101
|
Kiyonaga A, Korb FM, Lucas J, Soto D, Egner T. Dissociable causal roles for left and right parietal cortex in controlling attentional biases from the contents of working memory. Neuroimage 2014; 100:200-5. [PMID: 24945665 DOI: 10.1016/j.neuroimage.2014.06.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 05/12/2014] [Accepted: 06/07/2014] [Indexed: 10/25/2022] Open
Abstract
The contents of working memory (WM) steer visual attention, but the extent of this guidance can be strategically enhanced or inhibited when WM content is reliably helpful or harmful to a visual task. Current understanding of the neural substrates mediating the cognitive control over WM biases is limited, however, by the correlational nature of functional MRI approaches. A recent fMRI study provided suggestive evidence for a functional lateralization of these control processes in posterior parietal cortex (PPC): activity in left PPC correlated with the presentation of WM cues that ought to be strategically enhanced to optimize performance, while activity in the right PPC correlated with the presentation of cues that ought to be inhibited to prevent detrimental attentional biases in a visual search. Here, we aimed to directly assess whether the left and right PPC are causally involved in the cognitive control of WM biases, and to clarify their precise functional contributions. We therefore applied 1 Hz repetitive transcranial magnetic stimulation (rTMS) to left and right PPC (and a vertex control site) prior to administering a behavioral task assessing WM biasing control functions. We observed that the perturbation of left PPC eliminated the strategic benefit of predictably helpful WM cueing, while the perturbation of right PPC amplified the cost of unpredictable detrimental WM cueing. The left and right PPC thus play distinct causal roles in WM-attention interactions: the left PPC to maximize benefits, and the right PPC to minimize costs, of internally maintained content on visual attention.
Collapse
|
102
|
Mora Casterá E, Sánchez Sempere M, Lucas J, Jiménez M, Giménez Richarte Á, López T. C0409: Assessment Of Different Coagulation Assays in Real Patients Under Stable Treatment with Dabigatran Etexilate and Rivaroxaban. Thromb Res 2014. [DOI: 10.1016/s0049-3848(14)50146-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
103
|
Lucas J, Schouman A, Lyphout L, Cousin X, Lefrancois C. Allometric relationship between body mass and aerobic metabolism in zebrafish Danio rerio. JOURNAL OF FISH BIOLOGY 2014; 84:1171-1178. [PMID: 24628562 DOI: 10.1111/jfb.12306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 11/15/2013] [Indexed: 06/03/2023]
Abstract
The relationship between body mass (M) and metabolic rate was investigated through the assessment of active (R(A)) and standard (R(S)) metabolic rate at different life stages in zebrafish Danio rerio (5 day-old larvae, 2 month-old juveniles and 6 month-old adults). Scaling exponents and constants were assessed for standard (R(S) = 0·273M(0·965) in mgO(2) g(-1) h(-1)) and active metabolic rate (R(A) = 0·799M(0·926) in mgO(2) g(-1) h(-1)). These data provide the basis for further experiments regarding the effects of environmental factors on aerobic metabolism throughout the life cycle of this species.
Collapse
|
104
|
Ansel D, Debuigne J, Denes G, Pannetier J, Lucas J. About SnF2Stannous Fluoride V.: Conduction Characteristics. ACTA ACUST UNITED AC 2014. [DOI: 10.1002/bbpc.197800067] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
105
|
Lucas J, Patton D, Maravilla K. Retention of a Vaginal Film. Fertil Steril 2014. [DOI: 10.1016/j.fertnstert.2013.11.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
106
|
Lucas J. The face of freedom: comment on "Consciousness in the universe. A review of the 'Orch OR' theory" by Stuart Hameroff and Roger Penrose. Phys Life Rev 2013; 11:87-8; discussion 94-100. [PMID: 24315388 DOI: 10.1016/j.plrev.2013.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 11/13/2013] [Indexed: 10/26/2022]
