CENTER FOR EARLY DIAGNOSIS AND THERAPY RESEARCH ON NEURODEGENERATIVE DISEASES – A SWEDISH NETWORK ANNUAL REPORT JULY 2012 – JUNE 2013 Table of Content Page Wordings from the Director 3 Summary 4 Background & Objectives 5 Outcome & Major Achievements 6 External Collaboration 9 Organisation and infrastructure 11 List of Core Coordinators and other members 13 Information Dissemination 17 Research Budget Allocation 19 Swedish Brain Power in Future 21 List of Research Projects 22 Publication List 25 2 Wordings from the Director Swedish Brain Power has now been a part of the scientific community for eight years. During this time, public interest in how our brain works has grown in pace with the brain research made progress. It is a young and very exiciting research area and a “hot topic” in many contexts. People are eager to know how one can prevent dementia using everything from food to meditation. This increasing interest in brain functions and characteristics at an individual level is very satisfying. Unfortunately it has not yet been followed by an equally strong interest in how to prevent the health threat of dementia on a societal and community level. According to WHO's latest report, dementia is now the fastest growing public health disease in the world and will cost huge amounts if nothing is done. Swedish Brain Power has tried to draw attention to this in the public debate, including opinion articles in the press and on the web. If we look at the Swedish Brain Power's purely scientific contributions, the list of new discoveries and the amount of published scientific papers in this report, speaks for themselves. The research collaboration across both disciplinary and geographical boundaries has given an added value that is greater than we could ever hope for. Swedish Brain Power is now an established research network and an important contributor to neurobiological research. For us it is clear that dementia research is underfunded relative to what dementia costs society in both suffering and money. Let us hope that awareness of this increase with the interest in the brain itself. In other words, our mission is both social and scientific. I am optimistic for the simple reason that anything else would be a disaster. Finally, I would like to thank our board and our founder, Knut & Alice Wallenberg Foundation, for their unfailing interest and valuable support. Bengt Winblad 3 Summary The Swedish Brain Power (SBP) program started in summer 2005. From July 2010, Knut & Alice Wallenberg (KAW) Foundation is the sole sponsor for a 5 year period. SBP focuses on research for early diagnosis and treatment of neurodegenerative disorders and has become a well-established leading national research network. Collaboration To increase the interaction between the national experts in the neurodegenerative area was one of the main goals for the SBP program. This has by far been reached; The Swedish Brain Power researchers have obtained a genuine understanding, collaboration and interaction between all involved research groups, as well as individual researchers. SBP researchers are to a great extent collaborating with our Nordic neighbouring countries, such as the establishment of a Nordic collaborative academic program, and several collaborative experimental research projects with research groups in Oslo, Stavanger, Copenhagen and Kuopio. In addition, SBP researchers have extensive collaboration with both pharma and biotech industry, both on individual levels and in clinical trials where the SBP clinical trial centers are first-choice worldwide for new, innovative clinical trials. The SBP initiated quality registry (SveDem) now comprises approx 40 000 new registrations of patients (out of which 24 000 from Primary Care), the figure for follow-up’s is 16 000 from Specialist settings respectively 11 000 from Primary Care. The registry currently includes 74% of all Primary Care Units in Sweden and 95% of all Geriatric Specialist Clinics. SveDem is the data source for several quality indicators in dementia care. A large number of research projects and publications are based on this registry. Through SBP, we have been able to establish joint bio banks all over Sweden including material from patients with Alzheimer Disease (AD), Parkinson Disease (PD), Amyotrophic Lateral Sclerosis (ALS) and healthy controls (cerebrospinal fluid (CSF), fibroblasts, blood, brains, DNA). SBP researchers are closely collaborating with the StratNeuro strategic research program including Karolinska Institutet, the Royal Institute of Technology (KTH) and the SBP members from Umeå University. Scientific outcome During the 8th year, 57 research projects resulted in totally 150 peer reviewed articles (81 within the clinical platform, 49 basic research platform and 20 within the caring/rehabilitation platform). All research projects are listed on pp 22-24 and all publications on pp 25-37. A summary of our major achievements can be found on pages 6-9 and a more descriptive summary of all on-going research projects is attached (attachment 1) to this report. SBP researchers continue to receive prestigious awards for their contribution to the research field. To mention some, this year Prof Laura Fratiglioni was awarded the “International Alzheimer Association Lifetime Achievement Award in Prof Bengt Winblad’s name”, Prof Kaj 4 Blennow received a remarkable European price “Fondation sur la recherché sur Alzheimer”, the Eric K Fernström’s award was given to Prof Martin Hallbeck and the “Eric & Waijlit Forsgrens pris” to Prof Agneta Nordberg. The Swedish Brain Power Program – Background & Objectives The Swedish Brain Power (SBP) program was established in July 2005, thanks to the initiative from the foundations Invest in Sweden Agency (ISA), KK Foundation, Foundation for Strategic Research, Vårdal Foundation, Knut & Alice Wallenberg Foundation and VINNOVA. From July 2010, the SBP program is sponsored by KAW for another 5 years (2010-2015) with in total 100 million SEK. The network is formed by the Swedish leading research groups in the field of neurodegenerative disorders with a main focus on ALS, Alzheimer and Parkinson disease. Through SBP, in-depth collaboration has been established between groups that rarely or not at all earlier used to collaborate. The SBP research program spans from basic to clinical, epidemiological and caring research. The organisation is outlined in order to facilitate and encourage collaboration between the involved research groups. The prioritization of developing translational research has also created many contacts and new collaborations between academic research and industry. It is an incentive for the program to keep the administrative costs as low as possible, and focus our efforts on research. The overall aim for the SBP network is to improve early diagnosis, treatment and care of patients affected by neurodegenerative diseases (Alzheimer and Parkinson disease, Amyotrophic Lateral Sclerosis). These often age-related diseases are a growing public health problem worldwide due to increased elderly population. There is a great need for new and more effective treatments for dementia and other neurodegenerative diseases, and for increased knowledge on how to give the best possible care. SPECIFIC OBJECTIVES To increase our knowledge regarding the pathogenesis of neurodegenerative diseases To validate the basic research target findings in cell and animal models To translate our basic research on biomarkers in order to improve diagnostic accuracy and identify adequate target populations for intervention To identify new mutations and risk genes To further identify and validate preventive strategies and initiate prevention trials To validate different treatment strategies in preclinical phases To achieve efficacious treatment of neurodegenerative diseases on a personalized basis To develop new instruments for improved measurement of intervention/treatment effects as well as new caring strategies; eg environmental and psychosocial. 