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Loures CDMG, Duarte RCF, Silva MVF, Cicarini WB, de Souza LC, Caramelli P, Borges KBG, Carvalho MDG. Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis. Semin Thromb Hemost 2019; 45:514-522. [PMID: 31096308 DOI: 10.1055/s-0039-1688444] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Alzheimer's disease (AD) is considered the most frequent cause of dementia. It is known that vascular risk factors play an important role in the development and progression of this condition. Alterations in vascular walls represent documented findings in patients with AD and other dementias affecting elderly people. The authors performed a systematic review and meta-analysis, aiming to synthesize observational studies that evaluated how the hemostatic system may contribute to cognitive decline in the elderly, using papers published until April 2018 and as indexed in Medline (PubMed), Scopus, Web of Science, ScienceDirect, Lilacs, Cinahl, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Among 5,278 studies identified, 32 were included in the final synthesis, and these included 485 patients with mild cognitive impairment, 568 with vascular dementia (VD), 1,781 with AD, and 2,855 participants without dementia. AD patients had increased plasma von Willebrand factor (VWF) (standardized mean difference [SMD]: 2.53; 95% confidence interval [CI]: 0.10-4.95), D-dimer (SMD: 0.50; 95% CI: 0.35-0.66), plasminogen activator inhibitor-1 (SMD: 3.34; 95% CI: 1.01-5.67), thrombomodulin (SMD: 1.08; 95% CI: 0.53-1.62), and homocysteine levels (SMD: 0.65; 95% CI: 0.15-1.15). In contrast, the VD group showed increased fibrinogen levels (SMD: 0.77; 95% CI: 0.13-1.41), activated factor VII (SMD: 0.36; 95% CI: 0.05-0.67), factor VIII (SMD: 0.57; 95% CI: 0.22-0.91), VWF (SMD: 2.34; 95% CI: 0.38-4.29), D-dimer (SMD: 1.14; 95% CI: 0.51-1.78), and homocysteine (SMD: 2.17; 95% CI: 1.67-2.68). AD showed an elevation in some markers of endothelial dysfunction, whereas VD presented mostly an involvement of coagulation cascade components.
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Champs APS, de Azeredo Passos VM, Carvalho G, Barreto SM, Meirelles C, Caramelli P. Cognitive impairment in HTLV-1-associated myelopathy, proviral load and inflammatory markers. Int J Infect Dis 2019; 84:121-126. [PMID: 31085316 DOI: 10.1016/j.ijid.2019.05.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/02/2019] [Accepted: 05/07/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES Myelopathy is a well-established long-term clinical manifestation of HTLV-1 infection. Besides motor dysfunction, cognitive impairment may be another consequence of HTLV-1 infection. Moreover, inflammatory markers may be associated with cognitive impairment in these patients. The present study compared the cognitive performance of HAM/TSP patients with healthy controls and investigated the associations between cognitive performance, proviral load and blood inflammatory markers. METHODS Eighty-three patients fulfilling diagnostic criteria for HAM/TSP were submitted to a comprehensive clinical, cognitive and functional evaluation, brain magnetic resonance imaging and determination of levels of IL-1β, IL-6, TNF-α, immunoglobulins and HTLV-1 proviral load in blood and cerebrospinal fluid. The control group was composed of 88 cognitively healthy subjects, matched for age, sex and educational level. RESULTS Compared to healthy subjects, HAM/TSP patients displayed significant global cognitive impairment and executive function deficits. HAM/TSP cognitive impairment was significantly associated with altered levels of IgM, IgG, IL-6 and TNF-α in blood. There was no association between HAM/TSP cognitive impairment and HTLV-1 proviral load. CONCLUSIONS This study suggests cognitive impairment may be a long-term clinical manifestation of HTLV-1 infection, which seems to be linked to the persistent inflammatory activity that is found in the disease.
