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Opel N, Cearns M, Clark S, Toben C, Grotegerd D, Heindel W, Kugel H, Teuber A, Minnerup H, Berger K, Dannlowski U, Baune BT. Large-scale evidence for an association between low-grade peripheral inflammation and brain structural alterations in major depression in the BiDirect study. J Psychiatry Neurosci 2019; 44:423-431. [PMID: 31304733 PMCID: PMC6821515 DOI: 10.1503/jpn.180208] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Preliminary research suggests that major depressive disorder (MDD) is associated with structural alterations in the brain; as well as with low-grade peripheral inflammation. However, even though a link between inflammatory processes and altered brain structural integrity has been purported by experimental research, well-powered studies to confirm this hypothesis in patients with MDD have been lacking. We aimed to investigate the potential association between structural brain alterations and low-grade inflammation as interrelated biological correlates of MDD. METHODS In this cross-sectional study, 514 patients with MDD and 359 healthy controls underwent structural MRI. We used voxel-based morphometry to study local differences in grey matter volume. We also assessed serum levels of high-sensitivity C-reactive protein (hsCRP) in each participant. RESULTS Compared with healthy controls (age [mean ± standard deviation] 52.57 ± 7.94 yr; 50% male), patients with MDD (49.14 ± 7.28 yr, 39% male) exhibited significantly increased hsCRP levels (Z = −5.562, p < 0.001) and significantly decreased grey matter volume in the prefrontal cortex and the insula. Prefrontal grey matter volume reductions were significantly associated with higher hsCRP levels in patients with MDD (x = 50, y = 50, z = 8; t1,501 = 5.15; k = 92; pFWE < 0.001). In the MDD sample, the significant negative association between hsCRP and grey matter appeared independent of age, sex, body mass index, current smoking status, antidepressant load, hospitalization and medical comorbidities. LIMITATIONS This study had a cross-sectional design. CONCLUSION The present study highlights the role of reduced grey matter volume and low-grade peripheral inflammation as interrelated biological correlates of MDD. The reported inverse association between peripheral low-grade inflammation and brain structural integrity in patients with MDD translates current knowledge from experimental studies to the bedside.
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Affiliation(s)
- Nils Opel
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Micah Cearns
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Scott Clark
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Catherine Toben
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Dominik Grotegerd
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Walter Heindel
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Harald Kugel
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Anja Teuber
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Heike Minnerup
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Klaus Berger
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Udo Dannlowski
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
| | - Bernhard T. Baune
- From the Department of Psychiatry and Psychotherapy, University of Münster, Germany (Opel, Grotegerd, Dannlowski, Baune) the Interdisciplinary Centre for Clinical Research (IZKF), University of Münster, Germany (Opel); the Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia (Cearns, Clark, Toben); the Institute of Clinical Radiology, University of Münster, Germany (Heindel, Kugel); the Institute of Epidemiology and Social Medicine, University of Münster, Germany (Teuber, Minnerup, Berger); the Department of Psychiatry, Melbourne Medical School, the University of Melbourne, Victoria, Australia (Baune); and the Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia (Baune)
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Yegla B, Foster T. Effect of Systemic Inflammation on Rat Attentional Function and Neuroinflammation: Possible Protective Role for Food Restriction. Front Aging Neurosci 2019; 11:296. [PMID: 31708767 PMCID: PMC6823289 DOI: 10.3389/fnagi.2019.00296] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Aging is characterized by subtle cognitive decline, which correlates with increased peripheral inflammation. Acute activation of the peripheral immune system, via lipopolysaccharide (LPS) injection, elicits deficits in hippocampal-dependent spatial memory. Little is known concerning the effect of chronic inflammation on prefrontal cortex (PFC)-dependent vigilance. We examined the impact of repeated LPS injections in young and middle-age rats on the 5-choice serial reaction time task (5-CSRTT), expecting repeated LPS treatment to induce attentional deficits with greater disruption in middle-age. Methods: Male Fischer-344 rats, 4- and 