Cognitive impairment and dementia

Our work on Cognitive Impairment centers on early detection and intervention against diseases that lead to dementia, with a primary focus on early predictors of dementia and Alzheimer’s disease. These conditions involve irreversible processes that develop insidiously over 10-20 years before clinical symptoms appear, making early precise disease diagnosis crucial. To identify early predictors and disease markers with dementia as the endpoint, we conduct longitudinal studies involving large cohorts of patients and controls at increased risk of developing dementia. We employ and publish on a wide range of techniques, contributing to advancements in cognitive investigations, imaging, proteomics, and genetics. Our approach involves both publishing major research findings in academic journals and filing key biomarker discoveries as DOFIs (to Inven2) for potential future patents. Currently, these patents have been licensed and commercialized by a biotech startup, Pre Diagnostic.

Cognitive impairment and dementia

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Research interests

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JPND/Horizon 2020-funded project including patients with pre-demented Alzheimer’s disease to find biomarkers for small vessel damage in the brain.

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Highlighted work

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2024

ACHE

AcuteHeadache Evaluation Study. (PIEspen Saxhaug Kristoffersen). Funding by Ahus.

2023

MultiHead

Multidisciplinary HeadacheTreatment. (PI Kjersti Grøtta Vetvik). Effect of headache treatment in amultidisciplinary team on headache burden and work participation. A cooperationwith the Norwegian Labour and welfare administration (NAV).

2024

Resolution

(PI Christofer Lundqvist) –Treatmentwith Eptinezumab in medication overuse headache. Sponsor Lundbeck AS.

2024

CandMig

PIChristofer Lundqvist). Candesartan for migraine. CandMig III:Kandesartan som forebyggende medisin ved hyppig migrene - Cristin. Fundedby Klinbeforsk.

2023

BioCer

(PIEspen Saxhaug Kristoffersen). Home-basedbiofeedback as a migraine treatment. Funded by the Norwegian Headache researchcenter (NorHead) and Nordic Brain tech.

www.biocer.no

Publications

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Read more

Costs of diagnosing early Alzheimer's disease in three European memory clinic settings: Results from the precision medicine in Alzheimer's disease project

PubMed↗
Wimo A, Kirsebom BE, Timón-Reina S, … , Fladby T
...
July 18, 2024

Homozygosity for R47H in TREM2 and the Risk of Alzheimer's Disease

PubMed↗
Stefansson H, Walters GB, Sveinbjornsson G, … , Stefansson K
...
June 19, 2024

Age-adjusted CSF t-tau and NfL do not improve diagnostic accuracy for prodromal Alzheimer's disease

PubMed↗
Knudtzon SL, Nordengen K, Grøntvedt GR, … , Kirsebom BE
...
May 29, 2024

Selected publications

  • Phenotype-informed polygenic risk scores are associated with worse outcome in individuals at risk of Alzheimer’s disease. Alzheimers Dement. 2022. Nordengen K, Pålhaugen L, Bettella F, Bahrami S, Selnes P, Jarholm J, Athanasiu L, Shadrin A, Andreassen OA, Fladby T.
    PMID: 35991219
  • Isobaric Quantification of Cerebrospinal Fluid Amyloid-β Peptides in Alzheimer’s Disease: C-Terminal Truncation Relates to Early Measures of Neurodegeneration. J Proteome Res. 2015. Rogeberg M, Almdahl IS, Wettergreen M, Nilsson LN, Fladby T. PMID: 26452689.
  • Detecting At-Risk Alzheimer’s Disease Cases. J Alzheimers Dis. 2017
    Fladby T, Pålhaugen L, Selnes P, Waterloo K, Bråthen G, Hessen E, Almdahl IS, Arntzen KA, Auning E, Eliassen CF, Espenes R, Grambaite R, Grøntvedt GR, Johansen KK, Johnsen SH, Kalheim LF, Kirsebom BE, Müller KI, Nakling AE, Rongve A, Sando SB, Siafarikas N, Stav AL, Tecelao S, Timon S, Bekkelund SI, Aarsland D. PMID: 28826181.
  • Mild cognitive impairment: cerebrospinal fluid tau biomarker pathologic levels and longitudinal changes in white matter integrity. Radiology 2013.
    Amlien IK, Fjell AM, Walhovd KB, Selnes P, Stenset V, Grambaite R, Bjørnerud A, Due-Tønnessen P, Skinningsrud A, Gjerstad L, Reinvang I, Fladby T. PMID: 23151827.