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Valente ES, Caramelli P, Gambogi LB, Mariano LI, Guimarães HC, Teixeira AL, de Souza LC. Phenocopy syndrome of behavioral variant frontotemporal dementia: a systematic review. ALZHEIMERS RESEARCH & THERAPY 2019; 11:30. [PMID: 30935398 PMCID: PMC6444822 DOI: 10.1186/s13195-019-0483-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background The phenocopy syndrome of behavioral variant of frontotemporal dementia (phFTD) refers to patients presenting with neuropsychiatric symptoms mimicking the behavioral variant frontotemporal dementia (bvFTD), but lacking frontotemporal atrophy/hypometabolism on neuroimaging and not evolving to dementia during the follow-up. It is important to recognize phFTD for clinical and research purposes. Objective The aim of this study was to perform a systematic review of the available literature on phFTD taking into account its clinical, cognitive, imaging, genetic, and pathological features. Methods and results We searched for the following terms in two electronic databases (PubMed and Scopus): “frontotemporal dementia and slowly progressive,” “frontotemporal dementia and phenocopy,” “frontotemporal dementia and non-progressive,” “frontotemporal dementia and benign progression,” and “frontotemporal dementia and benign.” We did not include review articles. Papers had to be written in English, French, Portuguese, or Spanish. Overall, 235 studies were retrieved in the initial search. A total of 31 studies composed the final selection, comprising 292 patients. Patients with phFTD are predominantly male and have no major cognitive deficits, with globally preserved executive functions and episodic memory. Some cases (n = 7) of slowly progressive FTD have been associated with C9orf72 genetic expansion. There are only four reports of phFTD neuropathological data, with two patients with no neurodegenerative findings and two with frontotemporal lobar degeneration with ubiquitin-positive inclusions. Conclusion The neurobiological underpinnings of phFTD remain unknown. It is controversial whether phFTD belongs to the FTD spectrum. Studies with biomarkers and pathological data are needed to solve the phFTD conundrum.
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Rodrigues AC, Lima MDM, de Souza LC, Furtado C, Marques CE, Gonçalves L, Lima MV, Lasmar RP, Caramelli P. No Evidence of Association Between Soccer Heading and Cognitive Performance in Professional Soccer Players: Cross-Sectional Results. Front Neurol 2019; 10:209. [PMID: 30915024 PMCID: PMC6422927 DOI: 10.3389/fneur.2019.00209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 02/18/2019] [Indexed: 12/29/2022] Open
Abstract
Although the scientific community has focused on the effects of concussions in contact sports, the role of subconcussive impacts, as it can occur during soccer heading, has recently gained attention, considering that it may represent an additional mechanism of cumulative brain injury. The aim of this study is to investigate the effects of soccer heading on cognitive functioning in active professional soccer players. Male soccer players (n = 44), from two soccer teams that play in the Brazilian A Series Championship, and non-athletes (n = 47), comparable in age and education, were submitted to cognitive assessment, consisting of computerized and conventional neuropsychological testing (Neupsilin battery). In the computerized cognitive assessment, soccer players performed better than controls on reaction time measures in general motor coordination, executive functioning and memory tests, and on accuracy measures in executive functioning tests. There were no significant differences between groups on the Neupsilin battery. A comparison between two sub-groups of soccer players, based on the self-reported number of headings, did not show significant differences on tests performance. No significant correlations were found between an estimate of exposure to heading during professional soccer career and cognitive performance. Our data demonstrate no evidence of cognitive impairment in soccer players, compared to non-athletes, and no association between heading exposure and performance on neuropsychological tests. Longitudinal investigations, including neuroimaging assessment, will help to clarify whether soccer heading may be associated with brain injury and cognitive dysfunction.