12-months-old, were food restricted and trained on the 5-CSRTT. Once rats reached criterion, they were injected with LPS (1 mg/kg, i.p.) weekly for 4 weeks and testing started 48 h after each injection. To examine the possibility that mild food restriction inherent to the behavioral task influenced inflammation markers, a second group of food-restricted or ad-lib-fed rats was assessed for cytokine changes 48 h after one injection. Results: Performing LPS-treated rats exhibited a sickness response, manifesting as reduced initiated and completed trials during the first week but recovered by the second week of testing. After the first week, LPS-treated rats continued to exhibit longer response latencies, despite no change in food retrieval latency, suggestive of LPS-induced cognitive slowing. Similarly, LPS-induced impairment of attention was observed as increased omissions with heightened cognitive demand and increased age. Repeated LPS-treatment increased the level of PFC IL-1α, and PFC IL-6 was marginally higher in middle-age rats. No effect of age or treatment was observed for plasma cytokines in performing rats. Histological examination of microglia indicated increased colocalization of Iba1+ and CD68+ cells from middle-age relative to young rats. Examination of food restriction demonstrated an attenuation of age- and LPS-related increases in plasma cytokine levels. Conclusions: Systemic inflammation, induced through LPS treatment, impaired attentional function, which was independent of sickness and exacerbated by increased cognitive demand and increased age. Additional studies revealed that food restriction, associated with the task, attenuated markers of neuroinflammation and plasma cytokines. The results emphasize the need for improved methods for modeling low-level chronic systemic inflammation to effectively examine its impact on attention during aging.
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Affiliation(s)
- Brittney Yegla
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Thomas Foster
- Department of Neuroscience, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Genetics and Genomics Program, University of Florida, Gainesville, FL, United States
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Adelantado-Renau M, Esteban-Cornejo I, Rodriguez-Ayllon M, Cadenas-Sanchez C, Gil-Cosano JJ, Mora-Gonzalez J, Solis-Urra P, Verdejo-Román J, Aguilera CM, Escolano-Margarit MV, Verdejo-Garcia A, Catena A, Moliner-Urdiales D, Ortega FB. Inflammatory biomarkers and brain health indicators in children with overweight and obesity: The ActiveBrains project. Brain Behav Immun 2019; 81:588-597. [PMID: 31330300 DOI: 10.1016/j.bbi.2019.07.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/15/2019] [Accepted: 07/18/2019] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Chronic inflammation plays an important role on the pathogenesis of several cardiovascular and metabolic diseases, as well as on brain function and behaviour. The aim of the present study was to examine the associations between inflammatory biomarkers and a wide range of brain health indicators (i.e., academic performance, executive function, behavioural and emotional functioning, and brain volume) in children with overweight/obesity. METHODS A total of 107 children (10.0 ± 1.1 years, 41% girls) from the ActiveBrains project were included in the analysis. Five inflammatory biomarkers were analysed in plasma: white blood cell (WBC) count, interleukin-6 (IL-6), interleukin-1β, tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). Academic performance was assessed by Woodcock-Muñoz Tests of Achievement. Executive function was assessed through the Design Fluency Test for cognitive flexibility, the Stroop test for cognitive inhibition, and the Delayed Non-Match-to-Sample task for working memory. Behavioural and emotional functioning was evaluated through the Behavior Assessment System for Children (BASC) questionnaire. Total and regional brain volume was assessed by magnetic resonance imaging. RESULTS IL-6 was inversely associated with adaptive skills (β = -0.228; p = 0.030), while TNF-α was related to mathematics (β = -0.198; p = 0.034). In addition, CRP was positively associated with externalizing (β = 0.246; p = 0.046) and internalizing problems (β = 0.234; p = 0.039), as well as the behavioural symptoms index (β = 0.236; p = 0.047). However, these significant associations disappeared after multiple comparisons correction. Inflammatory biomarkers were not associated with executive function and total brain volumes. Regarding regional brain analyses, WBC was positively associated with gray matter volume in the left middle temporal gyrus (β = 0.387; p < 0.001, k = 44), and CRP was positively associated with gray matter volume in the right superior temporal gyrus (β = 0.439; p < 0.001, k = 29). Additionally, when adjusting by total brain volume, CRP was positively associated with gray matter volume in the right