5 Outcome & Major Achievements In our continuous efforts to contribute to an accurate early diagnosis of neurodegenerative disorders, we have found that AD mutation carriers showed high regional PIB retention fifteen years before expected age of onset while. Also astrocytosis appears to be an early phenomenon in FAD pathology, preceding with years the deposition of fibrillar amyloid. In MRI studies, we have shown that depressed AD patients had significantly larger atrophy in the medial and lateral temporal cortex compared to non-depressed AD. The levels of 24Shydroxycholesterol in the circulation have also been found to reflect cholesterol metabolism in the brain, and increased in an early stage of a neurodegeneration. New methodologies have been developed for improved diagnosis and care. A semiautomatic method for segmentation of the transentorhinal region in the perirhinal cortex has been reported. Automated methods for both MRI and CT images resulted in absolute values comparable to manually delineated volumes, which encourages to further validate our proposed algorithm in larger datasets of CT images. New methods for exact quantification of synaptic proteins in CSF by mass spectrometry and for quantification (antibody-free) of APP isoforms in human CSF have been developed. A new instrument for early detection of problems in daily living that includes ADL, leisure and work has been developed. The instrument is aimed for primary care, needs limited education time and seems valid for detecting early ADL problems in dementia. In addition, another new instrument for assessing medical decision-making (LIMD) to be used as research tool has been validated. Implementation studies in care resulted in a generic model for national guidelines into nursing homes and other types of care facilities for persons with dementia disorders. Studies have been performed showing that residents with dementia in more person-centred units had a higher quality of life and better ability to perform activities of daily living. Epidemiological studies have reported that cognitive impairment is frequent (73%), often previously undetected and associated with a three-fold increase in mortality risk. Also, prevalence of dementia was stable from the late 1980s to the early 2000s in central Stockholm, Sweden, whereas survival of patients with dementia increased. These results suggest that incidence of dementia may have decreased during this period. In clinical trials, we have been able to show that encapsulated NGF cell therapy to the basal forebrain in ten patients with increasing dose is safe and well tolerated with improved cognition in a subset of patients. Cognitive responders to the NGF treatment show increased cholinergic activity. Cost-effectiveness studies reported that the main reasons for the higher costs with Disease Modifying Treatment (DMT) were the costs of DMT itself and the prolonged survival with DMT. But - even if costs increase with DMT, the model indicates cost effectiveness. 6 A large number of novel findings in disease mechanisms have been published, including new genetic findings and possible disease targets; - In frontotemporal dementia and amyotrophic lateral sclerosis, a novel mechanism of nonATG initiated translation in C9orf72 mutation carriers was found. This mechanism leads to an intraneuronal aggregation of poly-dipeptides especially in the cerebellum and can be detected by a method called C9RANT. Another study showed that EPHA4 is a disease modifier of ALS both in animal models and in humans. - In Parkinson disease (PD), the rs9722 polymorphism in the S100B gene was significantly associated with age of onset in two separate populations with totally 1500 individuals. - We have shown that removal of PTEN, which disinhibits Akt, increases the neurite growth potential of neurons in mice. When embryonic PTEN-KO Dopaminergic neurons are grafted to MitoPark mice, they survive and function better than wild type embryonic neurons, leading to structural, electrophysiological and behavior improvements. This suggests one way in which dopaminergic neuron grafts may become more effective therapeutic tools. - Of important for PD mechanisms, another study showed that both monomers and oligomers of α-synuclein transfer from neuron to neuron via neuritic connections. However, the efficacy of transfer seems to differ between different species, α-synuclein-related pathology occurs largely independently from LRRK2 expression, at least within neurons of the mouse hindbrain. LRRK2 has an important role in adult neurogenesis, in particular in neuronal morphogenesis. - In Alzheimer disease (AD) novel findings demonstrated that the amyloid beta peptide (Aβ) can influence the number of contact points between mitochondria and the endoplasmic reticulum. - Also, a new mediator of AD pathology has been found. Trx80, truncated form of trx1 acts as an Aβ-antiaggregant. Moreover measuring Trx80 in CSF discriminates AD from MCI and control patients. - Another study reported that levels of the SPM lipoxin A4 (LXA4) were reduced in both CSF and hippocampus from AD-patients, and correlated with tau phosphorylation and minimental state examination (MMSE) score. This study suggests that in AD there is an impairment of the resolution phase of neuroinflammation. - Studies of ageing have shown that in humans there is a link between lower dopamine D1 receptor densities in neocortical regions and higher within-person variability during a task assessing the ability to deal with cognitive interference. Another report has demonstrated that germline mitochondrial DNA mutations per se aggravate ageing. Thus, there are genetic risk factors for ageing located outside of the regular genome, and inherited exclusively from the mother. 7 PUBLICATIONS We have published 150 original articles including: Eighteen (18) publications with an impact factor 7-15 (12%), published in Neurology, Brain, Hum Mol Gen, Ann Neurol, Eur Hear J, Hum Brain Map, J Neurosci, PNAS, and EMBO Mol Med and Eight (8) publications with an impact factor 15-20 (~5%), published in Nat Med, Nat Gen, Nature, Nat Neurosci, Nat Methods and BMJ DISSERTATIONS A total of 11 SBP PhD students defended their thesis this year: 1. Lena Johansson on Psychological stress in relation to dementia and brain structural changes, September 14, 2012 2. Eva Lindqvist on Assistive technology as cognitive support in everyday life for persons with dementia or stroke, September 14, 2012 3. Jaime M Ross on Mitochondrial DNA mutations. Brain developmental and ageing consequences, and possible treatments, September 28, 2012 4. Johanna Wanngren on Molecular studies of the γ-secretase complex: Focus on genetic and pharmacological modulations, October 5, 2012 5. Tobias Karlsson on Nogo receptors, plasticity and lasting memories, November 16, 2012 6. Annelie Pamrén on Different types of γ-secretase complexes