|
107
|
Carrasquillo M, Crook J, Pedraza O, Pankratz V, Allen M, Nguyen T, Malphrus K, Ma L, Bisceglio G, Roberts R, Lucas J, Ivnik R, Machulda M, Graff‐Radford N, Petersen R, Younkin S, Ertekin‐Taner N. P4–004: Association study of late‐onset Alzheimer's disease risk variants and memory decline. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.1392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
108
|
Rivera F, Illescas ML, López-Rubio E, Fulladosa J, Poveda R, Baltar J, Fernández-Juárez G, Ballarín J, Oliet A, Vigil A, Lucas J, Sierra M, Frutos MA, García-Frías P, Ramos C, Mérida E, Praga M, Segarra A. Mycophenolate as maintenance therapy for lupus nephritis with impaired renal function. Am J Nephrol 2013; 37:509-17. [PMID: 23689615 DOI: 10.1159/000350756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 03/19/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mycophenolate (MF) is effective as a maintenance therapy after induction therapy in patients with lupus nephritis (LN). However, little is known about its role in patients with impaired renal function. The purpose of this study was to evaluate the efficacy and safety of MF as a maintenance therapy for LN and its association with renal function. METHODS Data were obtained for 56 Spanish patients who were receiving MF as a maintenance therapy for LN. Patients were classified into two groups according to renal function at the initiation of MF treatment: group 1 [estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73 m(2)] and group 2 (eGFR <60 ml/min/1.73 m(2)). The primary endpoints of the study were the rates of renal relapse and responses, and their relationship with baseline renal function. Secondary outcomes were the appearance of side effects during treatment. RESULTS At initiation of MF treatment, the only differences between the groups were for age, hemoglobin levels, anti-DNA antibody titer, proteinuria, and renal function. In group 1 (n = 38), the eGFR was 98 ± 34 ml/min/1.73 m(2) and in group 2 (n = 18) the eGFR was 43 ± 14 ml/min/1.73 m(2). Only 3 cases had an eGFR <30 ml/min/1.73 m(2). No significant differences were observed in the rate of relapse at 6 months (group 1: 20%; group 2: 23%) or at 12 months (group 1: 25%; group 2: 17%). Response rates were also similar in both groups. Side effects were unremarkable. CONCLUSIONS MF is effective and safe as a maintenance therapy for LN both in patients with normal renal function and in those with renal impairment.
Collapse
|
109
|
Zauls AJ, Watkins JM, Lucas J, Shirai K, Sharma AK. Requirement of percutaneous endoscopic gastrostomy tube placement in head-and-neck cancer treated with definitive concurrent chemoradiation therapy: An analysis of clinical and anatomic factors. Pract Radiat Oncol 2013; 3:e61-9. [DOI: 10.1016/j.prro.2012.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2012] [Revised: 05/12/2012] [Accepted: 06/13/2012] [Indexed: 11/25/2022]
|
110
|
Lucas J, Mountain R, Gramza A, Schuller D, Wilkie N, Lang J. Expression of cyclin d1 in squamous-cell carcinomas of the head and neck. Int J Oncol 2012; 5:469-72. [PMID: 21559599 DOI: 10.3892/ijo.5.3.469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Expression of oncogenes Cyclin D1, FGF-3 and FGF-4 was investigated in eight cases of squamous cell carcinoma of the head and neck (SCCHN) and matched normal controls using the sensitive detection technique of RT-PCR. We demonstrate elevated expression of cyclin D1 in 5/8 SCCHN tumor samples and describe the first report of overexpression of cyclin D1 in tumors of the pyriform sinus. In contrast, we do not detect, under routine conditions, expression of oncogenes FGF-3 and FGF-4 in these tumors and suggest that FGF-3 and FGF-4 are unlikely to play a role in the development of squamous cell carcinomas of the head and neck.