supplementary motor cortex (β = 0.453; p < 0.001, k = 51). Moreover, both, IL-6 (β = 0.366; p < 0.001, k = 81) and TNF-α (β = 0.368; p < 0.001, k = 62) were positively associated with white matter volume around the right inferior frontal gyrus pars opercularis, while CRP was inversely associated with white matter volume around the left superior frontal gyrus (β = -0.482; p < 0.001, k = 82). After adjusting by total brain volume, CRP was also inversely associated with white matter volume in 3 additional clusters (β ranging from -0.473 to -0.404; p < 0.001, k = 87). CONCLUSIONS Inflammation was slightly associated with brain health (i.e., academic performance, behavioural and emotional functioning and regional brain volume) in children with overweight or obesity. Further larger longitudinal and interventional studies are warranted to elucidate the short-term and long-term effect of systemic low-grade inflammation on children's brain health.
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Affiliation(s)
| | - Irene Esteban-Cornejo
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain; Center for Cognitive and Brain Health, Department of Psychology, Northeastern University, Boston, MA, USA
| | - María Rodriguez-Ayllon
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Cristina Cadenas-Sanchez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jose Juan Gil-Cosano
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Jose Mora-Gonzalez
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Patricio Solis-Urra
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain; IRyS Research Group, School of Physical Education, Pontificia Universidad Católica de Valparaíso, Valparaiso, Chile
| | - Juan Verdejo-Román
- Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Madrid, Spain; Mind, Brain, and Behavior Research Center-CIMCYC, University of Granada, Granada, Spain
| | - Concepción M Aguilera
- Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology, Center for Biomedical Research, University of Granada, Granada, Spain; CIBER Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Madrid, Spain; Instituto de Investigación Biosanitaria ibs, Granada, Spain
| | | | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
| | - Andrés Catena
- Department of Experimental Psychology, Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | | | - Francisco B Ortega
- PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain; Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
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Beydoun MA, Hossain S, Chitrala KN, Tajuddin SM, Beydoun HA, Evans MK, Zonderman AB. Association between epigenetic age acceleration and depressive symptoms in a prospective cohort study of urban-dwelling adults. J Affect Disord 2019; 257:64-73. [PMID: 31299406 PMCID: PMC6757325 DOI: 10.1016/j.jad.2019.06.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/07/2019] [Accepted: 06/29/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study tests associations of DNA methylation-based (DNAm) measures of epigenetic age acceleration (EAA) with cross-sectional and longitudinal depressive symptoms in an urban sample of middle-aged adults. METHODS White and African-American adult participants in the Healthy Aging in Neighborhoods of Diversity across the Life Span study for whom DNA samples were analyzed (baseline age: 30-65 years) we included. We estimated three DNAm based EAA measures: (1) universal epigenetic age acceleration (AgeAccel); (2) intrinsic epigenetic age acceleration (IEAA); and (3) extrinsic epigenetic age acceleration (EEAA). Depressive symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression scale total and sub-domain scores at baseline (2004-2009) and follow-up visits (2009-2013). Linear mixed-effects regression models were conducted, adjusting potentially confounding covariates, selection bias and multiple testing (N = 329 participants, ∼52% men, k = 1.9 observations/participant, mean follow-up time∼4.7 years). RESULTS None of the epigenetic age acceleration measures were associated with total depressive symptom scores at baseline or over time. IEAA - a measure of cellular epigenetic age acceleration irrespective of white blood cell composition - was cross-sectionally associated with decrement in "positive affect" in the total population (γ011± SE = -0.090 ± 0.030, P = 0.003, Cohen's D: -0.16) and among Whites (γ011 ± SE = -0.135 ± 0.048, P = 0.005, Cohen's D: -0.23), after correction for multiple testing. Baseline "positive affect" was similarly associated with AgeAccel. LIMITATIONS Limitations included small sample size, weak-moderate effects and measurement error. CONCLUSIONS IEAA and AgeAccel, two measures of EAA using Horvath algorithm, were linked to a reduced "positive affect", overall and among Whites. Future studies are needed to replicate our findings and test bi-directional relationships.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States.
