Understanding the molecular mechanisms that contribute to neuropsychiatric symptoms in Alzheimer Disease

了解导致阿尔茨海默病神经精神症状的分子机制

• 批准号: 10439255
• 负责人: STEVEN M FINKBEINER
• 金额: $ 44.14万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-15 至 2024-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10439255
• 关键词: Adverse effects; Agitation; Alzheimer' s Disease; Alzheimer' s disease related dementia; Autopsy; Biological Markers; Bipolar Disorder; Brain; Caregiver Burden; Cells; Clinical; Clinical Trials; Data; Data Set; Delusions; Dementia; Diagnosis; Disease; Electronic Health Record; Epigenetic Process; Gene Expression; Gene Expression Profile; Genetic Enhancer Element; Genetic Markers; Genotype; Goals; Hallucinations; Human; Impaired cognition; Institutionalization; Intervention; Lead; Major Depressive Disorder; Mental Depression; Methods; Modeling; Molecular; Nerve Degeneration; Pathology; Pathway interactions; Patients; Persons; Prognosis; Public Health; Quality of life; Regulatory Element; Research; Resolution; Sampling; Schizophrenia; Severities; Symptoms; Testing; Therapeutic; Time; biobank; brain tissue; care giving burden; cell type; clinical diagnosis; cost; daily functioning; deep learning; functional genomics; genomic data; high dimensionality; innovation; learning strategy; mild cognitive impairment; molecular marker; neuropathology; neuropsychiatric symptom; neuropsychiatry; novel; novel therapeutics; patient stratification; phenomics; phenotypic biomarker; potential biomarker; predictive modeling; severe mental illness; trait; translational potential

GENERAL PROJECT DESCRIPTION: ABSTRACT Neuropsychiatric symptoms (NPS) are core features of Alzheimer’s disease (AD) and related dementias that are associated with major adverse effects on daily function and quality of life, and accelerate time to institutionalization. Of all the NPS, depression is the most frequently observed symptom in people with mild cognitive impairment and early AD. As the disease progresses, agitation, delusions and hallucinations become more common, whereas apathy is the most persistent and frequent NPS throughout all the stages of AD. AD- NPS share some clinical features with serious mental illnesses (SMIs), such as schizophrenia, bipolar disorder and major depressive disorder, but whether these conditions share similar aethiopathies is unclear. Given that reliable treatments for NPS in the context of AD and other dementias do not exist, a better understanding of the molecular mechanisms and pathways underlying NPS in AD and other neuropsychiatric illnesses is a critical next step to identify reliable biomarkers that could lead to novel therapeutics. There are two overarching goals of this proposal. First, we will identify the molecular mechanisms and neuropathological changes that are associated with the presence of NPS in patients with AD. Second, we will examine if the mechanisms of pathology associated with NPS are shared or distinct among AD and SMIs. More specifically, we propose to build multi-scale integrative models using phenomics and genomics data from 1,264 autopsy cases derived from a single brain bank. The bank includes detailed phenomics data such as well characterized NPS, clinical diagnosis (AD and other neurodegenerative or neuropsychiatric traits), severity of cognitive decline and neuropathology for each patient sample. From each case, we will apply innovative approaches that reduce the cost and technical biases associated with conventional methods, and capture gene expression signatures and epigenetic regulatory elements at the single-cell level. Novel deep-learning methods will be applied for the multi-scale integration of neuropathologic changes with genetic markers and functional genomic changes (such as changes in gene expression and enhancer sequences) within specific cell types, to predict various NPS in AD and other neuropsychiatric traits; we refer to these integrative models as genotype- marker-phenotype models. We expect that these models will enable us to assign genotypes and molecular markers to specific NPS within AD and other neuropsychiatric traits at the single-cell level, an unprecedented level of resolution. In addition, we will test the translational potential of the genotype-marker-phenotype models to predict AD-NPS using independent large-scale biobank datasets, in which genotypes and electronic health records are available. Successful completion of the proposed studies will have immediate utility by generating potential biomarkers for NPS diagnosis and prognosis and by providing predictive models for patient stratification in clinical trials. In the longer term, our models will help us create a blueprint for therapeutic strategies and interventions to treat NPS in AD.

一般项目描述：摘要 神经精神症状（Neuropsychiatric symptoms，NMPs）是阿尔茨海默病（Alzheimer's disease，AD）及其相关痴呆的核心特征 与对日常功能和生活质量的主要不良影响相关，并加速 制度化。在所有这些症状中，抑郁症是轻度抑郁症患者最常见的症状。 认知障碍和早期AD。随着病情的发展，激动，妄想和幻觉变得 更常见，而冷漠是AD所有阶段中最持久和最常见的症状。AD- 精神分裂症和双相情感障碍等严重精神疾病有共同的临床特征 和重度抑郁症，但这些疾病是否有相似的精神病尚不清楚。鉴于 在AD和其他痴呆症的背景下，不存在可靠的治疗方法，更好地了解 AD和其他神经精神疾病中NPS的分子机制和途径是关键 下一步是确定可靠的生物标志物，可能导致新的治疗方法。 这项建议有两个首要目标。首先，我们将确定分子机制， 神经病理学变化与AD患者中存在的神经胶质瘤有关。二是 检查AD和SMI之间是否存在共同或不同的与AD相关的病理机制。更 具体地说，我们建议使用来自1264个国家的表型组学和基因组学数据建立多尺度综合模型， 从一个脑库中提取的尸检案例该银行包括详细的表型组学数据， 特征性痴呆、临床诊断（AD和其他神经退行性或神经精神病学特征）、 认知衰退和神经病理学。从每一个案例中，我们将应用创新的 减少与传统方法相关的成本和技术偏差的方法， 表达标签和表观遗传调控元件在单细胞水平。新的深度学习方法 将应用于神经病理变化与遗传标记和功能的多尺度整合 特定细胞类型内的基因组变化（如基因表达和增强子序列的变化）， 预测AD和其他神经精神特征的各种基因型;我们将这些综合模型称为基因型- 标记-表型模型我们希望这些模型将使我们能够分配基因型和分子 在单细胞水平上，AD和其他神经精神特征中的特异性标志物，这是前所未有的 分辨率水平。此外，我们将测试基因型-标记-表型模型的翻译潜力 使用独立的大规模生物库数据集预测AD-100，其中基因型和电子健康 记录可用。成功完成拟议的研究将产生直接的效用， 潜在的生物标志物，用于乳腺癌的诊断和预后，并提供用于患者分层的预测模型 在临床试验阶段从长远来看，我们的模型将帮助我们制定治疗策略的蓝图， 干预措施来治疗阿尔茨海默病。