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de Freitas Cardoso MG, Faleiro RM, de Paula JJ, Kummer A, Caramelli P, Teixeira AL, de Souza LC, Miranda AS. Cognitive Impairment Following Acute Mild Traumatic Brain Injury. Front Neurol 2019; 10:198. [PMID: 30906278 PMCID: PMC6418036 DOI: 10.3389/fneur.2019.00198] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 02/15/2019] [Indexed: 01/28/2023] Open
Abstract
Patients with mild traumatic brain injury (mTBI) may present cognitive deficits within the first 24 h after trauma, herein called “acute phase,” which in turn may lead to long-term functional impairment and decrease in quality of life. Few studies investigated cognition in mTBI patients during the acute phase. The objectives of this study were to investigate the cognitive profile of patients with mTBI during the acute phase, compared to controls and normative data, and whether loss of consciousness (LOC), previous TBI and level of education influence cognition at this stage. Fifty-three patients with mTBI (aged 19–64 years) and 28 healthy controls participated in the study. All patients were evaluated at bedside within 24 h post-injury. Demographic and clinical data were registered. Cognitive function was assessed with the Mini-mental state examination (MMSE), the Frontal Assessment Battery (FAB), Digit Span (working memory), and the Visual Memory Test/Brief Cognitive Battery (for episodic memory). The clinical sample was composed mainly by men (58.5%). The mean age was 39 years-old and 64.3% of the patients had more than 8 years of education. The most common causes of mTBI were fall from own height (28.3%), aggression (24.5%), and fall from variable heights (24.5%). Compared to controls, mTBI patients exhibited significantly worse performance on MMSE, FAB, naming, incidental memory, immediate memory, learning, and delayed recall. Compared to normative data, 26.4% of patients had reduced global cognition as measured by the MMSE. Episodic memory impairment (13.2%) was more frequent than executive dysfunction (9.4%). No significant differences were found in cognitive performance when comparing patients with or without LOC or those with or without history of previous TBI. Patients with lower educational level had higher rates of cognitive impairment (VMT naming−28.6 vs. 4.2%; VMT immediate memory−32 vs. 4.2%; VMT learning−39.3 vs. 4.2%, all p < 0.05). In sum, we found significant cognitive impairment in the acute phase of mTBI, which was not associated with LOC or history of TBI, but appeared more frequently in patients with lower educational level.
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Resende EDPF, Rosen HJ, Chiang K, Staffaroni AM, Allen I, Grinberg LT, Carmona KC, Guimarães HC, Carvalho VA, Barbosa MT, de Souza LC, Caramelli P. Primary School Education May Be Sufficient to Moderate a Memory-Hippocampal Relationship. Front Aging Neurosci 2018; 10:381. [PMID: 30515091 PMCID: PMC6255790 DOI: 10.3389/fnagi.2018.00381] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 10/31/2018] [Indexed: 01/30/2023] Open
Abstract
According to the cognitive reserve theory, intellectual stimuli acquired during life can prevent against developing cognitive impairment. The underlying cognitive reserve mechanisms were underexplored in low-educated individuals. Because episodic memory impairment due to hippocampal dysfunction is a key feature of Alzheimer's dementia (AD), we sought to look at a possible cognitive reserve mechanism by determining whether few years of education moderated the relationship between the hippocampal volumes and the episodic-memory scores. The sample was composed by 183 older adults, 40.1% male, with the median age of 78[76,82] years and the median years of education of 4[2,10] who had undergone an episodic-memory test and a 3-Tesla MRI scan to access the hippocampal volumes. Overall, 112 were cognitively healthy, 26 had cognitive impairment-no dementia (CIND) and 45 had dementia. We used multiple linear regression to assess whether the interaction between years of education and each hippocampal volume significantly predicted the episodic-memory scores' variance, controlling for cognitive diagnosis and nuisance variables. The interaction term with the left hippocampus (ß = 0.2, p = 0.043, CI = 1.0, 1.4), but not with the right (ß = 0.1, p = 0.218, CI = 0.9, 1.2) significantly predicted the variation on memory scores. The mechanism by which the left hippocampus seems to play a more important role on memory processing in more educated individuals needs to be further investigated and might be associated with a better use of mnemonic strategies or higher hippocampal connectivity. Because the sample's median years of education was four, which corresponds to primary school, we may infer that this level might be sufficient to contribute for building cognitive reserve.
