Severe Preeclampsia Linked With Neuroinflammation, Neurofilament Light Associated With Memory Function, Discrimination Effects on Cognition

WATCH TIME: 4 minutes

Welcome to this special edition of Neurology News Network. I’m Marco Meglio. This week’s episode is centered around the recently concluded 2022 Alzheimer’s Association International Conference.

According to data presented at the 2022 Alzheimer’s Association International Conference (AAIC), July 31 to August 4, in San Diego, California, severe cases of preeclampsia (PE), a pregnancy specific hypertensive disorder, were found to elevate markers of neuroinflammation and neurovascular damage, while demonstrating increased amyloid-ß concentration.The study included 40 women with histories of normotensive pregnancies, considered the control group, with 40 age- and parity-matched women with history of mild (n = 33) or severe (n = 7) PE. When comparing the groups, those with history of severe PE had a significantly higher concentration of amyloid-ß carrying extracellular vesicles (EVs; P = .003). Additionally, plasma concentration of total amyloid-ß was also significantly greater in women with history of severe vs mild PE. In addition to having a higher concentration of amyloid-ß, women with a history of severe PE had significantly greater EVs positive for the markers of blood-brain barrier-endothelial damage (P = .008) and inflammatory coagulation pathway activator (P = .002) compared with controls, as well as compared with those with a history of mild PE.

Preliminary data from the Columbia-Boston (COLBOS) longitudinal biomarker study showed that plasma neurofilament light (NfL) levels were associated with memory function and overall status, but not sleep quality, in patients with autosomal-dominant Alzheimer disease. Using a cohort of 51 non-demented Presenillin1 (PSEN1) E280A carriers and 49 age-matched noncarriers, baseline NfL levels predicted recall scores on the CERAD word delay (P = .03) and Mini Mental State Examination (MMSE) performance. COLBOS, a collaborative project between the Universidad de Antioquia Columbia and Massachusetts General Hospital, in Boston, works with the kindred of approximately 6000 individuals in Antioquia, Columbia, which includes roughly 1500 carriers of PSEN1 E280A. These carriers are genetically determined to develop early-onset AD with almost 100% certainty and have a well-characterized disease course, with mild cognitive impairment occurring at a median age of 44 years, and dementia at 49 years.

Using a cohort of adults older than 90 years who were followed for incident dementia, findings from the LifeAfter90 (LA90) study suggested inequalities in cognition persist after accounting for experiences of lifetime discrimination. Presented at the 2022 Alzheimer’s Association International Conference (AAIC), July 31 to August 3, in San Diego, California, the study investigators noted that experiences of discrimination have an “indelible” association with cognitive health.Class 1 (n = 51) consisted of mostly White men who reported workplace discrimination and had an average of 2 major discrimination experiences, while Class 2 (n = 342), known as the reference group, included White women and non-White participants who reported little/no discrimination averaging 0 experiences. Class 3 (n = 52) included all non-White participants who reported a mean of 4 discrimination experiences. As compared with Class 2, those in Class 1 at baseline had significantly better executive function (ß: 0.28; 95% CI, 0.03-0.52), while no differences were found between Class 1 and Class 3. Baseline semantic memory was significantly better for Class 1 (ß: 0.33; 95% CI, 0.07-0.58) and significantly worse for Class 3 (ß: –0.24; 95% CI, -0.48 to 0.00) compared with Class 2. Across all 3 classes, no differences were observed for verbal episodic memory. Additionally, all classes demonstrated cognitive decline in all domains (ß range: –0.31 to –0.46), but the rate of change did not differ significantly by latent class.

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