Collapse
|
111
|
Chengappa KA, Lucas J, Milburn HJ. P52 The Use of Magnetic Resonance Studies [MR] in Assessing Response and Guiding Duration of Treatment in Spinal Tuberculosis. Thorax 2012. [DOI: 10.1136/thoraxjnl-2012-202678.193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
112
|
Li B, Widlicka D, Boucher S, Hayward C, Lucas J, Murray JC, O’Neil BT, Pfisterer D, Samp L, VanAlsten J, Xiang Y, Young J. Telescoped Flow Process for the Syntheses of N-Aryl Pyrazoles. Org Process Res Dev 2012. [DOI: 10.1021/op300209p] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
113
|
Trama AM, Liao H, Foulger A, Marshall DJ, Whitesides JF, Parks R, Meyerhoff R, Lloyd KE, Donathan M, Lucas J, Soderberg K, Kepler TB, Vandergrift N, Yates N, Tomaras GD, Moody MA, Haynes BF. Lack of IgA envelope-reactive antibody producing cells in terminal ileum in early and chronic HIV-1 infection. Retrovirology 2012. [PMCID: PMC3441430 DOI: 10.1186/1742-4690-9-s2-p201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
114
|
Boeve B, Graff-Radford N, Boylan K, DeJesus-Hernandez M, Knopman D, Josephs K, Pedraza O, Vemuri P, Rush B, Fields J, Ferman T, Baker M, Rutherford N, Jones D, Lowe V, Wszolek Z, Adeli A, Savica R, Boot B, Gavrilova R, Kuntz K, Whitwell J, Kantarci K, Jack C, Dickson D, Parisi J, Lucas J, Petersen R, Rademakers R. Characterization of Frontotemporal Dementia +/- Amyotrophic Lateral Sclerosis Associated with the GGGGCC Repeat Expansion in C9ORF72 (S54.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s54.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
115
|
Pedraza O, Boeve B, DeJesus-Hernandez M, Rush B, Lucas J, Fields J, Machulda M, Graff-Radford N, Knopman D, Josephs K, Rutherford N, Baker M, Ferman T, Smith G, Ivnik R, Wszolek Z, Boylan K, Petersen R, Rademakers R. Cognitive Endophenotype Associated with the C9ORF72 GGGGCC Expansion in FTD/ALS (P05.063). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|
116
|
McIntyre IM, Sherrard J, Lucas J. Postmortem Carisoprodol and Meprobamate Concentrations in Blood and Liver: Lack of Significant Redistribution. J Anal Toxicol 2012; 36:177-81. [DOI: 10.1093/jat/bks011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
117
|
Ryckewaert-D'Halluin A, Le Bouar G, Odent S, Milon J, D'Hervé D, Lucas J, Rouget F, Loget P, Poulain P, Le Gall E, Taque S. Diagnosis of fetal urinary tract malformations: prenatal management and postnatal outcome. Prenat Diagn 2011; 31:1013-20. [DOI: 10.1002/pd.2824] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 06/06/2011] [Accepted: 06/06/2011] [Indexed: 11/07/2022]
|
118
|
Marshall R, Kombrink A, Motteram J, Loza-Reyes E, Lucas J, Hammond-Kosack KE, Thomma BP, Rudd JJ. Analysis of two in planta expressed LysM effector homologs from the fungus Mycosphaerella graminicola reveals novel functional properties and varying contributions to virulence on wheat. PLANT PHYSIOLOGY 2011; 156:756-69. [PMID: 21467214 PMCID: PMC3177273 DOI: 10.1104/pp.111.176347] [Citation(s) in RCA: 220] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 04/05/2011] [Indexed: 05/18/2023]
Abstract
Secreted effector proteins enable plant pathogenic fungi to manipulate host defenses for successful infection. Mycosphaerella graminicola causes Septoria tritici blotch disease of wheat (Triticum aestivum) leaves. Leaf infection involves a long (approximately 7 d) period of symptomless intercellular colonization prior to the appearance of necrotic disease lesions. Therefore, M. graminicola is considered as a hemibiotrophic (or necrotrophic) pathogen. Here, we describe the molecular and functional characterization of M. graminicola homologs of Ecp6 (for extracellular protein 6), the Lysin (LysM) domain-containing effector from the biotrophic tomato (Solanum lycopersicum) leaf mold fungus Cladosporium fulvum, which interferes with chitin-triggered immunity in plants. Three LysM effector homologs are present in the M. graminicola genome, referred to as Mg3LysM, Mg1LysM, and MgxLysM. Mg3LysM and Mg1LysM genes were strongly transcriptionally up-regulated specifically during symptomless leaf infection. Both proteins bind chitin; however, only Mg3LysM blocked the elicitation of chitin-induced plant defenses. In contrast to C. fulvum Ecp6, both Mg1LysM and Mg3LysM also protected fungal hyphae against plant-derived hydrolytic enzymes, and both genes show significantly more nucleotide polymorphism giving rise to nonsynonymous amino acid changes. While Mg1LysM deletion mutant strains of M. graminicola were fully pathogenic toward wheat leaves, Mg3LysM mutant strains were severely impaired in leaf colonization, did not trigger lesion formation, and were unable to undergo asexual sporulation. This virulence defect correlated with more rapid and pronounced expression of wheat defense genes during the symptomless phase of leaf colonization. These data highlight different functions for MgLysM effector homologs during plant infection, including novel activities that distinguish these proteins from C. fulvum Ecp6.
