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Patients with Increased Non-Ceruloplasmin Copper Appear a Distinct Sub-Group of Alzheimer's Disease: A Neuroimaging Study

[ Vol. 14 , Issue. 12 ]

Author(s):

Rosanna Squitti*, Ilaria Simonelli, Emanuele Cassetta, Domenico Lupoi, Mauro Rongioletti, Mariacarla Ventriglia and Mariacristina Siotto   Pages 1318 - 1326 ( 9 )

Abstract:


Background: Meta-analyses show that copper non-bound to ceruloplasmin (non-Cp Cu, also known as ‘free’ copper) in serum is higher in a percentage of Alzheimer's disease (AD) patients. Genetic heterogeneity in AD patients stratified on the basis of non-Cp Cu cut-off sustains the existence of a copper AD metabolic subtype.

Objective: In order to find evidence of the existence of a detectable metabolic subtype of AD associated to copper abnormalities, we explore the hypothesis of a neuroimaging pattern heterogeneity in an homogenous and well characterized AD population classified in two groups by the stratification of patients on the basis non-Cp Cu cut-off.

Method: We assessed levels of copper, ceruloplasmin, non-Cp Cu, cerebrospinal levels of total Tau protein (h-tau), Thr 181 phosphorylated tau protein (P-tau) and β-amyloid 1-42, and APOE4 genotype in 66 AD patients and compared neuroimaging indices of a visual rating scale of cerebral atrophy and neurovascular burden in AD patients stratified in ‘Normal’ and ‘High’ non-Cp Cu groups.

Results: The stratification for non-Cp Cu originated AD groups which did not differ for medial temporal lobe atrophy, periventricular hyperintensities, deeper hyperintensities (including frontal, parietooccipital and temporal white matter hyperintensities), infratentorial hyperintensities indices, while they differed for global atrophy. More specifically, AD patients within the high non-Cp Cu group had a less severe burden of global atrophy (p=0.042).

Conclusion: This neuroimaging heterogeneity between AD groups is suggestive of the existence of a copper metabolic subtype of AD; non-Cp Cu appears a good marker of this copper AD.

Keywords:

Neuroimaging heterogeneity, copper not bound to ceruloplasmin (non-Cp Cu), Alzheimer's disease, free copper, global atrophy, copper.

Affiliation:

Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio- Fatebenefratelli, 25125 Brescia, Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Department of Radiology, Fatebenefratelli Hospital, Rome, Department of Laboratory Medicine, Research and Development Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Fatebenefratelli Foundation, AFaR Division, Fatebenefratelli Hospital, Isola Tiberina, Rome, Don Carlo Gnocchi ONLUS Foundation, Milan



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