and their effect on substrate processing, December 7, 2012 7. Erik Olsson on Volumetric assessment of hippocampus and cerebral white matter lesions in structural MRI, January 21, 2013 8. Debora Rizzuto on Living longer than expected: protective and risk factors related to human longevity, February 8, 2013 9. Caroline Ingre on the aetiology of ALS: a comprehensive genetic study, April 17, 2013 10. Daniel Sjölie on Human brains and virtual realities, computer-generated presence in theory and practice, May 17, 2013 11. S Savage on the role of forebrain cholinergic innervation for phencyclidine-induced behaviors and gene expression patterns, June 4, 2013 8 External Collaboration NATIONAL & INTERNATIONAL EXTERNAL COLLABORATION (ie outside SBP) Except for the internal collaboration between involved SBP research groups, the individual SBP researchers are involved in a number of EU projects. The national and especially international collaborations are extensive. In addition, we are also to a great extent collaborating with industry. All collaboration agreements are on individual level with the involved SBP researcher. Below are listed a number of our collaborations; - EU projects o EU-FP7 INMIND o EU-JPND BIOMARKAPD o FTD consortium (GWAS), Early onset dementia consortium & the GENFI group o CLINIGENE (the NGF study was included) - National Academic collaboration o Malmö Diet and Cancer study o FAS Epi Life Center, Gothenburg (www.epilife.sahlgrenska.gu.se) o StratNeuro program at Karolinska Institutet o Dept of Clinical Neuroscience, Dept of Mol Medicine and Surgery, Karolinska Institutet o KTH (Royal Institute of Technology) o Luleå University, Stockholm University (Stress Research Center), Umeå University, Lund University (Radiology section) o Wallenberg Neuroscience Center, Lund - International Academic collaboration o Genetic Epidemiology of Parkinson Disease (GEO-PD) o Norway: MedCoast (Gothenburg-Oslo MCI study), Oslo Univ (Kirkevold) o Finland: Åbo Akademi Univ (Laine), Turku Univ (Rinne), Univ of Eastern Finland, Kuopio (Koistinaho, Soininen) o Germany: DZNE, Magdeburg (Lindenberger), Tübingen Univ, Dept of Neurology (Schule, Schöls), Hertie Inst for Clin Brain Research, Tübingen (Gasser, Biskup), Max Planck Institute for Biology of Ageing (NG Larsson) o Belgium: Leuven Univ, Dept of Molecular and Developmental Genetics (de Strooper) o The Netherlands: VUMc, Amsterdam (Scheltens, Visser), Maastricht Univ (Verhey, Handels) o Italy: Univ of Bologna (Rimondini, Atti), Univ of Florence, Dept Neurology (Pantoni), Univ of Brescia, Clin & Med Exp Science o Spain: Univ of Oviedo (Gutierrez) o France: Inserm Centre for research in epidemiology and population health, Univ of Bourgogne (Bretillon) o McGill Univ Canada (Cuello), UVic, Canada (Mac Donald) o Dept of Biomedical Engineering, Univ of Alberta, Edmonton, Canada 9 o South Carolina Univ (Granholm), Brown Univ (Wahlberg), Mayo Univ, Alzheimer Disease Research Center (eg Bienek), Rockefeller Univ (Sakmar), Brigham Young Univ, Utah, Cornell Univ, New York, La Trobe Univ (Taylor) o Lab of Genetics, NIA & NIH, Bethesda (Cookson, Dillman) o La Trobe Univ, Australia o Japan: Kobe Univ (Tanemura), RIKEN Brain Institute (Saido, Nilsson) - Industrial o GE Healthcare o Bayer Pharma o DiaGenic o NsGene A/S o Hoffmann-La Roche o AstraZeneca o Boehringer-Ingelheim o Gyros AB, Uppsala o BioArctic, Stockholm Furthermore, a large number of clinical trials, sponsored by the pharma industry, are performed at the three involved clinics on the SBP prioritized diseases: ALS, Alzheimer and Parkinson diseases. These include both studies for drug development and on biomarkers for diagnosis. 10 Organisation and infrastructure One main goal with the Swedish Brain Power network is to facilitate and encourage efficient interdisciplinary collaboration in order to take advantage of the partners’ expertise and achieve best possible research outcome. In a legal aspect, Swedish Brain Power is a Center of Excellence within Karolinska Institutet (KI) with collaborators all over Sweden. The Coordination Unit is located at the KI Center for Alzheimer Research, Department NVS, Karolinska Institutet. SBP is directed by Prof Bengt Winblad, together with Maria Eriksdotter as co-Director and Gunilla Johansson as Coordinator. The SBP work is structured into three research platforms; Clinic-Epidemiology, Basic and Caring/Technology platforms (green, blue, lilac in the figure below). Each platform is formed by several cores; eg pre-clinics & transgenic models, epidemiology, care/caring & rehabilitation. Since “Ethics” concerns all research areas, this core is placed within the middle circle. Each core consists of research groups from the involved universities, and is headed by scientific core coordinators, who in turn form a Steering Committee. The SBP Organisation Plan Leadership and coordination SBP is led by a Governing Board with representatives from eg the founder, academia, industry and county council. The Board takes a global responsibility for the SBP program, takes the final decision on research activities and allocation of the budget, and makes the policy decisions. The Board members also act as ambassadors for the program and strive to attract additional funding and industrial collaboration. The Governing Board meets at least once per term, and additional times if required. 11 Governing Board Håkan Eriksson, Chair Agneta Holmäng, Göteborg Christer Köhler, Stockholm Staffan Normark, Stockholm Olle Stendahl, Linköping Göran Stiernstedt, Stockholm Co-opted members of the Governing Board Kerstin Tham/Angel Cedazo Minguez, Head/Acting Head of NVS Dept, KI Bengt Winblad, Director SBP Maria Eriksdotter, Co-Director SBP Gunilla Johansson, Coordinator SBP During year 8, the Governing Board met twice; in December 2012 and in May 2013. Steering Committee The Steering Committee (SC) consists of all core coordinators (see list next page). The SC deals with more specific issues, such as scientific activities including a first evaluation of the research projects to be presented to the Board for decision. The SC usually meets 1-2 times per term, last year in October 2012 and April 2013. Executive Group The Executive Group deals with the daily decisions and consists of Director Bengt Winblad, Co-Director Maria Eriksdotter and Coordinator Gunilla Johansson. Since Maria Eriksdotter will be the new Head of the Dept NVS from August 1, Angel Cedazo Minguez will replace her as Co-Director from that date. SBP PhD’s and PhD students Currently, 39 postdocs, 22 registered PhD students and 13 research nurses/technicians obtain salary support from the program. In addition, all 25 core coordinators & approx 40 postdocs/others are partly involved in the research projects without any funding from SBP. All collaborators are listed on page 14-17. During year 8, eleven PhD students have defended their thesis; Lena Johansson, ARC KI Solna, Eva Lindqvist, KI Huddinge, Jaime Ross, KI Solna, Johanna Wanngren, KI Huddinge, Tobias Karlsson, KI Solna, Anneli Pamrén, KI Huddinge, Erik Olsson, Gothenburg, Deborah Rizzuto, ARC KI Solna, Caroline Ingre, Umeå, Daniel Sjölie, Umeå and S Savage, KI Solna. 