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de Souza RKM, Grinberg LT, Josviak ND, de Almeida DB, Ramina R, Kowacs PA, Caramelli P. A patient with posterior cortical atrophy due to Alzheimer's disease. Dement Neuropsychol 2018; 12:326-328. [PMID: 30425798 PMCID: PMC6200153 DOI: 10.1590/1980-57642018dn12-030015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Oliveira ACRD, Magalhães CA, Loures CMG, Fraga VG, Souza LCD, Guimarães HC, Cintra MTG, Bicalho MA, Sousa MCR, Silveira JN, Silva IFO, Caramelli P, Carvalho MG, Gomes KB. BsmI polymorphism in the vitamin D receptor gene is associated with 25-hydroxy vitamin D levels in individuals with cognitive decline. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:760-766. [DOI: 10.1590/0004-282x20180116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/20/2018] [Indexed: 12/20/2022]
Abstract
ABSTRACT Elderly people are at a high risk of developing vitamin D (VitD) deficiency due to both decreased intake and cutaneous synthesis. Most of the biological actions of VitD are mediated by the vitamin D receptor (VDR), which is present in neurons and glial cells of the hippocampus, and in the cortex and subcortical nuclei, essential areas for cognition. It is known that VDR gene polymorphisms may decrease the VDR affinity for VitD. Objective: The present study aimed to investigate the influence of VitD levels on cognitive decline in patients with dementia due to Alzheimer's disease (AD, n = 32) and mild cognitive impairment (MCI, n = 15) compared to cognitively healthy elderly (n = 24). We also evaluated the association of VDR gene polymorphisms with cognitive disturbance. Methods: Four polymorphisms on the VDR gene were studied, namely, BsmI, ApaI, FokI and TaqI, by polymerase chain reaction-restriction fragment length polymorphism. Serum levels of 25-hydroxy vitamin D (25(OH)D) were determined by high performance liquid chromatography. Results: No significant difference in 25(OH)D levels or genotypic/allelic frequencies was observed between the groups. Deficiency of 25(OH)D was more frequently observed in women. The AA/AG genotypes of the BsmI polymorphism was associated with sufficient 25(OH)D levels, while the GG genotype of this same polymorphism was associated to insufficient levels in the cognitively-impaired group (individuals with AD or MCI). Conclusions: The data obtained do not confirm the relationship between reductions of VitD levels, polymorphisms in the VDR gene, and altered cognitive function in this sample. However, the data indicate that BsmI polymorphism in the VDR gene is associated with the VitD levels in individuals with cognitive decline.
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Borelli WV, Carmona KC, Studart-Neto A, Nitrini R, Caramelli P, da Costa JC. Operationalized definition of older adults with high cognitive performance. Dement Neuropsychol 2018; 12:221-227. [PMID: 30425784 PMCID: PMC6200160 DOI: 10.1590/1980-57642018dn12-030001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 07/04/2018] [Indexed: 11/21/2022] Open
Abstract
Recently, there has been an increasing number of studies on exceptional cognitive aging. Herein, we aim to objectively provide the operationalized characterization of older adults with unusually high memory ability. Some authors have defined them as "SuperAgers", individuals aged 80 years or older with memory ability similar or superior to middle-aged subjects. On the other hand, the terminology "high-performing older adults" (HPOA) seems to appropriately conceptualize these individuals without exaggeration. A threshold for age is not a reliable criterion, but may be defined as 75 and 80 years of age for developing and developed countries, respectively. We propose that HPOA may exhibit episodic memory test scores equal to or greater than those of individuals aged 50-60 years, according to the validated tables for the respective country. This group must also have global cognition scores within expected average values for age and education. Executive functioning may play a central role in the exceptional memory performance of this group. Further studies are essential to confirm existing findings and may provide important evidence for cognitive aging theory and the neurobiology of dementia.
