Eyjolfsdottir Helga, Koenig Thomas, Karami Azadeh, Almqvist Per, Lind Göran, Linderoth Bengt, Wahlberg Lars, Seiger Åke, Darreh-Shori Taher, Eriksdotter Maria, Jelic Vesna
Department of Neurobiology, Care Science and Society, Karolinska Institutet, Solna, Sweden.
Theme Inflammation and Aging, Karolinska University, Stockholm, Sweden.
Front Aging Neurosci. 2022 Apr 25;14:756687. doi: 10.3389/fnagi.2022.756687. eCollection 2022.
Basal forebrain cholinergic neurons are dependent on nerve growth factor (NGF) for growth and survival and these cells are among the first to degenerate in Alzheimer's disease (AD). Targeted delivery of NGF has been suggested as a potential therapy for AD. This hypothesis was tested in a clinical trial with encapsulated cell biodelivery of NGF (NGF-ECB) in AD patients. Three of six patients showed improved biomarkers for cognition by the end of the study. Here, we report on the effects of targeted delivery of NGF on human resting EEG.
NGF-ECB implants were implanted bilaterally in the basal forebrain of six AD patients for 12 months. EEG recordings and quantitative analysis were performed at baseline, 3 and 12 months of NGF delivery, and analyzed for correlation with changes in Mini-mental state examination (MMSE) and levels of the cholinergic marker choline acetyltransferase (ChAT) in cerebrospinal fluid (CSF).
We found significant correlations between the topographic variance of EEG spectral power at the three study points (baseline, 3 and 12 months) and changes in MMSE and CSF ChAT. This possible effect of NGF was identified in a narrow window of alpha frequency 10-11.5 Hz, where a stabilization in MMSE score during treatment was related to an increase in EEG alpha power. A similar relation was observed between the alpha power and ChAT. More theta power at 6.5 Hz was on the contrary associated with a decrease in CSF ChAT during the trial period.
In this exploratory study, there was a positive correlative pattern between physiological high-frequency alpha activity and stabilization in MMSE and increase in CSF ChAT in AD patients receiving targeted delivery of NGF to the cholinergic basal forebrain.
基底前脑胆碱能神经元的生长和存活依赖于神经生长因子(NGF),这些细胞是阿尔茨海默病(AD)中最早发生退化的细胞之一。NGF的靶向递送被认为是AD的一种潜在治疗方法。在一项针对AD患者进行的NGF封装细胞生物递送(NGF-ECB)临床试验中对这一假设进行了检验。在研究结束时,六名患者中有三名的认知生物标志物有所改善。在此,我们报告NGF靶向递送对人类静息脑电图的影响。
将NGF-ECB植入物双侧植入六名AD患者的基底前脑,持续12个月。在NGF递送的基线、3个月和12个月时进行脑电图记录和定量分析,并分析其与简易精神状态检查表(MMSE)变化以及脑脊液(CSF)中胆碱能标志物胆碱乙酰转移酶(ChAT)水平的相关性。
我们发现三个研究点(基线、3个月和12个月)脑电图频谱功率的地形方差与MMSE和CSF ChAT的变化之间存在显著相关性。在10 - 11.5 Hz的窄α频率窗口中确定了NGF的这种可能作用,在此窗口中,治疗期间MMSE评分的稳定与脑电图α功率的增加相关。在α功率和ChAT之间也观察到了类似的关系。相反,在试验期间,6.5 Hz处更多的θ功率与CSF ChAT的降低相关。
在这项探索性研究中,接受NGF靶向递送至胆碱能基底前脑的AD患者中,生理性高频α活动与MMSE稳定以及CSF ChAT增加之间存在正相关模式。