Sex-Specific Adaptations in Alzheimer's Disease and Ischemic Stroke: A Longitudinal Study in Male and Female APPswe/PS1dE9 Mice

Klara J Lohkamp, Nienke Timmer, Gemma Solé Guardia, Justin Shenk, Vivienne Verweij, Bram Geenen, Pieter J Dederen, Lieke Bakker, Cansu Egitimci, Rengin Yoldas, Minou Verhaeg, Josine Kothuis, Desirée Nieuwenhuis, Maximilian Wiesmann, Amanda J Kiliaan

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The long-term impact of stroke on Alzheimer's disease (AD) progression, particularly regarding sex-specific differences, remains unknown. Using a longitudinal study design, we investigated transient middle cerebral artery occlusion in 3.5-month-old APP /PS1 (APP/PS1) and wild-type mice. In vivo, we assessed behavior, cerebral blood flow (CBF), and structural integrity by neuroimaging, as well as post-mortem myelin integrity (polarized light imaging, PLI), neuroinflammation, and amyloid beta (Aß) deposition. APP/PS1 mice exhibited cognitive decline, white matter degeneration (reduced fractional anisotropy (FA) via diffusion tensor imaging (DTI)), and decreased myelin density via PLI. Despite early hypertension, APP/PS1 mice showed only sporadic hypoperfusion. Cortical thickening and hippocampal hypertrophy likely resulted from Aß accumulation and neuroinflammation. Stroke-operated mice retained cognition despite cortical thinning and hippocampal atrophy due to cerebrovascular adaptation, including increased CBF in the hippocampus and thalamus. Stroke did not worsen AD pathology, nor did AD exacerbate stroke outcomes. Sex differences were found: female APP/PS1 mice had more severe Aß deposition, hyperactivity, lower body weight, and reduced CBF but less neuroinflammation, suggesting potential neuroprotection. These findings highlight white matter degeneration and Aß pathology as key drivers of cognitive decline in AD, with stroke-related deficits mitigated by (cerebro)vascular adaptation. Sex-specific therapies are crucial for AD and stroke.
Original languageEnglish
Article number333
Number of pages39
JournalLife
Volume15
Issue number3
DOIs
Publication statusPublished - 21 Feb 2025

Keywords

  • Alzheimer’s disease
  • MRI
  • cerebral blood flow
  • cognition neuroinflammation
  • neuropathology
  • sex differences
  • stroke

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