12 SWEDISH BRAIN POWER – Core Coordinators and Other Members Director: Bengt Winblad, Professor Co-Director: Maria Eriksdotter, Professor Coordinator: Gunilla Johansson Communication Manager: Annbritt Ryman Core Coordinators Other Members Diagnostics and Therapeutic research, Clinical Trial Center Karolinska Institutet, Stockholm Agneta Nordberg, Professor Karolinska Institutet, Stockholm Niels Andreasen, MD, PhD Maria Eriksdotter, Professor, MD Dag Aarsland, Professor, MD Ove Almkvist, Professor Taher Darreh-Shori, PhD Amelia Marutle, PhD Elena Rodriguez-Vieitez, PhD Karim Farid, PhD Larysa Voytenko, PhD Erik Hjorth, PhD Helga Eyjolfsdottir, PhD stud Ruiqing Ni, PhD stud Sara Garcia-Ptacek, PhD stud Skåne University Hospital, Malmö Lennart Minthon, Professor Skåne University Hospital, Malmö Elisabet Londos, Assoc Prof, MD Katarina Nägga, MD, PhD Oskar Hansson, MD, PhD Erik Stomrud, PhD Gustav Torisson, PhD stud Malin Lavesson, RN Sahlgrenska Academy, Univ of Gothenburg Anders Wallin, Professor Sahlgrenska Academy, Univ of Gothenburg Arto Nordlund, PhD Erik Olsson, PhD Carl Eckerström, PhD Michael Jonsson, PhD Maria Bjerke, PhD Annika Öhrfelt, PhD Niklas Klasson, PhD stud Mårten Carlsson, PhD stud Eva Bringman, research nurse Uppsala University Lars Lannfelt, Professor Uppsala University Martin Ingelsson, Assoc Prof Joakim Bergström, PhD Hedvig Welander, PhD Lund University Gunnar Gouras, Professor Lund University Patrik Brundin, Professor Sonia George, PhD Mathilde Faideau, PhD 13 Epidemiology Karolinska Institutet,Stockholm Laura Fratiglioni, Professor Sahlgrenska Academy, Univ of Gothenburg Ingmar Skoog, Professor Neuropsychology Karolinska Institutet, Stockholm Lars Bäckman, Professor University of Gothenburg Boo Johansson, Professor Umeå University Lars Nyberg, Professor Care Research, Rehabilitation Karolinska Institutet, Stockholm Miia Kivipelto, Professor Hui-Xin Wang, PhD Chengxuan Qiu, PhD Lina Rosvall, PhD Barbara Caracciolo, PhD Weili Xu, PhD Sahlgrenska Academy, Univ of Gothenburg Pernille Olesen, PhD Hanna Falk, PhD Svante Östling, PhD Simona Sacuiu, PhD Karolinska Institutet, Stockholm Marc Gitart-Masip, PhD Göran Papenberg, PhD Erika Jonsson Laukka, PhD Yvonne Brehmer, PhD Gregoria Kalpouzos, PhD Anna Rieckmann, PhD stud University of Gothenburg Linda Hassing, Assoc Prof Valgeir Thorvaldsson, PhD Anne Ingeborg Berg, PhD Marcus Praetorius, Peter Karlsson, PhD stud Umeå University Anna Neely Stigsdotter, PhD Urban Ekman, PhD Daniel Sjölie, PhD stud Umeå University, Umeå Per-Olof Sandman, Professor Umeå University Birgit Rasmussen, RN, PhD David Edvardsson, RN, PhD Karin Sjögren, RN, PhD stud Karolinska Institutet Louise Nygård, Professor Karolinska Institutet, Stockholm Lena Borell, Professor Camilla Malinowsky, PhD Eva Lindqvist, PhD Sofia Wikström, PhD Mandana Fallahpour, PhD Lund University Anna-Karin Edberg, Professor Lund University Anneli Orrung Wallin, PhD stud University of Gothenburg Helle Wijk, Assoc Professor 14 Primary Care, Health Economics, Interactive training technology Biomarkers (Imaging, CSF etc) Genetics, Brain Bank Karolinska Institutet, Stockholm Anders Wimo, Professor Karolinska Institutet, Stockholm Linus Jönsson, MD, PhD Anders Sköldunger, PhD stud Britt-Marie Sjölund, PhD stud Linköping University Hospital Jan Marcusson, Professor Linköping Univ Hospital Anna Kvitting Segernäs, PhD stud Maria Johansson, PhD stud Umeå University Helena Lindgren, PhD Umeå University Dipak Surie, PhD Sahlgrenska Academy, Univ of Gothenburg Kaj Blennow, Professor Sahlgrenska Academy, Univ of Gothenburg Henrik Zetterberg, MD, Professor Annika Öhrfelt, PhD Maria Bjerke, PhD Pia Gudmundsson, PhD Erik Portelius, PhD Karolinska Institutet, Stockholm Lars-Olof Wahlund, Professor Karolinska Institutet, Stockholm Agneta Nordberg, Professor Dag Aarsland, Professor Olof Lindberg, PhD Eric Westman, PhD Carlos Aguilar, PhD stud Olga Voevodskaya, PhD stud Aleksandra Lebedeva, PhD stud Karolinska Institutet, Stockholm Caroline Graff, MD, Professor Karolinska Institutet, Stockholm Lars Olson, Professor Mimi Westerlund Olofsson, PhD Andrea Carmine Belin, PhD Dagmar Galter, PhD Lina Rosvall, PhD Huei-Hsin Chiang, PhD Caroline Ran, PhD Sandra Gellhaar, PhD Vesna Jelic, PhD Annica Rönnbäck, PhD Charlotte Forsell, BMA Lena Lilius, BMA Marie Fallström, Brain Bank coord Sahlgrenska Academy, Univ of Gothenburg Hans Nissbrandt, Professor Sahlgrenska Academy, Univ of Gothenburg Elias Eriksson, Professor Olle Bergman, PhD Camilla Fardell, PhD stud Umeå University Peter M Andersen, Professor Umeå University Anna Birve, PhD Angelica Nordin, PhD Caroline Ingre, PhD stud Helena Alstermark, technician Lund University Patrik Brundin, Professor Sonia George, PhD 15 Linköping University Martin Hallbeck, PhD Lotta Agholme, PhD Pre-clinical research, Transgenic models Karolinska Institutet, Stockholm Lars Olson, Professor Angel Cedazo-Minguez, Assoc Professor Ingemar Björkhem, Professor Karolinska Institutet, Stockholm; Marianne Schultzberg, Professor Nils-Göran Larsson, Professor Eirikur Benedikz, Assoc Prof Lars Tjernberg, Assoc Prof Erik Sundström, Assoc Prof Helena Karlström, PhD Andrea Carmine Belin, PhD Anna Sandebring, PhD Dagmar Galter, PhD Susanne Frykman, PhD Tobias Weber, PhD Silvia Maioli, PhD stud Jaime Ross, PhD stud Mustafa Ismail, PhD stud Torbjörn Persson, PhD stud Anita Lövgren-Sandblom, BMA Uppsala University Lars Lannfelt, Professor Martin Ingelsson, Assoc Prof Dag Sehlin, PhD Hedvig Welander, PhD Lund University Gunnar Gouras, Professor Mathilde Faideau, PhD Ethics Karolinska Institutet, Stockholm Erik Sundström, Assoc Professor Maria Eriksdotter, Professor Karolinska Institutet, Stockholm Kevin Grimes, PhD Sara Stormoen, PhD stud Mette Bergman, PhD stud 16 Information dissemination Knowledge dissemination and communication, both internal and external, is one of SBP’s priorities. To this end SBP has, since October 2007, engaged a Communication Manager at halftime to work close together with the Executive Group. The overall goal is to make SBP’s position as a leading research network known to a wider public in order to promote necessary investments in research to combat one of our fastest growing public health problems; dementia. Externally the aim is to reach relevant target groups such as other scientists, physicians’ clinics, patients, decision makers in society and industry as well as the general public. Internally the aim is to facilitate and enhance communication and collaboration within the network. External and Internal • The SBP website www.swedishbrainpower.se plays an important role in knowledge dissemination, both externally and internally. The site presents the SBP and related news to external target groups and to the public. The change in website technical platform last year has enabled more focus on continuous update and news and the statistics show a growing interest in the SBP website. • Statistics over SBP’s presence on Facebook www.facebook.com/SwedishBrainPower and Twitter twitter.com/SwedBrainPower also show a growing, both internal and external, interest. • Efforts to further increase the website’s accessibility and usability has been made continuously by search optimizing and updating both content and technical functions. External • Publication in scientific journals is the main channel for scientific knowledge dissemination, both nationally and internationally. News about important publications in major scientific journals is reported on the website in a popular form along with links to the scientific articles. • The SBP scientists give lectures and present the SBP programme and the scientific outcome at scientific conferences, as well as at public meetings and seminars, both nationally and internationally, often in collaboration with patient associations. • The SBP-scientists are often interviewed in media and their appearances are reproduced on the website. 