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Paula França Resende E, Rosen HJ, Chiang K, Allen I, Staffaroni AM, Grinberg LT, Carmona KC, Guimaraes HC, Carvalho VA, Barbosa MT, Cruz de Souza L, Caramelli P. F3‐04‐02: PRIMARY SCHOOL EDUCATION CAN BE SUFFICIENT TO MODERATE THE RELATIONSHIP BETWEEN HIPPOCAMPUS VOLUME AND MEMORY PERFORMANCE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vale TC, Barbosa MT, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Cardoso F, Caramelli P. Parkinsonism in a population-based study of individuals aged 75+ years: The Pietà study. Parkinsonism Relat Disord 2018; 56:76-81. [PMID: 29934195 DOI: 10.1016/j.parkreldis.2018.06.030] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Parkinsonism is one of the most prevalent neurological syndromes in the elderly. There are only a few epidemiological studies focusing on parkinsonism in oldest-old individuals, particularly in Latin America. This study aims to investigate the prevalence and characteristics of parkinsonism in subjects aged 75 + years living in the community. METHODS The Pietà study is a population-based investigation on brain aging conducted in Caeté, southeast Brazil. A sample composed of 610 community-dwelling individuals aged 75 + years (48.7% of the total population within this age range) underwent clinical, neurological, cognitive and functional assessments. RESULTS The sample comprised mostly women (61.5%), with mean age of 83.3 years and mean schooling of 2.5 years. Parkinsonism was identified in 65 subjects (crude prevalence = 10.7%). Parkinson's disease, Parkinsonism + dementia syndrome, drug-induced parkinsonism, vascular parkinsonism and Lewy-body dementia were identified in, respectively, 19 (29.2%), 19 (29.2%), 8 (12.3%), 4 (6.1%) and 1 (1.5%) subjects. In 14 individuals (21.5%), the etiology of parkinsonism could not be determined. The most important vascular risk factor was hypertension (64.6%). Cognitive evaluation disclosed dementia in 37 (56.9%) subjects. Mean Pfeffer's functional activities questionnaire score was 12.2 points and 22 (33.8%) subjects were impaired in basic activities of daily living. CONCLUSION Parkinsonism was common in this oldest-old population, being associated with dementia and vascular risk factors, particularly hypertension. Different confounders, such as concomitant dementia and exposure to anti-dopaminergic drugs, were present in this population, challenging the definition of causes of parkinsonism.
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Yassuda MS, Lima da Silva TB, O'Connor CM, Mekala S, Alladi S, Bahia VS, Amaral-Carvalho V, Guimaraes HC, Caramelli P, Balthazar MLF, Damasceno B, Brucki SMD, Nitrini R, Hodges JR, Piguet O, Mioshi E. Apathy and functional disability in behavioral variant frontotemporal dementia. Neurol Clin Pract 2018; 8:120-128. [PMID: 29708208 DOI: 10.1212/cpj.0000000000000429] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 01/29/2018] [Indexed: 12/13/2022]
Abstract
Background Behavioral variant frontotemporal dementia (bvFTD) has profound consequences on patients and their families. In this multicenter study, we investigated the contribution of cognitive and neuropsychiatric factors to everyday function at different levels of overall functional impairment. Methods In a retrospective cross-sectional study, 109 patients with bvFTD from 4 specialist frontotemporal dementia centers (Australia, England, India, and Brazil) were included. The measures administered evaluated everyday function (Disability Assessment for Dementia [DAD]), dementia staging (Clinical Dementia Rating [CDR]), general cognition (Addenbrooke's Cognitive Examination-revised [ACE-R]), and neuropsychiatric symptoms (Neuropsychiatric Inventory [NPI]). Patients were then subdivided according to functional impairment on the DAD into mild, moderate, severe, and very severe subgroups. Three separate multiple linear regression analyses were run, where (1) total DAD, (2) basic activities of daily living (BADL), and (3) instrumental activities of daily living (IADL) scores were dependent variables; ACE-R total score and selected NPI domains (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) were used as independent variables. Age, sex, education, and country of origin were controlled for in the analyses. Results Cognitive deficits were similar across the mild, moderate, and severe subgroups but significantly worse in the very severe subgroup. NPI domain scores (agitation/aggression, euphoria, apathy, disinhibition, irritability, aberrant motor behavior) did not differ across the DAD subgroups. In the multiple regression analyses, a model including ACE-R and NPI apathy explained 32.5% of the variance for total DAD scores. For IADL, 35.6% of the variance was explained by the ACE-R only. No model emerged for BADL scores. Conclusions Cognitive deficits and apathy are key contributors to functional disability in bvFTD but factors underlying impairment in BADLs remain unclear. Treatments targeting reduction of disability need to address apathy and cognitive impairment to ensure greater efficacy, especially in regards to IADLs.
