plausible candidates missed by GWAS-only approaches. Using bulk RNA-seq from 99 neuropathologically confirmed PD cases and 30 neuropathologically confirmed controls, we prioritized candidate genes across 78 loci and classified them according to concordance between genetic evidence and differential expression in diseased cortices. This integrative approach recovered candidate genes not captured by external GWAS-based prioritization methods and highlighted synaptic, lysosomal, and proteostasis pathways as major components of PD risk biology. Network and transcription factor analyses further suggested coordinated regulation of these genes, with STAT3 emerging as a putative upstream glial regulator. Together, these findings suggest that integrating disease-state transcriptomics with genetic prioritization can refine PD risk-gene nomination and uncover regulatory programs that may be missed by GWAS alone.

Alzheimer's pathology progresses through anatomically distinct brain regions, yet how molecular programs are temporally organized across vulnerable regions remains poorly understood. Here, we reconstructed continuous proteomic trajectories from matched dorsolateral prefrontal cortex (DLPFC) and superior temporal gyrus (STG) proteomes to investigate cross-regional molecular progression in AD. The inferred trajectories closely recapitulated established neuropathological staging while remaining independent of age, sex, and race. Across regions, a mitochondrial bioenergetic protein subset declined substantially earlier in the STG than in the DLPFC, revealing a previously unrecognized regional temporal offset in metabolic dysfunction. In parallel, a broadly shared proteomic program progressed in both regions but more rapidly in the STG, indicating that shared molecular responses differ in their temporal progression despite overall coordination. Together, these findings demonstrate that regional vulnerability in AD is reflected not only by the molecular programs involved but also by their temporal organization during disease progression.

BackgroundAmyloid-beta (A{beta}) and Tau are defining pathologies of Alzheimers disease, but their relationship varies substantially across the brain. Amyloid deposition is spatially widespread, whereas Tau shows greater regional heterogeneity and closer relationships with disease severity. Consequently, understanding the disease requires more than measuring the two pathologies independently or summarizing them within predefined regions. A major unresolved question is how Amyloid and Tau covary across the whole brain, where their spatial patterns converge or diverge, and whether their local combination carries distinct information about disease stage and cognition. MethodsWe analyzed paired florbetapir Amyloid PET and flortaucipir Tau PET from the Alzheimers Disease Neuroimaging Initiative (ADNI), comprising 378 paired imaging sessions from 320 participants spanning cognitively normal (CN), mild cognitive impairment (MCI), and Alzheimers Dementia (AD). High-order joint independent component analysis was used to identify fine-grained, data-driven patterns of Amyloid-Tau covariance across individuals. The resulting Amyloid and Tau maps were characterized by their spatial similarity and correspondence with rsfMRI-derived intrinsic functional networks. We then used the same data-driven spatial regions to quantify, for each participant, the relative extent of Amyloid abnormality alone, Tau abnormality alone, and spatially overlapping Amyloid-Tau abnormality. ResultsNinety-six non-artifactual Amyloid-Tau components were identified, of which 73 showed appreciable spatial correspondence between their paired Amyloid and Tau maps, while 17 were Tau-localized and 6 Amyloid-localized. Amyloid component maps more frequently corresponded with rsfMRI-derived intrinsic network organization than Tau maps. Expression of the joint components differed across diagnosis groups, demonstrating spatially heterogeneous disease-stage patterns. Within the same data-driven regions, isolated Amyloid, isolated Tau, and overlapping Amyloid-Tau abnormality showed markedly different disease-stage profiles: Amyloid-only abnormality was more prominent in the earlier CN-to-MCI contrast, Tau-only abnormality in contrasts involving AD, whereas spatially overlapping Amyloid-Tau abnormality showed the broadest differences across disease stages and the largest mean CN-to-AD expansion. Overlapping abnormality was also associated with cognition across the greatest number of components and showed the strongest overall association with ADAS13. APOE4-related diagnosis-stage differences were considerably more widespread for pathology measures containing Amyloid than for Tau-only abnormality.

Structured AbstractO_ST_ABSIntroductionC_ST_ABSBrain glucose hypometabolism is a hallmark of Alzheimers disease (AD), yet conventional [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) analyses have limited sensitivity in preclinical stages. Metabolic brain network approaches may better capture early vulnerability preceding clinical conversion. MethodsCognitively unimpaired individuals (n = 127) from the ADNI cohort with baseline FDG-PET and amyloid (A) and tau (T) status were classified as clinically stable or converters over an average longitudinal follow-up of 5.8 years. Baseline brain FDG uptake patterns were analyzed at the regional, voxel, and network levels across AT profiles. Network density was quantified globally and within functional networks. AD biomarkers and cognitive performance were also examined. ResultsConventional FDG-PET SUVr analyses failed to distinguish cognitively stable individuals from clinical converters at baseline, either at the regional or voxel levels. AT(N) biomarkers and neuropsychological performance likewise did not differ significantly between groups. In contrast, clinical converters exhibited hyperconnected metabolic networks at baseline, including within the default-mode network. These effects were consistent across A-T-, A+T-, and A+T+ groups, with network density higher in clinical converters than in cognitively stable individuals. Conversely, network density among stable individuals declined with AT progression, pointing to divergent network trajectories. DiscussionMetabolic network organization analysis revealed early AD-related vulnerability beyond regional hypometabolism, even before detectable amyloid positivity, and may reflect divergent trajectories of resilience and pathological propagation preceding clinical conversion. By leveraging existing FDG-PET datasets, this framework offers a valuable opportunity to identify individuals at risk of clinical progression at scale.