17 • A debate article has been published in the Swedish national newspaper “Svenska Dagbladet” about the dementia threat to society. SBP-researchers have also appeared in several specialty supplements to Swedish newspapers. • The existing portable roll ups and folders for presentation to target groups and public have been supplemented with a leaflet in English giving details explaining how the network is structured and works across both disciplinary and geographic boundaries. Internal • Every year a 2-day workshop is organized where all researchers in the network meet and exchange experiences, ideas and results and where the young researchers in the network present their cutting edge projects. This year, the workshop was held October 10-11, 2013 at Vår Gård in Saltsjöbaden gathering 95 researchers participating in SBP projects. We are especially happy that several of our Board members participated at least partly in the meeting. An annual award of 5 000 SEK each for best pedagogic oral and best pedagogic poster presentation is given out at each workshop, aimed to be used for presenting the research project at an international conference. This year Anna Lilja was awarded for her oral presentation “Neurotrophic and neuroprotective actions of (-)- and (+)-phenserine, candidate drugs for Alzheimer disease” and Annicka Hedman was awarded for her poster presentation “Functioning over time in persons with MCI: Patterns of everyday technology use and involvement in activities”. • A contact group of people from different research areas and sites has been formed to provide the Communication Manager and the website with up-to-date information from the various research groups in different parts of the country. 18 Research Budget Allocation The grant from KAW Foundation for the SBP program during July 2010 – June 2015 (5 yrs) is in total 100 MSEK. During year 8 (120701—130630), approx 20 MSEK has been allocated to research projects in form of 50% salary support. Approx 3 MSEK has been used for managerial and administrative costs, including part-time salary for managerial staff, website and workshop, meetings and travels for all researchers involved in the program. See table below. COORDINATION CENTER Salary cost Salaries (Director, Co-Director, Adm coord) Communikator Board fees SUM SALARIES OTHERS COSTS Rental Meetings (board, leading groups, core groups) Travels Workshop Recruitment announcement Computer, softwares, web hotel Office supplies Other running costs SUM OTHER COSTS 100701-110630 110701-120630 120701-130630 ÅR 8 ÅR 6 ÅR 7 1 441 848 830 833 1 404 828 355 857 76 517 402 724 300 000 210 000 300 000 2 097 705 1 117 350 2 107 552 116 000 18 162 113 354 328 605 116 000 38 101 114 172 279 327 24 331 16 114 10 598 17 845 296 691 30 494 6 031 44 659 657 305 13 681 1 597 15 027 577 905 SUM SALARY and OTHER COSTS INDI 19%, 19.07% resp 15,38% 1 414 041 267 120 2 764 857 425 235 2 675 610 411 509 SUB TOTAL; costs taken centrally 1 681 161 3 190 092 3 087 119 ALLOCATED GRANTS FOR RESEARCH PROJECTS 201007—12 incl 19% INDI 201101—06 incl 19,07% INDI 201107—2013-06 incl 15,38% INDI 6 559 875 7 367 465 18 136 005 20 048 769 116 000 37 024 74 779 SUBTOTAL; ALLOCATED GRANTS 13 927 340 18 136 005 20 048 769 GRAND TOTAL COSTS 15 608 501 21 326 097 23 135 888 19 Below is summarized the allocation (%) of grants 2010-07—201306 (year 6-8) per university and per project leader. No of Project Leaders per university: KI 19, Gbg 6, Malmö/Lund 4, Umeå 4, Nordanstig 1, Linköping 2, Uppsala 1. Matching funds The SBP program only contributes with 50% of the salary for the given positions, even though the researcher is expected to work full time for the project. That means that the unit receiving SBP support contributes with the equal amount to cover for full salary. In addition, they have to cover for all running costs needed to perform the project. By this, the recipients of SBP grants contributes themselves with a total matching fund of approx 27 msek for the 63 positions including running costs. The clinical trials performed at the three SBP clinics are estimated to render approx 20 msek annually, mainly from international drug companies. 20 Swedish Brain Power In FUTURE Both nationally and internationally, Swedish Brain Power has become a well-known trademark. Being a part of Swedish Brain Power is something all involved are very proud of. The many recent publications in high impact journals and the high number of excellent PhD examinations so far, is a proof of the scientific quality. The Knut & Alice Wallenberg Foundation supports the SBP program for five years, ending June 30, 2015. Since we are now entering into our fourth year, we are intensifying our work trying to find support for primarily another five years. Our plans are to approach eg suitable foundations and the host universities. To keep the network together requires to our mind not only a small “network grant”, the criteria for allocation of funding to our researchers really have a great impact on this why the optimal funding should include funding also for joint research projects. We have appointed a small group of “younger” researchers to come up with new ideas and to take main responsibility for this important task. As we have hard times to believe that we will not be able to convince our stakeholders of the waste it would be to disrupt this successful program, we are looking forward to the future with confidence. For the Swedish Brain Power Program Bengt Winblad Director Maria Eriksdotter Co-Director Gunilla Johansson Coordinator 21 LIST OF RESEARCH PROJECTS (In total 57 research projects) 22 CLINICAL PLATFORM (PI within brackets) 1. Multi-tracer PET studies for understanding of disease processes and development of early diagnostic biomarkers (A Nordberg) 2. Imaging of astrocytes, fibrillar amyloid load and cerebral glucose metabolism in Tg mice with APPswe mutation with µPET technique (A Nordberg) 3. Studies of neuroplasticity and functional neurogenesis in AD (A Nordberg) 4. A comparison between families with the C90RF72- and the SOD1 gene mutation in Swedish families suffering from ALS or ALS/FTD (LO Wahlund, P Andersen) 5. Genetics of ALS/FTD and paraclinical studies (Fat dysmetabolisme, Q10, PET, MR-Imaging, NRF2) (P Andersen) 6. Mevalonate pathway and cholesterol homeostasis in patients with different types of ALS and ALS-FTD (I Björkhem, P Andersen) 7. Early diagnosis of AD (Tidig demensdiagnostik I Skåne, TIDIS) (L Minthon, O Hansson) 8. The Normal Material Study 2 (NoMaS 2) (K Nägga, L Minthon) 9. Cognitive impairment in elderly medical inpatients (L Minthon) 10. Neurochemical identification of incipient subcortical VaD and AD (A Wallin) 11. Functional and structural brain imaging (MRI) in normal aging, vascular and non-vascular MCI (A Wallin) 12. Encapsulated cell bio-delivery of nerve growth factor (NGF) to Alzheimer disease patients (M Eriksdotter) 13. Evaluation of Aβ oligomers/protofibrils as biomarkers for Alzheimer disease (L Lannfelt) 14. Genetic background and lifestyle-related factors in relation to risk of dementia and cognitive decline (L Fratiglioni & I Skoog) 15. Longitudinal population-based studies in Sweden: Defining new clinical outcomes (L Fratiglioni) 16. Brain atrophy and cerebrovascular disease