Ongoing projects and clinical studies

  • DDI - Dementia Disease Initiation. Cross-regional project which aims to establish uniform diagnostics, especially with regard to biomarkers, at all university centres.
    Started in 2012. Funded by various national partners.
  • PMI-AD - Precision Medicine in Alzheimer’s disease. JPND/Horizon 2020-funded project based on CNG/Ahus. The project follows patients with cognitive impairment, not dementia, over time to find out what triggers progression to dementia. Image examinations, blood and spinal fluid tests are central.
  • DEBBIE - Developing BBB-ASL as a non-invasive early biomarker of Alzheimer’s Disease (DEBBIE). JPND/Horizon 2020-funded project including patients with pre-demented Alzheimer’s disease to find biomarkers for small vessel damage in the brain.
  • ANeED - Ambroxol in new and early Dementia with Lewy Bodies (ANeED): investigate the tolerability, safety and effects of ABX in patients with DLB. This is a multicentre, phase IIa, double-blinded, randomised and placebo-controlled clinical trial, using a parallel arm design for 18 months’ follow-up. Started in 2021. Sponsor: Helse Fonna HF
  • Evoke - A research study investigating Semaglutide in people with early Alzheimer’s disease. Started in 2021. Funded by Novo Nordisk
  • NOPARK: A randomized controlled trial of nicotinamide supplementation in early Parkinson’s disease. Startet in 2020. Helse Bergen HF
  • Mechanisms and biomarkers in Lewy body disease. The project follows patients with Lewy body disease such as Early stage Parkinson’s. Special focus on early cognitive symptoms to find out what triggers progression to dementia. Image examinations, blood and spinal fluid tests are central. NFR-funded project, in collaboration with Pre-Diagnostics AS based on CNG IP.

Infrastructure

  • Biobanks
    DDI (Dementia Disease Initiation) biobank: DDI is a cross-regional project coordinated by AHUS and includes sites in South-Eastern-, Western-, Central- and Northern Norway Regional Health Authorities. The biobank consists of RNA isolation tubes, full blood, plasma, serum, monocytes and CSF samples. The biobank consist of sample material from > 1000 unique subjects, with repeat samples from inclusion at baseline, and follow up visits every second year. The DDI biobank is located at AHUS.
    The DDI bio-and databank is now internationally unique in this respect, with repetitive sampling of cerebrospinal fluid, blood, imaging and cognitive testing every two years now up to 10 years. This has been a costly long-term investment, which now pays of in increasing cohort and biobank value leading to an increasing number of publications with higher impact, and increasing relevance in the field.

    General Research Biobank for Neurological Diseases: Various types of sample material, both CSF and full blood, have been collected from 2011 and up to the present date. That includes > 2700 CSF samples and > 2500 full blood samples.
  • The XNAT database: Our research data includes standardized CRFs from all patients and visits corresponding to the biobank samples, implemented in a customized database (XNAT). XNAT was evaluated by the Norwegian Data Protection Authority (Datatilsynet) for integration of clinical, proteomic, imaging and genetic data, and we currently assemble data from all national (DDI) and international collaborators. The XNAT database forms the main data hub, designed to be ontologically and multimodally searchable, expandable and secure. All storage and retrieval of sensitive data is via the TSD (in Norwegian, Service for Sensitive Data) service.
  • Biomarkers: CNG has acquired equipment for fluid biomarker detection and assay development: QuickPlex SQ 120 from MesoScale Discovery (sensitive ELISA), Simoa SR-X from Quanterix (digital ELISA), Q Exactive Orbitrap Mass Spectrometer from Thermo Fisher Scientific

Members

Leader

Tormod Fladby

Tormod Fladby

MD PhD

Chief of Neurology/Professor II

Associate Professor

Bjørn-Eivind Kirsebom

Bjørn-Eivind Kirsebom

PhD

Associate professor/Psychologist

Researchers

Panpan You

Panpan You

MSc

Other/Researcher

Post.doc.

Sandra Tecelao

Sandra Tecelao

PhD

Post.doc.

PhD Students

Cecilia Magdalena Erikson

Cecilia Magdalena Erikson

MD

PhD Student

Ingvild Vøllo Eliassen

Ingvild Vøllo Eliassen

cand. psychol.

PhD Student

Jonas Jarholm

Jonas Jarholm

MD

PhD Student

Lene Pålhaugen

Lene Pålhaugen

MD

PhD Student

Doctors in research

Denesha Kandiah

Denesha Kandiah

MD

Doctor in research

Eirik Auning

Eirik Auning

MD, PhD

Doctor in research

Kim-Mai Le

Kim-Mai Le

MD

Doctor in research

Krisztina Johansen

Krisztina Johansen

MD, PhD

Doctor in research

Nikias Ioannis Siafarikas

Nikias Ioannis Siafarikas

MD, PhD

Doctor in research

Per Selnes

Per Selnes

MD, PhD

Doctor in research

Sigrid Elisabet Medhus

Sigrid Elisabet Medhus

MD, PhD

Doctor in research

Other

Berglind Gisladottir

Berglind Gisladottir

MSc

Other/biotechnicians

Heidi Fladeby Refsnes

Heidi Fladeby Refsnes

Other/Research Coordinator

Julia Kristine Gundersen

Julia Kristine Gundersen

MD

Other/Affiliated

Kaja Nordengen

Kaja Nordengen

MD, PhD

Other/Affiliated

Marianne Wettergreen

Marianne Wettergreen

MSc

Other/biotechnicians

Panpan You

Panpan You

MSc

Other/Researcher

Peter Mikael Arnesen

Peter Mikael Arnesen

Other/Bioinformatician

Santiago Timón Reina

Santiago Timón Reina

PhD

Other/Computer engineer

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