Sex is a major determinant of Alzheimers disease risk and progression, yet the molecular mechanisms underlying this dimorphism remain poorly defined, limiting the development of sex-informed therapeutics. {beta}-Arrestin2 is a pervasive, multifunctional regulator common to a host of G protein-coupled receptors (GPCRs) in the brain, but whether it has a sex-dependent role in Alzheimers disease is unknown. Here, we demonstrate that {beta}-arrestin2 deficiency produces sexually dimorphic effects on A{beta} pathology, neuroinflammation, cognition and autophagic flux in APPswe/PS1{Delta}E9 (APP/PS1) mice. In males, Arrb2 deletion reduced A{beta} oligomer burden, enhanced autophagy, suppressed astrocytic and microglial reactivity, and broadly rescued cognition encompassing spatial working memory, spatial learning, cognitive flexibility, and recognition memory. In females, A{beta} pathology and astrogliosis was unchanged and microgliosis was enhanced, with cognitive improvement limited to recognition memory. The male-specific reduction in pathology was accompanied by decreased S473-Akt and S9-GSK3{beta} phosphorylation and enhanced GSK3{beta}/ZBTB16-mediated autophagy, identifying {beta}-arrestin2 as a molecular switch driving sex-restricted A{beta} pathology, glial activation, and cognitive decline in male APP/PS1 mice. These findings identify {beta}- arrestin2 as a sex-dependent node linking A{beta} pathology to cognitive outcomes in males but not females, underscoring the necessity of sex-stratified consideration in the design of GPCR-targeted Alzheimers disease therapeutics.

BackgroundSensitive biomarkers that objectively stage Huntington disease (HD) are needed to improve participant stratification and facilitate the enrichment of clinical trials with biologically and clinically homogeneous populations. The HDClarity study, an international longitudinal biofluid collection initiative for HD, provides a unique resource for large-scale proteomic profiling of matched CSF and serum samples spanning the disease spectrum. Here, we leveraged baseline proteomic data from HDClarity to characterize protein signatures associated with HD stage and clinical severity, compare measurements across analytical platforms and biofluid compartments, and identify candidate multi-protein panels for disease staging. MethodsBaseline proteomic data generated using Olink Explore ([~]3,000 proteins) and SomaScan v4.1 ([~]7,000 proteins) were analyzed in matched CSF and serum samples from 315 HD gene-expansion carriers and 92 non-HD controls. A total of 2,119 proteins overlapped between Olink and SomaScan, enabling assessment of cross-platform concordance, while CSF-serum relationships were evaluated using all available protein measurements within each assay. Covariate-adjusted linear regression models were used to assess disease stage-associated differences in protein abundance, while partial correlation analyses evaluated relationships between protein abundance, clinical severity in HD gene-expansion carriers, and estimated years to disease onset in premanifest participants. A nested machine-learning pipeline incorporating univariate feature ranking, penalized regression-based feature selection, and repeated cross- validation was used to derive compact multi-protein classifiers for HD staging. ResultsCross-platform and CSF-serum correlations were highly protein-dependent, with some analytes showing strong concordance and others exhibiting weak or inverse relationships. These findings highlight substantial heterogeneity in biomarker behaviour across analytical platforms and biofluids. Adjusted models identified both known HD-associated markers (NEFL, GFAP, CHI3L1) and less well-characterized proteins in CSF and serum whose baseline abundance differed across HD-Integrated Staging System (HD-ISS) and clinical stages. Partial correlation analyses revealed additional candidate biomarkers associated with clinical severity and estimated time to disease onset. Machine-learning models derived compact CSF and serum protein panels that accurately classified participants across HD-ISS stages 0 and 1, as well as the transition from premanifest to early manifest disease. ConclusionsThis study provides the first large-scale orthogonal comparison of matched CSF and serum proteomes in HDClarity, establishing robust baseline proteomic signatures across the HD continuum. Our findings demonstrate the importance of considering both analytical platform and biofluid when interpreting protein biomarkers and identify compact protein panels with potential utility for objective disease staging, patient stratification, and clinical trial enrichment in HD. Trial RegistrationNot applicable. One Sentence SummaryCaron et al. analyzed matched baseline CSF and serum proteomic data from the HDClarity study generated using two orthogonal proteomic platforms, identifying reproducible multi-protein panels capable of staging and stratifying Huntington disease.

Pseudotime trajectories can reconstruct latent disease progression from cross-sectional transcriptomic data. However, whether Alzheimer's disease (AD) progression follows a conserved molecular architecture across brain regions remains unclear. We applied pseudotime analysis to harmonized bulk RNA-seq data from 2,106 postmortem brain samples (1,364 AD, 742 controls) across nine brain regions from three AMP-AD cohorts (ROSMAP, Mayo, MSBB). Pseudotime was significantly associated with AD diagnosis in all nine regions and with Braak stage in seven of nine. We identified 21 genes with concordant pseudotime associations across all regions, increasing to 234 when the cerebellum was excluded. Pathway analysis revealed 1,268 significant associations, with synaptic deregulation as the most conserved process, and immune/ECM programs showing greater regional specificity. The cerebellum followed a distinct pattern, with enrichment for protein refolding and chaperone pathways rather than neurodegeneration. Co-expression network analysis identified six conserved metamodules, including immune/glial (MM1) and excitatory neuronal (MM2) programs spanning all nine regions, and an oligodendrocyte/myelin program (MM3) in seven cortical regions. Key driver analysis identified 76 unique genes across 35 modules, with HCK and LAPTM5 as the most broadly replicated immune regulators in seven regions. Oligodendrocyte-associated key drivers (MYRF, CNP, MOBP) increased along pseudotime in cortical regions, supporting active myelin remodeling during AD progression. These findings reveal a conserved transcriptional architecture underlying AD progression, organized around coordinated immune activation, synaptic loss, and myelin remodeling, with the cerebellum following a distinct trajectory.