on CT in elderly population samples; risk factors, secular changes and prognosis (I Skoog & LO Wahlund) 17. Individual differences in preclinical onset of dementia: What contributes to early/late onset of cognitive decline? (L Bäckman & B Johansson) 18. Dopamine and cognitive plasticity across the adult life span (L Bäckman) 19. Can social and emotional well-being reduce the effects of AD and small vessel neuropathology on neuropsychological functioning: Examining the socio-emotional reserve hypothesis in MCI patients (B Johansson) 20. Interactive training techniques (L Nyberg) 21. Evaluation of emotional and cognitive impairment using VR technique (L Nyberg) CARING / TECHNOLOGY PLATFORM 22. Exploring person-centred care in relation to health in people with dementia and staff in residential aged care (PO Sandman) 23. Evidence-based environments (AK Edberg) 24. Detection of subtle and early signs of disability in terms of difficulties in everyday technology use in older adults with MCI and AD (L Nygård) 25. The academic nursing home – a large scale intervention of the national guidelines for care of dementia (L Borell) 26. Functional capacity and costs of care (A Wimo) 27. Dementia; costs for disease, drugs and diagnostics (A Wimo) 23 28. Cognitive testing and functional evaluation in primary care dementia investigations (J Marcusson) 29. Providing tailored ICT-support to individuals with suspected or early dementia in their home and to their health professionals (Helena Lindgren) BASIC PLATFORM 30. Development of CSF biomarkers of synaptic degeneration in AD (K Blennow, J Gobom) 31. APP in CNS development and degeneration (K Blennow) 32. Lactate as a biomarker for aging and Alzheimer – a translational MRS study on mitochondrial dysfunction (LO Wahlund) 33. Structural brain changes associated with depression and apathy in patients with AD (D Aarsland) 34. Genetic, neuropathological and clinical studies in FTLD (C Graff) 35. Clinical and experimental studies of FAD: a model for identifying prognostic and early diagnostic markers of sporadic AD (C Graff) 36. Coordinator for a common neuropathological strategy in SBP projects (C Graff) 37. Prion-like propagation of Aβ- and tau-pathology in AD: translational studies in Tg mouse models (P Brundin) 38. Defining Aβ/CTFβ induced synaptic changes in Alzheimer disease (G Gouras, L Tjernberg) 39. Disease-causing mutations in familial PD (H Nissbrandt) 40. Identification and modelling genetic factors in PD (A Carmine Belin) 41. Closing some of the gaps between genetic studies and pathology (D Galter) 42. Investigating the selective neuronal vulnerability in AD pathogenesis (L Tjernberg, A Sandebring) 43. The mitochondria theory of aging, mtDNA mutator mice and high brain lactate as early biomarker of AD + translating ageing findings in mice to human brains, expression patterns of LDH-A and B, and other genes… (L Olson) 44. LOTUS: A new regulator of brain plasticity; role in the formation of lasting memories (L Olson) 45. Three new ways to counteract disease phenotype in a genetic model of PD (L Olson) 46. APOE genotype and risk factors in AD; to understand the underlying mechanisms (A Cedazo Minguez) 47. Modulation of gamma-secretase by APOE, a mechanistic explanation leading to sporadic AD (A Cedazo Minguez) 48. Role of cholesterol metabolism and functions of oxysterols in healthy and AD brains (A Cedazo Minguez & I Björkhem) 49. Role of the oxysterol 27-hydroxycholesterol in neurodegeneration (I Björkhem) 50. Inflammation as target for treatment of AD with special focus on the resolution phase (M Schultzberg) 51. Biomarkers and memory in the transgenic AD rat (E Benedikz) 52. Role of the Aph-1 isoforms in the γ-secretase complex for selective processes of APP and Notch (H Karlström) 53. Impact of gamma-secretase modulators and FAD-mutations on a wide range of gammasecretase substates (H Karlström, T Weber) 54. Neuronal cell cultures derived from induced pluripotent cells as a platform to study AD mechanisms (E Sundström) 55. Investigation on cellular transmission for alpha-synuclein (M Hallbeck) ETHICS 56. Medical decision making capacity in patients with compromised cognitive functions (E Sundström) 57. To live with risk for Alzheimer disease (Maria Eriksdotter) 24 PUBLICATIONS YEAR 8 (In total 150 publications; 81 within clinical platform, 20 within care/rehab platform and 49 within the basic research platform) 25 CLINICAL RESEARCH PLATFORM (DIAGNOSTICS, THERAPEUTICS, CLINICAL TRIALS, EPIDEMIOLOGY, NEUROPSYCHOLOGY) 2013 Berg AI, Wallin A, Nordlund A, Johansson B. Living with stable MCI: experiences among 17 individuals evaluated at a memory clinic. Aging Ment Health. 2013;17(3):293-9. Billstedt E, Skoog I, Duberstein P, Hällström T, Andrén M, Björkelund C., Östling S, Waern, M. A 37 year prospective study of neuroticism and extroversion in women followed from mid-life to late life. Acta Psychiatr Scand. 2013 Feb 19. Billstedt E, Waern M, Duberstein P, Marlow T, Hellström T, Ostling S, Skoog I Secular changes in personality: study on 75-year-olds examined in 1976-77 and 2005-2006. Int J Geriatr Psychiatry 2013;28:298-304. Caracciolo B, Gatz M, Xu W, Marengoni A, Pedersen NL, Fratiglioni L. Relationship of subjective cognitive impairment and cognitive impairment no dementia to chronic disease and multimorbidity in a nation-wide twin study. J Alzheimers Dis. 2013 Jan 1;36(2):275-84. Choo IH,Ni R, Schöll M et al. Combination of 18F-FDG PET and CSF biomarkers as a better predictor of the progression to Alzheimer Disease in MCI patients. J Alzheimer´s Dis, 2013:33:929-939. Daborg J, Holmgren S, Abramsson A, Andreasson U, Zetterberg M, Nilsson S, Minthon L, Skoog I, Blennow K, Pekna M, Hanse E, Zetterberg H. Complement Gene Single Nucleotide Polymorphisms and Biomarker Endophenotypes of Alzheimer's Disease. J Alzheimer’s Dis. 2013;35:51-7. Eckerström C, Olsson E, Bjerke M, Malmgren H, Edman A, Wallin A, Nordlund A. A combination of neuropsychological, neuroimaging, and cerebrospinal fluid markers predicts conversion from mild cognitive impairment to dementia. J Alzheimer’s Dis. 2013 Jan 1;36(3):421-31 Eckerström M, Skoogh J, Rolstad S, Göthlin M, Steineck G, Johansson B, Wallin A. Sahlgrenska Academy Self-reported Cognitive Impairment Questionnaire (SASCI-Q)--a research tool discriminating between subjectively cognitively impaired patients and healthy controls. Int Psychogeriatr. 2013 Mar;25(3):420-30. Edison P, Carter SF, Rinne JO et al. Comparison of MRI based and PET template based approaches in the quantitative analysis of amyloid imaging with PIB-PET. Neuroimage 2013: 70:423-433. Ferencz B, Laukka EJ, Lövdén M, Kalpouzos G, Keller L, Graff C, Wahlund LO, Fratiglioni L, Bäckman L. The influence of APOE and TOMM40 polymorphisms on hippocampal volume and episodic memory in old age. Front Hum Neurosci. 2013 May 22;7:198. Fredén Klenfeldt I, Karlsson B, Sigström R, Waern M, Östling S, Marlow T, Gustafson D, Skoog I. Prevalence of Obsessive-compulsive Disorder in Relation to Depression and Cognition in an Elderly Population. Am J Geriatr Psychiatry. 2013 Mar 13. Guldberg-Kjär T, Sehlin S, Johansson B. ADHD symptoms across the lifespan in a population-based Swedish sample aged 65 to 80. Int Psychogeriatr. 