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Wang, Xiao ORCID logoORCID: https://orcid.org/0009-0003-8877-6451; Freiesleben, Silka D. ORCID logoORCID: https://orcid.org/0000-0002-2141-8671; Schneider, Luisa-Sophie; Preis, Lukas ORCID logoORCID: https://orcid.org/0000-0001-7601-6410; Priller, Josef ORCID logoORCID: https://orcid.org/0000-0001-7596-0979; Spruth, Eike J. ORCID logoORCID: https://orcid.org/0000-0002-8976-7309; Altenstein, Slawek ORCID logoORCID: https://orcid.org/0000-0003-2753-5999; Schneider, Anja ORCID logoORCID: https://orcid.org/0000-0001-9540-8700; Fliessbach, Klaus ORCID logoORCID: https://orcid.org/0000-0002-0183-7510; Wiltfang, Jens ORCID logoORCID: https://orcid.org/0000-0003-1492-5330; Hansen, Niels ORCID logoORCID: https://orcid.org/0000-0001-5785-9594; Jessen, Frank ORCID logoORCID: https://orcid.org/0000-0003-1067-2102; Rostamzadeh, Ayda ORCID logoORCID: https://orcid.org/0000-0001-5189-134X; Duzel, Emrah ORCID logoORCID: https://orcid.org/0000-0002-0139-5388; Glanz, Wenzel ORCID logoORCID: https://orcid.org/0000-0002-5865-4176; Incesoy, Enise I. ORCID logoORCID: https://orcid.org/0000-0003-2014-4098; Buerger, Katharina ORCID logoORCID: https://orcid.org/0000-0002-5898-9953; Janowitz, Daniel ORCID logoORCID: https://orcid.org/0009-0003-4090-547X; Ewers, Michael ORCID logoORCID: https://orcid.org/0000-0001-5231-1714; Perneczky, Robert ORCID logoORCID: https://orcid.org/0000-0003-1981-7435; Rauchmann, Boris-Stephan ORCID logoORCID: https://orcid.org/0000-0003-4547-6240; Teipel, Stefan J. ORCID logoORCID: https://orcid.org/0000-0002-3586-3194; Kilimann, Ingo ORCID logoORCID: https://orcid.org/0000-0002-3269-4452; Goerss, Doreen ORCID logoORCID: https://orcid.org/0000-0002-5336-8349; Laske, Christoph ORCID logoORCID: https://orcid.org/0009-0009-3434-936X; Munk, Matthias H.J. ORCID logoORCID: https://orcid.org/0000-0002-5339-4045; Spottke, Annika ORCID logoORCID: https://orcid.org/0000-0001-9854-2972; Roy-Kluth, Nina ORCID logoORCID: https://orcid.org/0009-0005-7434-5356; Heneka, Michael T. ORCID logoORCID: https://orcid.org/0000-0003-4996-1630; Brosseron, Frederic ORCID logoORCID: https://orcid.org/0000-0003-3137-7516; Wagner, Michael ORCID logoORCID: https://orcid.org/0000-0003-2589-6440; Wolfsgruber, Steffen ORCID logoORCID: https://orcid.org/0000-0002-3962-3219; Ramirez, Alfredo ORCID logoORCID: https://orcid.org/0000-0003-4991-763X; Kleineidam, Luca ORCID logoORCID: https://orcid.org/0009-0006-3309-6856; Stark, Melina ORCID logoORCID: https://orcid.org/0009-0005-3812-023X und Peters, Oliver ORCID logoORCID: https://orcid.org/0000-0003-0568-2998 (2024): Association of Neurogranin and BACE1 With Clinical Cognitive Decline in Individuals With Subjective Cognitive Decline. In: Neurology, Bd. 103, Nr. 8, e209806

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Abstract

Background and Objectives : CSF biomarkers have immense diagnostic and prognostic potential for Alzheimer disease (AD). However, AD is still diagnosed relatively late in the disease process, sometimes even years after the initial manifestation of cognitive symptoms. Thus, further identification of biomarkers is required to detect related pathology in the preclinical stage and predict cognitive decline. Our study aimed to assess the association of neurogranin and β-site amyloid precursor protein-cleaving enzyme 1 (BACE1) with cognitive decline in individuals with subjective cognitive decline (SCD). Methods : We enrolled participants with available neurogranin and BACE1 measurements in CSF from the DELCODE (DZNE-Longitudinal Cognitive Impairment and Dementia, Germany) cohort. The longitudinal change of Preclinical Alzheimer's Cognitive Composite score was assessed as the primary outcome in participants with SCD and controls. The secondary outcome was defined as conversion of SCD to mild cognitive impairment (MCI) during follow-up. Levels of neurogranin, BACE1, and neurogranin/BACE1 ratio across groups were compared by analysis of covariance after adjustment for demographics. The linear mixed-effects model and Cox regression analysis were applied to evaluate their association with cognitive decline and progression of SCD to MCI, respectively. Results : A total of 530 participants (mean age: 70.76 ± 6.01 years, 48.7% female) were analyzed in the study. The rate of cognitive decline was faster in individuals with SCD with higher neurogranin and neurogranin/BACE1 ratio (β = −0.138, SE = 0.065, p = 0.037, and β = −0.293, SE = 0.115, p = 0.013). Higher baseline neurogranin and neurogranin/BACE1 ratio were associated with an increased rate of conversion from SCD to MCI (hazard ratio [HR] 1.35 per SD, 95% CI 1.03–1.77, p = 0.028, and HR 1.53 per SD, 95% CI 1.13–2.07, p = 0.007). In addition, the impact of higher neurogranin levels on accelerating the rate of cognitive decline was more pronounced in the SCD group than in cognitively unimpaired controls (β = −0.077, SE = 0.033, p = 0.020). Discussion : Our findings suggest that CSF neurogranin and BACE1 begin to change in the preclinical stage of AD and they are associated with clinical progression in individuals with SCD.

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