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Resende EDPF, Tovar-Moll FF, Ferreira FM, Bramati I, de Souza LC, Carmona KC, Guimarães HC, Carvalho VA, Barbosa MT, Caramelli P. Integrity of white matter structure is related to episodic memory performance in the low-educated elderly. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 75:778-784. [PMID: 29236820 DOI: 10.1590/0004-282x20170158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/11/2017] [Indexed: 11/22/2022]
Abstract
The low-educated elderly are a vulnerable population in whom studying the role of white matter integrity on memory may provide insights for understanding how memory declines with aging and disease. METHODS Thirty-one participants (22 women), 23 cognitively healthy and eight with cognitive impairment-no dementia, aged 80.4 ± 3.8 years, with 2.2 ± 1.9 years of education, underwent an MRI scan with diffusion tensor imaging (DTI) acquisition. We verified if there were correlations between the performance on the Brief Cognitive Screening Battery (BCSB) and the Rey Auditory Verbal Learning Test (RAVLT) with DTI parameters. RESULTS The BCSB delayed recall task correlated with frontotemporoparietal connection bundles, with the hippocampal part of the cingulum bilaterally and with the right superior longitudinal fasciculus. The RAVLT learning and delayed recall scores also correlated with the hippocampal part of the cingulum bilaterally. CONCLUSIONS Although preliminary, our study suggests that the integrity of white matter frontotemporoparietal fasciculi seems to play a role in episodic memory performance in the low-educated elderly. This finding opens opportunities to study potential targets for memory decline prevention in vulnerable populations.
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Teive HAG, Caramelli P. Arquivos de Neuro-Psiquiatria: 75 years. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:50-52. [PMID: 29364394 DOI: 10.1590/0004-282x20170187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 12/07/2017] [Indexed: 11/21/2022]
Abstract
This year marks the 75th year of publication of Arquivos de Neuro-Psiquiatria (ANP), the official journal of the Brazilian Academy of Neurology and one of the most important neuroscience journals in Latin America. ANP was initially edited by Oswaldo Lange, its founder, and subsequently by Antonio Spina-França Netto and, in recent years, by José Antonio Livramento and Luís dos Ramos Machado.
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Teive HAG, Caramelli P. Message from the new editors of Arquivos de Neuro-Psiquiatria. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:1. [PMID: 29364386 DOI: 10.1590/0004-282x20170191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 12/11/2017] [Indexed: 06/07/2023]
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Fraga VG, Guimarães HC, Teixeira AL, Barbosa MT, Carvalho MG, Caramelli P, Gomes KB. Polymorphisms in cytokine genes influence cognitive and functional performance in a population aged 75 years and above. Int J Geriatr Psychiatry 2017; 32:1401-1410. [PMID: 27891653 DOI: 10.1002/gps.4627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/20/2016] [Accepted: 10/21/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To investigate the frequency of the cytokine single nucleotide polymorphisms (SNPs) tumor necrosis factor (TNF)-α -308G > A, tumor growth factor (TGF)-β1 codon +10C > T, TGF-β1 codon +25G > C, interleukin (IL)-10 -1082A > G, IL-10 -819C > T, IL-10 -592C > A, IL-6 -174G > C, and IFN-γ +874T > A in a sample of healthy and cognitively impaired elderlies and to verify the probable association between these SNPs and cognitive and functional performance of subjects aged 75 years and above. METHODS 259 Brazilian subjects were included, comprising 81 with cognitive impairment no dementia (CIND) and 54 demented seniors (together made up the cognitively impaired group, CI) and 124 age-matched and gender-matched cognitively healthy controls (CHS). The genotyping was performed by multiplex polymerase chain reaction. The cognitive performance was evaluated by Mini-Mental State Examination Brief Cognitive Screening Battery. The functional performance was accessed by Functional Activities Questionnaire. RESULTS The CClower genotype of TGF-β1 codon +25G > C was frequent in both patient groups. The TThigher genotype of INF-γ +874T > A was less frequent in the dementia group. IL-10 haplotypes of lower expression were more frequent among CIND and demented patients. In CI, individuals with genetic variants that produce higher expression of TGF-β1, INF-γ, and IL-10 showed better normalized cognitive performance. Additionally, the Alower allele of INF-γ +874T > A was related to worse functional performance in CI, while the Alower allele of TNF-α -308G > A was associated with better cognitive and functional scores in the CIND group. CONCLUSIONS Our findings suggest a potential role for certain cytokine SNPs in the development of CIND and dementia, which may influence the functional and cognitive performance of these patients. Copyright © 2016 John Wiley & Sons, Ltd.