2013 Apr;25(4):667-75 26 Hange D, Mehlig K, Lauren L, Guo X, Bengtsson C, Skoog I, Björkelund C. Perceived mental stress in women associated with psychosomatic symptoms, but not mortality: observations from the Population Study of Women in Gothenburg. Int J Gen Med. 2013;6:307-15 Hjelm C, Broström A, Dahl A, Johansson B, Fredrikson M, Strömberg A. Factors Associated With Increased Risk for Dementia in Individuals Age 80 Years or Older With Congestive Heart Failure. J Cardiovasc Nurs. 2013 Jan 30. [Epub ahead of print] Hörder H, Skoog I, Frändin K. Health-related quality of life in relation to walking habits and fitness: a population-based study of 75-year-olds. Qual Life Res. 2013 Aug;22(6):1213-23. Irz X, Fratiglioni L, Kuosmanen N, Mazzocchi M, Modugno L, Nocella G, Shakersain B, Traill WB, Xu W, Zanello G. Sociodemographic determinants of diet quality of the EU elderly: a comparative analysis in four countries. Public Health Nutr. 2013 May 9:1-13 Jokinen H, Schmidt R, Ropele S, Fazekas F, Gouw AA, Barkhof F, Scheltens P, Madureira S, Verdelho A, Ferro JM, Wallin A, Poggesi A, Inzitari D, Pantoni L, Erkinjuntti T; LADIS Study Group. Diffusion changes predict cognitive and functional outcome: the LADIS study. Ann Neurol. 2013 May;73(5):57683. Johnell C, Religa D, Eriksdotter M. Dementia disorders and drug therapy: a nationwide study of over 7000 patients-data from SveDem. Ger Dem Cogn Disord 2013;35:239–248. Jonsson Laukka E, Lövdén M, Herlitz A, Karlsson S, Ferencz B, Pantzar A, Keller L, Graff C, Fratiglioni L & Bäckman L. Genetic effects on old-age cognitive functioning: A population-based study. Psychology and Aging, 2013;28:262-274. Kern S, Skoog I, Börjesson-Hanson A, Blennow K, Zetterberg H, Östling S, Kern J, Gudmundsson P, Marlow T, Rosengren R, Waern M. Lower CSF Interleukin-6 predicts future depression in a population-based sample of older women followed for 17 years. Brain Behav Immun. 2013 Aug;32:153-8. Laukka EJ, Lövdén M, Herlitz A, Karlsson S, Ferencz B, Pantzar A, Keller L, Graff C, Fratiglioni L, Bäckman L. Genetic effects on old-age cognitive functioning: a population-based study. Psychol Aging. 2013 Mar;28(1):262-74. Lövdén M, Jonsson Laukka E, Rieckmann A, Kalpouzos G, Li T-Q, Jonsson T, Wahlund LO, Fratiglioni L & Bäckman L. The dimensionality of between-person differences in white-matter microstructure in old age. Human Brain Mapping, 2013;34:1386-1398. Magnusson K, Sehlin D, Syvänen S, Svedberg MM, Philipson O, Söderberg L, Tegerstedt K, Holmquist M, Gellerfors P, Tolmachev V, Antoni G, Lannfelt L, Hall H, Nilsson LN. Specific Uptake of an Amyloidβ Protofibril-Binding Antibody-Tracer in AβPP Transgenic Mouse Brain. J Alzheimer’s Dis. 2013 Jan 1;37(1):29-40. Marutle A, Gillberg PG, Bergfors A et al. 3H-deprenyl and 3H-PIB autoradiography show different laminar distribution of astroglia and fibrillar ß-amyloid in Alzheimer brain. J Neuroinflammation 2013:10:90. Mellqvist Fässberg M, Östling S, Börjesson-Hanson A, Skoog I, Waern M. Suicidal feelings in the twilight of life: A cross-sectional population-based study of 97-year-olds. BMJ Open. 2013 Feb 1;3(2). 27 Morin J, Wiktorsson S, Marlow T, Olesen PJ, Skoog I, Waern M. Alcohol use disorder in elderly suicide attempters: A controlled study. Am J Geriatr Psychiatry. 2013;21:196-203. Ni R, Gillberg PG, Bergfors A et al. Amyloid tracers detect multiple binding sites in Alzheimer´s disease brain tissue. Brain 2013: 136: 2217-2227. Nordberg A, Carter SF, Rinne J et al. European multi-center PET study of fibrillar amyloid in Alzheimer´s disease. Eur J Nucl Med Mol Imaging 2013: 40: 104-114 Olsson E, Klasson N, Berge J, Eckerström C, Edman A, Malmgren H, Wallin A. White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method-The Gothenburg MCI Study. J Aging Res. 2013;198471 Papenberg G, Bäckman L, Nagel IE, Nietfeld W, Schröder J, Bertram L, Heekeren HR, Lindenberger U & Li S-C. (2013). Dopaminergic gene polymorphisms affect long-term forgetting in old age: Further support for the magnification hypothesis. J Cognitive Neuroscience, 25, 571-579. Pedersen NL, Christensen K, Dahl AK, Finkel D, Franz CE, Gatz M, Horwitz BN, Johansson B, Johnson W, Kremen WS, Lyons MJ, Malmberg B, McGue M, Neiderhiser JM, Petersen I, Reynolds CA. IGEMS: the consortium on Interplay of Genes and Environment across Multiple Studies. Twin Res Hum Genet. 2013 Feb;16(1):481-9. Piccinin AM, Muniz-Terrera G, Clouston S, Reynolds CA, Thorvaldsson V, Deary IJ, Deeg DJ, Johansson B, Mackinnon A, Spiro A 3rd, Starr JM, Skoog I, Hofer SM. Coordinated analysis of age, sex, and education effects on change in MMSE scores. J Gerontol B Psychol Sci Soc Sci. 2013 May;68(3):37490. Praetorius M, Thorvaldsson V, Hassing LB, Johansson B. Substantial effects of apolipoprotein E ε4 on memory decline in very old age: longitudinal findings from a population-based sample. Neurobiol Aging. 2013 Jul 12. Prestia A, Caroli A, van der Flier V et al. Prediction of dementia in MCI patients based upon core diagnostic markers for Alzheimer´s disease. Neurology 2013:80:1-9. Qiu C, von Strauss E, Bäckman L, Winblad B, Fratiglioni L.Twenty-year changes in dementia occurrence suggest decreasing incidence in central Stockholm, Sweden. Neurology. 2013 May 14;80(20):1888-94. Reynolds CA, Zavala C, Gatz M, Vie L, Johansson B, Malmberg B, Ingelsson E, Prince JA, Pedersen NL. Sortilin receptor 1 predicts longitudinal cognitive change. Neurobiol Aging. 2013 Jun;34(6):1710.e118. Rolstad S, Berg AI, Bjerke M, Johansson B, Zetterberg H, Wallin A. Cerebrospinal fluid biomarkers mirror rate of cognitive decline. J Alzheimer’s Dis. 2013 Jan 1;34(4):949-56. Sjöberg L, Östling S, Waern M, Falk H, Skoog I. Secular changes in the relation between depression and social factors. A study of two birth cohorts of Swedish septuagenarians followed for 5 years. J Affect Disord. 2013 Sep 5;150(2):245-52. 28 Soveri A, Tallus J, Laine M, Nyberg L, Bäckman L, Hugdahl K, Tuomainen J, Westerhausen R & Hämäläinen H. Modulation of auditory attention by training. Experimental Psychology, 2013;60:4452. Wang HX, Jin Y, Hendrie HC, Liang C, Yang L, Cheng Y, Unverzagt FW, Ma F, Hall KS, Murrell JR, Li P, Bian J, Pei JJ, Gao S. Late life leisure activities and risk of cognitive decline. J Gerontol A Biol Sci Med Sci. 2013 Feb;68(2):205-13. Wiberg P, Waern M, Billstedt E, Östling S, Skoog I. Secular trends in the prevalence of dementia and depression in Swedish septugenarians 1976- 2006. Psychol Med. 2013 Mar 12:1-8. Xu WL, Caracciolo B, Wang HX, Santoni G, Winblad B, Fratiglioni L. Accelerated progression from mild cognitive impairment to dementia among APOE ε4ε4 carriers. J Alzheimer’s Dis. 2013;33(2):507-15. Zhang H, Xu W, Dahl A, Xu Z, Wang HX, Qi X. Relation of socioeconomic status to impaired fasting glucose and type 2 diabetes: findings based on a large population-based cross-sectional study in Tianjin, China. Diabet Med. 2013 Feb 8. Zhi X, Joas E, Waern M, Östling S, Börjesson-Hanson A, Skoog I. Prevalence of cardiovascular disorders and risk factors in two 75-year-olds birth cohorts examined in 1976-77 and 2005-06. Aging Clin Exp Res. 2013;25:377-83 Zimmermann-Viehoff F, Wang HX, Kirkeeid R, Schneiderma N, Erdur L, Dete H-C, K. Women’s Exhaustion and Coronary Artery Atherosclerosis Progression. The Stockholm Female Coronary Angiography Study. Psychosom Med. 2013 Jun;75(5):478-85. 