Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis

Background: Amyotrophic lateral sclerosis (ALS) represents a complex syndrome characterized by motor, psychiatric, and cognitive symptoms, where associations between cellular immune features and non-motor manifestations remain unknown. Methods: In this cohort study, we enrolled 250 incident people w...

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Main Authors: Yihan Hu, Elie Deeba, Ulf Kläppe, Linn Öijerstedt, John Andersson, Nicolas Ruffin, Fredrik Piehl, Caroline Ingre, Fang Fang, Christina Seitz
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Brain, Behavior, & Immunity - Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666354624001856
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author Yihan Hu
Elie Deeba
Ulf Kläppe
Linn Öijerstedt
John Andersson
Nicolas Ruffin
Fredrik Piehl
Caroline Ingre
Fang Fang
Christina Seitz
author_facet Yihan Hu
Elie Deeba
Ulf Kläppe
Linn Öijerstedt
John Andersson
Nicolas Ruffin
Fredrik Piehl
Caroline Ingre
Fang Fang
Christina Seitz
author_sort Yihan Hu
collection DOAJ
description Background: Amyotrophic lateral sclerosis (ALS) represents a complex syndrome characterized by motor, psychiatric, and cognitive symptoms, where associations between cellular immune features and non-motor manifestations remain unknown. Methods: In this cohort study, we enrolled 250 incident people with ALS (pwALS) assessed with the Hospital Anxiety and Depression Scale, and 226 pwALS with the Montreal Cognitive Assessment, including 218 overlapping pwALS. All individuals were diagnosed between January 2015 and January 2023 in Stockholm, Sweden. We applied joint latent class models to delineate distinct trajectories of anxiety, depression, and cognition, incorporating survival outcomes. A majority of the pwALS had data on leukocyte counts and flow cytometric analyses using a comprehensive T cell panel. We then used immune cell subtypes measured at diagnosis to predict trajectories of these outcomes following ALS diagnosis. Results: We identified two distinct trajectories for anxiety, depression, and cognitive function following ALS diagnosis. PwALS with longer survival displayed more stable trajectories, while those with shorter survival showed decreasing anxiety symptom, increasing depressive symptom, and declining cognitive function. Higher count of leukocytes at the time of ALS diagnosis tended to associate with anxiety and depression trajectories related to shorter survival. Among T cell subpopulations, several CD8+ T cell subsets were associated with a stable trajectory of depressive symptom, and, in turn, better survival. Conclusion: ALS-associated psychiatric and cognitive trajectories vary significantly between pwALS with different prognosis. Certain T cell subsets measured at diagnosis might be indicative of depression trajectories post-diagnosis.
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spelling doaj-art-377f1f5fbca2481db3a8c27b7e58828d2025-08-20T02:50:32ZengElsevierBrain, Behavior, & Immunity - Health2666-35462024-12-014210090710.1016/j.bbih.2024.100907Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosisYihan Hu0Elie Deeba1Ulf Kläppe2Linn Öijerstedt3John Andersson4Nicolas Ruffin5Fredrik Piehl6Caroline Ingre7Fang Fang8Christina Seitz9Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Corresponding author. Unit of Integrative Epidemiology Institute of Environmental Medicine Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.Institute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDepartment of Neurology, Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenInstitute of Environmental Medicine, Karolinska Institutet, Stockholm, SwedenBackground: Amyotrophic lateral sclerosis (ALS) represents a complex syndrome characterized by motor, psychiatric, and cognitive symptoms, where associations between cellular immune features and non-motor manifestations remain unknown. Methods: In this cohort study, we enrolled 250 incident people with ALS (pwALS) assessed with the Hospital Anxiety and Depression Scale, and 226 pwALS with the Montreal Cognitive Assessment, including 218 overlapping pwALS. All individuals were diagnosed between January 2015 and January 2023 in Stockholm, Sweden. We applied joint latent class models to delineate distinct trajectories of anxiety, depression, and cognition, incorporating survival outcomes. A majority of the pwALS had data on leukocyte counts and flow cytometric analyses using a comprehensive T cell panel. We then used immune cell subtypes measured at diagnosis to predict trajectories of these outcomes following ALS diagnosis. Results: We identified two distinct trajectories for anxiety, depression, and cognitive function following ALS diagnosis. PwALS with longer survival displayed more stable trajectories, while those with shorter survival showed decreasing anxiety symptom, increasing depressive symptom, and declining cognitive function. Higher count of leukocytes at the time of ALS diagnosis tended to associate with anxiety and depression trajectories related to shorter survival. Among T cell subpopulations, several CD8+ T cell subsets were associated with a stable trajectory of depressive symptom, and, in turn, better survival. Conclusion: ALS-associated psychiatric and cognitive trajectories vary significantly between pwALS with different prognosis. Certain T cell subsets measured at diagnosis might be indicative of depression trajectories post-diagnosis.http://www.sciencedirect.com/science/article/pii/S2666354624001856Amyotrophic lateral sclerosisLeukocytesT cellsAnxietyDepressionCognitive function
spellingShingle Yihan Hu
Elie Deeba
Ulf Kläppe
Linn Öijerstedt
John Andersson
Nicolas Ruffin
Fredrik Piehl
Caroline Ingre
Fang Fang
Christina Seitz
Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
Brain, Behavior, & Immunity - Health
Amyotrophic lateral sclerosis
Leukocytes
T cells
Anxiety
Depression
Cognitive function
title Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
title_full Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
title_fullStr Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
title_full_unstemmed Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
title_short Immune cells and the trajectories of depression, anxiety, and cognitive function among people with amyotrophic lateral sclerosis
title_sort immune cells and the trajectories of depression anxiety and cognitive function among people with amyotrophic lateral sclerosis
topic Amyotrophic lateral sclerosis
Leukocytes
T cells
Anxiety
Depression
Cognitive function
url http://www.sciencedirect.com/science/article/pii/S2666354624001856
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