Collapse
|
119
|
Segal L, Hourihane J, Clarke A, Alizadehfar R, Lucas J, Roberts G, Lajeunesse M, DunnGalvin A. A Systematic Evaluation of the Cork-Southampton Food Challenge Outcome Calculator in a Canadian Sample. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
120
|
Shabbir M, Lucas J, Lazarchick J, Shirai K. Secondary hemophagocytic syndrome in adults: a case series of 18 patients in a single institution and a review of literature. Hematol Oncol 2010; 29:100-6. [PMID: 20809477 DOI: 10.1002/hon.960] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 06/24/2010] [Indexed: 12/24/2022]
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is rare in adults and is usually fatal without treatment. We present a consecutive series of 18 adults with HLH diagnosed at our institution between 2004 and 2009. All diagnoses were confirmed by pathology. The median age at diagnosis was 56 years (range: 18-73 years), with a male: female ratio of 2:1. Patients uniformly presented with fever. Fifty-five per cent of the patients presented with evidence of hepatomegaly or splenomegaly. All of the patients had at least a bi- or trilineage cytopenia. Elevated liver enzymes, hyperferritinemia, hypertriglyceridemia and hyperfibrinogenemia were seen in 50, 100, 40 and 50% of patients, respectively. The presumed causes were as follows; haematological malignancies (n = 4), post-autologous stem cell transplant (n = 2), infection (n = 2), rheumatologic illness (n = 2), sickle cell disease (n = 1), post-orthotopic liver transplant (n = 1) and idiopathic (n = 3). The median time from suspicion to diagnosis was 5 days (1-27 days). Corticosteroids and/or cyclosporine were the most frequently used treatment regimen. Other agents used were etoposide, IVIG, cyclophosphamide and chemotherapy. The mortality rate was 72%, with multi-system organ failure being the most common cause of death. Median survival time from diagnosis was 35 days. Six patients are alive to date. In a univariate analysis, the presence of fever was the only factor that was statistically significant for predicting a poor prognosis (early mortality) (p = 0.05). In conclusion, a high index of suspicion is the critical factor for early diagnosis. Early treatment with immunosuppressant is warranted, and a thorough diagnostic evaluation to identify the underlying cause should be undertaken.
Collapse
|
121
|
Sano M, Jacobs D, Luo X, Andrews H, Andrews K, Bell K, Graff-Radford N, Lucas J, Rabins P, Bolla K, Mitsis E. O4‐08‐02: Prevention of Postmenopausal Alzheimer's Disease and Cognitive Loss with Replacement Estrogen (PREPARE) Study Results. Alzheimers Dement 2010. [DOI: 10.1016/j.jalz.2010.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
122
|
Adams Waldorf KM, Gammill HS, Lucas J, Aydelotte TM, Leisenring WM, Lambert NC, Nelson JL. Dynamic changes in fetal microchimerism in maternal peripheral blood mononuclear cells, CD4+ and CD8+ cells in normal pregnancy. Placenta 2010; 31:589-94. [PMID: 20569981 DOI: 10.1016/j.placenta.2010.04.013] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2010] [Revised: 04/16/2010] [Accepted: 04/24/2010] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Cell trafficking during pregnancy results in persistence of small populations of fetal cells in the mother, known as fetal microchimerism (FMc). Changes in cell-free fetal DNA during gestation have been well described, however, less is known about dynamic changes in fetal immune cells in maternal blood. We have investigated FMc in maternal peripheral blood mononuclear cells (PBMC) longitudinally across gestation. STUDY DESIGN Thirty-five women with normal pregnancies were studied. FMc was identified in PBMC, CD4+ and CD8+ subsets employing quantitative PCR assays targeting fetal-specific genetic polymorphisms. FMc quantities were reported as fetal genome equivalents (gEq) per 1,000,000 gEq mother's cells. Poisson regression modeled the rate of FMc detection. MAIN OUTCOME MEASURE FMc in PBMC. RESULTS The probability of detecting one fetal cell equivalent increased 6.2-fold each trimester [Incidence Rate Ratio (IRR) 95% CI: 1.73, 21.91; p = 0.005]. Although FMc in PBMC was not detected for the majority of time points, 7 of 35 women had detectable FMc during pregnancy at one or more time points, with the majority of positive samples being from the third trimester. There was a suggestion of greater HLA-sharing in families where women had FMc in PBMC. FMc was detected in 9% of CD4+ (2/23) and 18% of CD8+ (3/25) subsets. CONCLUSIONS FMc in PBMC increased as gestation progressed and was found within CD4+ and CD8+ subsets in some women in the latter half of gestation. A number of factors could influence cellular FMc levels including sub-clinical fetal-maternal interface changes and events related to parturition. Whether FMc during pregnancy predicts persistent FMc and/or correlates with fetal-maternal HLA relationships also merits further study.