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Dias FLDC, Teixeira AL, Guimarães HC, Barbosa MT, Resende EDPF, Beato RG, Carmona KC, Caramelli P. Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2017; 39:276-279. [DOI: 10.1590/2237-6089-2017-0046] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 05/19/2017] [Indexed: 11/21/2022]
Abstract
Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.
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de Souza LC, Teixeira AL, de Oliveira GNM, Caramelli P, Cardoso F. A critique of phrenology in Moby-Dick. Neurology 2017; 89:1087-1090. [PMID: 28871062 DOI: 10.1212/wnl.0000000000004335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 06/05/2017] [Indexed: 11/15/2022] Open
Abstract
Phrenology has a fascinating, although controversial, place in the history of localizationism of brain and mental functions. The 2 main proponents of phrenology were 2 German-speaking doctors, Joseph Gall (1758-1828) and Johann Spurzheim (1776-1832). According to their theory, a careful examination of skull morphology could disclose personality characters. Phrenology was initially restricted to medical circles and then diffused outside scientific societies, reaching nonscientific audiences in Europe and North America. Phrenology deeply penetrated popular culture in the 19th century and its tenets can be observed in British and American literature. Here we analyze the presence of phrenologic concepts in Moby-Dick; or, The Whale, by Herman Melville (1819-1891), one of the most prominent American writers. In his masterpiece, he demonstrates that he was familiarized with Gall and Spurzheim's writings, but referred to their theory as "semi-science" and "a passing fable." Of note, Melville's fine irony against phrenology is present in his attempt to perform a phrenologic and physiognomic examination of The Whale. Thus, Moby-Dick illustrates the diffusion of phrenology in Western culture, but may also reflect Melville's skepticism and criticism toward its main precepts.
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Magalhães CA, Carvalho MDG, Sousa LPD, Caramelli P, Gomes KB. Alzheimer’s disease and cytokine IL-10 gene polymorphisms: is there an association? ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:649-656. [DOI: 10.1590/0004-282x20170110] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 06/13/2017] [Indexed: 02/26/2023]
Abstract
ABSTRACT Alzheimer’s disease (AD) is the most common form of dementia. In the last 15 years, a new theory has proposed the autoimmune mechanism as a trigger for AD. Studies on the association between AD and inflammatory biomarkers have yielded controversial results. Interleukin-10 (IL-10), an anti-inflammatory mediator, has been pointed out as one of the main cytokines associated with the occurrence of AD. Moreover, treatment that increases IL-10 levels could be a potential therapy for AD, since this cytokine acts on amyloid and pro-inflammatory molecule reduction. Based on the current literature, this study reviews evidence regarding the role of IL-10 polymorphisms in the context of AD, which has been shown to be of paramount importance for attenuating neuroinflammation, cognitive dysfunction and neurodegeneration.