2012 Andel R, Crowe M, Hahn EA, Mortimer JA, Pedersen NL, Fratiglioni L, Johansson B, Gatz M. Workrelated stress may increase the risk of vascular dementia. J Am Geriatr Soc. 2012 Jan;60(1):60-7. Brehmer Y, Westerberg H & Bäckman L. Working-memory training in younger and older adults: Training gains, transfer, and maintenance. Frontiers in Human Neuroscience, 2012;6:63. Brown CL, Gibbons LE, Kennison RF, Robitaille A, Lindwall M, Mitchell MB, Shirk SD, Atri A, Cimino CR, Benitez A, Macdonald SW, Zelinski EM, Willis SL, Schaie KW, Johansson B, Dixon RA, Mungas DM, Hofer SM, Piccinin AM. Social activity and cognitive functioning over time: a coordinated analysis of four longitudinal studies. J Aging Res. 2012; 287438. Burzynska AZ, Nagel IE, Preuschhoff C, Gluth S, Bäckman L, Li S-C, Lindenberger U & Heekeren HR. (2012). Cortical thickness is linked to executive functioning in adulthood and aging. Human Brain Mapping, 33, 1607-1620. Caracciolo B, Gatz M, Xu W, Pedersen NL, Fratiglioni L. Differential distribution of subjective and objective cognitive impairment in the population: a nation-wide twin-study. J Alzheimer’s Dis 2012; 29: 393-403. Cavallin L, Bronge L, Zhang Y, Oksengård AR, Wahlund LO, Fratiglioni L, Axelsson R. Comparison between visual assessment of MTA and hippocampal volumes in an elderly, non-demented population. Acta Radiol. 2012 Jun 1;53(5):573-9. 29 Clerici F, Caracciolo B, Cova I, Fusari Imperatori S, Maggiore L, Galimberti D, Scarpini E, Mariani C, Fratiglioni L. Does vascular burden contribute to the progression of mild cognitive impairment to dementia? Dement Geriatr Cogn Disord. 2012;34(3-4):235-43. Eriksdotter-Jönhagen M, Linderoth B, Lindb G, Aladellie L, Almkvist O,Andreasen N, Blennow K, Bogdanovic N, Jelic V, Kadir A, Nordberg A, Sundström E, Wahlund LO, Wall A, Wiberg M, Winblad B, Seiger Å, Almqvist P, Wahlberg. Encapsulated cell biodelivery of NGF to the basal forebrain in patients with Alzheimer´s disease. Dem Ger Cogn Disord. 2012;33:18-28. Eriksdotter-Jönhagen M, Linderoth B, Lind G , Eyjolfsdottir H, Seiger Å, Almqvist P, Wahlberg L. Intracerebral tillförsel av tillväxtfaktorn NGF med inkapslade celler hos patienter med Alzheimers sjukdom. Neurologi 1: 15-22, 2012 Forsberg A, Engler H, Blomquist G et al. The use of PIB PET as a dual pathological and functional biomarker in AD. Biochemica et Biophysica Acta 2012:1822: 380-385. Jacobs AH, Taviatian B and the INMIND consortium. Noninvasive molecular imaging of neuroinflammation. J Cereb Blood FLow Metab 2012: 32: 1393-1415. Jonsson M, Skoog I, Marlow T, Mellqvist M, Waern M. Anxiety symptoms and suicidal feelings in a population sample of non-demented 70-year-olds. Int Psychogeriatr. 2012;24:1865-71. Jonsson Laukka E, MacDonald S W S, Fratiglioni L & Bäckman L. Preclinical cognitive trajectories differ for Alzheimer's disease and vascular dementia. J Int Neuropsychol Society, 2012;18: 1-9. Kadir A, Almkvist O, Forsberg A et al. Dynamic changes in PET amyloid and FGD imaging at different stages of Alzheimer´s disease. Neurobiology of Aging 2012: 33: 198e-198e14. Lak VW, Guo X, Skoog I. Secular trends in lung function and its relation to survival in Swedish 75-year olds 1976-2006. Age Ageing. 2012;41:735-40. Lindwall M, Cimino CR, Gibbons LE, Mitchell MB, Benitez A, Brown CL, Kennison RF, Shirk SD, Atri A, Robitaille A, Macdonald SW, Zelinski EM, Willis SL, Schaie KW, Johansson B, Praetorius M, Dixon RA, Mungas DM, Hofer SM, Piccinin AM. Dynamic associations of change in physical activity and change in cognitive function: coordinated analyses of four longitudinal studies. J Aging Res. 2012;493598. Lövdén M, Schaefer S, Noack H, Bodammer N, Kühn S, Heinze H-J, Düzel E, Bäckman L & Lindenberger U. Spatial navigation training protects the hippocampus against age-related changes during early and late adulthood. Neurobiology and Aging, 2012;33:620. MacDonald SWS, Karlsson S, Rieckmann A & Bäckman L. (2012). Age-related increases in behavioral variability: Relations to losses of dopamine D1 receptors. J Neuroscience, 32, 8186-8191. Mangialasche F, Kivipelto M, Solomon A, Fratiglioni L. Dementia prevention: current epidemiological evidence and future perspective. Alzheimers Res Ther. 2012 Feb 13;4(1):6 Mitchell MB, Cimino CR, Benitez A, Brown CL, Gibbons LE, Kennison RF, Shirk SD, Atri A, Robitaille A, Macdonald SW, Lindwall M, Zelinski EM, Willis SL, Schaie KW, Johansson B, Dixon RA, Mungas DM, Hofer SM, Piccinin AM. Cognitively Stimulating Activities: Effects on Cognition across Four Studies with up to 21 Years of Longitudinal Data. J Aging Res. 2012;461592. Epub 2012 Sep 13. Nilsson J, Ostling S, Waern M, Karlsson B, Sigström R, Guo X, Skoog I.. The 1-month prevalence of Generalized Anxiety Disorder according to DSM-IV, DSM-V and ICD-10 among non-demented 75year-olds in Gothenburg, Sweden. Am J Geriatr Psychiatry. 2012;20:963-72. 30 Nyberg L, Lövdén M, Riklund K, Lindenberger U & Bäckman L. Memory aging and brain maintenance. Trends in Cognitive Sciences, 2012;6:292-305. Paillard-Borg S, Fratiglioni L, Xu W, Winblad B, Wang HX. An active lifestyle postpones dementia onset by more than one year in very old adults. J Alzheimer’s Dis. 2012;31(4):835-42. Richard E, Andrieu S, Solomon A, Mangialasche F, Ahtiluoto S, Moll van Charante EP, Coley N, Fratiglioni L, Neely AS, Vellas B, van Gool WA, Kivipelto M. Methodological challenges in designing dementia prevention trials - the European Dementia Prevention Initiative (EDPI). J Neurol Sci. 2012 Nov 15;322(1-2):64-70. Rieckmann A, Karlsson S, Fischer H & Bäckman L. Increased bilateral frontal connectivity in younger adults under the influence of a dopamine D1 receptor antagonist. J Neuroscience 2012;32: 1706717072. Rizzuto D, Orsini N, Qiu C, Wang HX, Fratiglioni L. Lifestyle, social factors, and survival after age 75: population based study. BMJ. 2012 Aug 29;345:e5568 Robitaille A, Muniz G, Piccinin AM, Johansson B, Hofer SM. Multivariate Longitudinal Modeling of Cognitive Aging: Associations Among Change and Variation in Processing Speed and Visuospatial Ability. GeroPsych (Bern). 2012;25(1):15-24. Rolstad S, Berg AI, Zetterberg H, Johansson B, Wallin A. All cognitive systems but speed and visuospatial functions reduce the effect of CSF pathology on other systems. Curr Alzheimer Res. 2012 Nov;9(9):1043-9. Rydwik E, Welmer AK, Kåreholt I, Angleman S, Fratiglioni L, Wang HX. Adherence to physical exercise recommendations in people over 65--The SNAC-Kungsholmen study. Eur J Public Health. 2012 Oct 31. Sehlin D, Englund H, Simu B, Karlsson M, Ingelsson M, Nikolajeff F, Lannfelt L, Pettersson FE. Large aggregates are the major soluble Aβ species in AD brain fractionated with density gradient ultracentrifugation. PLoS One. 2012;7(2):e32014 Torisson G, Minthon L, Stavenow L, Londos E. Cognitive impairment is undetected in medical inpatients: a study of mortality and recognition amongst healthcare professionals. BMC Geriatr. 2012;12:47. Wahlberg LU, Lind G, Almqvist PM, Kusk P, Tornøe J, Juliusson B, Söderman M, Selldén E, Seiger, Å, Eriksdotter-Jönhagen M. Linderoth, B,.Targeted therapy of NGF in Alzheimer’s disease with EC Biodelivery™ – A technology platform for restorative neurosurgery, J Neurosurg. 2012;117:340- 347. Welmer AK, Kåreholt I, Angleman S, Rydwik E, Fratiglioni L. Can chronic multimorbidity explain the age-related differences in strength, speed and balance in older adults? Aging Clin Exp Res. 2012 Oct;24(5):480-9. Wenger E, Schaefer S, Noack H, Kühn S, Mårtensson J, Heinze H-J, Düzel E, Bäckman L, Lindenberger U & Lövdén M. Cortical thickness changes following spatial navigation training in adulthood and aging. Neuroimage, 2012;59: 3389-339. 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