Collapse
|
123
|
Peiro AM, Bastande N, Fernández ML, Lucas J, López‐Abadía E, Tarín F. An optimized method for Paroxysmal Nocturnal Hemoglobinuria screening flow cytometric diagnosis. FASEB J 2010. [DOI: 10.1096/fasebj.24.1_supplement.966.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
124
|
Barbato A, Frischer T, Kuehni CE, Snijders D, Azevedo I, Baktai G, Bartoloni L, Eber E, Escribano A, Haarman E, Hesselmar B, Hogg C, Jorissen M, Lucas J, Nielsen KG, O'Callaghan C, Omran H, Pohunek P, Strippoli MPF, Bush A. Primary ciliary dyskinesia: a consensus statement on diagnostic and treatment approaches in children. Eur Respir J 2009; 34:1264-76. [DOI: 10.1183/09031936.00176608] [Citation(s) in RCA: 324] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
125
|
Molano J, Boeve B, Ferman T, Smith G, Parisi J, Dickson D, Knopman D, Graff-Radford N, Geda Y, Lucas J, Kantarci K, Shiung M, Jack C, Silber M, Pankratz VS, Petersen R. Mild cognitive impairment associated with limbic and neocortical Lewy body disease: a clinicopathological study. ACTA ACUST UNITED AC 2009; 133:540-56. [PMID: 19889717 DOI: 10.1093/brain/awp280] [Citation(s) in RCA: 155] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
There are little data on the relationship between Lewy body disease and mild cognitive impairment syndromes. The Mayo Clinic aging and dementia databases in Rochester, Minnesota, and Jacksonville, Florida were queried for cases who were diagnosed with mild cognitive impairment between 1 January 1996 and 30 April 2008, were prospectively followed and were subsequently found to have autopsy-proven Lewy body disease. The presence of rapid eye movement sleep behaviour disorder was specifically assessed. Mild cognitive impairment subtypes were determined by clinical impression and neuropsychological profiles, based on prospective operational criteria. The diagnosis of clinically probable dementia with Lewy bodies was based on the 2005 McKeith criteria. Hippocampal volumes, rate of hippocampal atrophy, and proton magnetic resonance spectroscopy were assessed on available magnetic resonance imaging and spectroscopy scans. Eight subjects were identified; six were male. Seven developed dementia with Lewy bodies prior to death; one died characterized as mild cognitive impairment. The number of cases and median age of onset (range) for specific features were: seven with rapid eye movement sleep behaviour disorder-60 years (27-91 years), eight with cognitive symptoms-69 years (62-89 years), eight with mild cognitive impairment-70.5 years (66-91 years), eight with parkinsonism symptoms-71 years (66-92 years), six with visual hallucinations-72 years (64-90 years), seven with dementia-75 years (67-92 years), six with fluctuations in cognition and/or arousal-76 years (68-92 years) and eight dead-76 years (71-94 years). Rapid eye movement sleep behaviour disorder preceded cognitive symptom onset in six cases by a median of 10 years (2-47 years) and mild cognitive impairment diagnosis by a median of 12 years (3-48 years). The mild cognitive impairment subtypes represented include: two with single domain non-amnestic mild cognitive impairment, three with multi-domain non-amnestic mild cognitive impairment, and three with multi-domain amnestic mild cognitive impairment. The cognitive domains most frequently affected were attention and executive functioning, and visuospatial functioning. Hippocampal volumes and the rate of hippocampal atrophy were, on average, within the normal range in the three cases who underwent magnetic resonance imaging, and the choline/creatine ratio was elevated in the two cases who underwent proton magnetic resonance spectroscopy when they were diagnosed as mild cognitive impairment. On autopsy, six had neocortical-predominant Lewy body disease and two had limbic-predominant Lewy body disease; only one had coexisting high-likelihood Alzheimer's disease. These findings indicate that among Lewy body disease cases that pass through a mild cognitive impairment stage, any cognitive pattern or mild cognitive subtype is possible, with the attention/executive and visuospatial domains most frequently impaired. Hippocampal volume and proton magnetic resonance spectroscopy data were consistent with recent data in dementia with Lewy bodies. All cases with rapid eye movement sleep behaviour disorder and mild cognitive impairment were eventually shown to have autopsy-proven Lewy body disease, indicating that rapid eye movement sleep behaviour disorder plus mild cognitive impairment probably reflects brainstem and cerebral Lewy body disease.
Collapse
|