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Fraga VG, Carvalho MDG, Caramelli P, de Sousa LP, Gomes KB. Resolution of inflammation, n-3 fatty acid supplementation and Alzheimer disease: A narrative review. J Neuroimmunol 2017; 310:111-119. [PMID: 28778434 DOI: 10.1016/j.jneuroim.2017.07.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Revised: 07/09/2017] [Accepted: 07/10/2017] [Indexed: 12/25/2022]
Abstract
In patients with Alzheimer's disease (AD), a persistent and unresolved neuroinflammatory process can contribute to neuronal loss and a decline in their cognitive and functional abilities. Recent studies have demonstrated that the ability to resolve inflammation is impaired in the brains of patients with AD. Preclinical evidence demonstrates the potential of therapeutic interventions on the resolution phase of inflammation in AD. Supplementation of omega-3 fatty acids (n-3 FAs), precursors for specialized pro-resolving mediators, emerged as a possibility for prevention and management of AD. Here, we provide a narrative review of resolving inflammation in AD and the role of n-3 FA supplementation in AD.
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Chaves ACS, Fraga VG, Guimarães HC, Teixeira AL, Barbosa MT, Carvalho MDG, Mota APL, Silva IDFO, Caramelli P, Gomes KB, Alpoim PN. Estrogen receptor-alpha gene XbaI A > G polymorphism influences short-term cognitive decline in healthy oldest-old individuals. ARQUIVOS DE NEURO-PSIQUIATRIA 2017; 75:172-175. [PMID: 28355325 DOI: 10.1590/0004-282x20170018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022]
Abstract
Methods The individuals were categorized in two groups according to the presence or absence of cognitive decline. Cognitive data were related to genetic information. Results The XbaI -351 AA genotype was more common among cognitive decliners, while -351G allele carriers showed cognitive stability or improvement. Conclusion These results suggest that ESR-1 could be associated with one-year cognitive decline in healthy oldest-old individuals, since the estrogen pathway may be involved with neuroprotection, even in healthy brain aging.
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Yassuda MS, Bahia VS, Cecchini MA, Cassimiro L, Lima‐Silva TB, Guimaraes HC, Gambogi LB, Cruz de Souza L, Caramelli P, Figueredo Balthazar ML, Damasceno BP, Dozzi Brucki SM, Nitrini R. [P2–467]: TESTS OF EXECUTIVE FUNCTION MAY NOT DIFFERENTIATE ALZHEIMER's DISEASE FROM BEHAVIORAL VARIANT FRONTOTEMPORAL DEMENTIA. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Paula França Resende E, Chiang K, Allen I, Guimaraes HC, Barbosa MT, Carmona KC, Machado TH, Carvalho VA, Leite FC, Valcour V, Miller BL, Rosen HJ, Cruz de Souza L, Caramelli P. [P2–359]: EDUCATION CAN STRENGTHEN THE ROLE OF THE LEFT HIPPOCAMPUS IN EPISODIC MEMORY PERFORMANCE. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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149
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Guimaraes HC, Teixeira AL, Barbosa MT, Beato RG, Carmona KC, Paula França Resende E, Gomes Borges KB, Caramelli P. [P2–164]: SOLUBLE TNF‐α RECEPTORS, BDNF AND CORTISOL DO DOT PLAY A RELEVANT ROLE IN AGE‐ASSOCIATED COGNITIVE AND FUNCTIONAL IMPAIRMENT: CROSS‐SECTIONAL AND SHORT‐TERM LONGITUDINAL FINDINGS FROM A COMMUNITY‐BASED SAMPLE OF OLDEST ELDERLY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Carvalho VA, Mariano LI, Lima‐Silva TB, Guimaraes HC, Cruz de Souza L, Barbosa MT, Machado Rodrigues RB, Paula França Resende E, Machado de Campos Bottino C, Yassuda MS, Nitrini R, Caramelli P. [P3–441]: THE ADDENBROOKE's COGNITIVE EXAMINATION‐REVISED (ACE‐R) IN THE DIAGNOSIS OF MILD COGNITIVE IMPAIRMENT DUE TO ALZHEIMER's DISEASE: A PRELIMINARY ANALYSIS. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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