| | - Sharmin Hossain
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States
| | - Kumaraswamy Naidu Chitrala
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States
| | - Salman M Tajuddin
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States
| | - Hind A Beydoun
- Department of Research Programs, Fort Belvoir Community Hospital, Fort Belvoir, VA, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States
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Miller ZA, Rosenberg L, Santos-Santos MA, Stephens M, Allen IE, Hubbard HI, Cantwell A, Mandelli ML, Grinberg LT, Seeley WW, Miller BL, Rabinovici GD, Gorno-Tempini ML. Prevalence of Mathematical and Visuospatial Learning Disabilities in Patients With Posterior Cortical Atrophy. JAMA Neurol 2019; 75:728-737. [PMID: 29630699 DOI: 10.1001/jamaneurol.2018.0395] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Importance Increased prevalence of language-based learning disabilities (LDs) has been previously reported in patients with primary progressive aphasia (PPA). This study hypothesized that patients with focal neurodegenerative syndromes outside the language network, such as posterior cortical atrophy (PCA), would have a higher rate of nonlanguage LDs, congruent with their mainly visuospatial presentation. Objective To investigate the prevalence and type of LD (language and/or mathematical and visuospatial) in a large cohort of patients with PCA compared with patients with logopenic variant PPA (lvPPA) and amnestic Alzheimer disease (AD). Design, Setting, and Participants This case-control study reviewed 279 medical records from a university-based clinic and research center for patients with neurodegenerative diseases for LD history, including patients with PCA (n = 95), patients with lvPPA (n = 84), and a matched cohort with amnestic AD (n = 100). No records were excluded. The study compared cognitive and neuroimaging features of patients with PCA with and without LDs. A review of the records of patients presenting from March 1, 1999, to August 31, 2014, revealed 95 PCA cases and 84 lvPPA cases. Then 100 patients with amnestic AD from this same period were chosen for comparison, matching against the groups for age, sex, and disease severity. Data analysis was performed from September 8, 2013, to November 6, 2017. Main Outcomes and Measures Prevalence of total LD history and prevalence of language and mathematical or visuospatial LD history across all cohorts. Results A total of 179 atypical AD cases (95 with PCA and 84 with lvPPA) and 100 disease control cases (amnestic AD) were included in the study. The groups were not statistically different for mean (SD) age at first visit (PCA, 61.9 [7.0] years; lvPPA, 65.1 [8.7] years; amnestic AD, 64.0 [12.6] years; P = .08), mean (SD) age at first symptom (PCA, 57.5 [7.0] years; lvPPA, 61.1 [9.0] years; amnestic AD, 59.6 [13.7] years; P = .06), or sex (PCA, 66.3% female; lvPPA, 56.0% female; amnestic AD, 57.0% female; P = .30) but differed on non-right-hand preference (PCA, 18.3%; lvPPA, 20.2%; amnestic AD, 7.7%; P = .04), race/ethnicity (PCA, 88.3% white; lvPPA, 99.0% white; amnestic AD, 80.0% white; P < .001), and mean (SD) educational level (PCA, 15.7 [3.2] years; lvPPA, 16.2 [3.3] years; amnestic AD, 14.8 [3.5] years; P = .02). A total of 18 of the 95 patients with PCA (18.9%) reported a history of LD, which is greater than the 3 of 100 patients (3.0%) in the amnestic AD cohort (P < .001) and the 10.0% expected rate in the general population (P = .007). In the PCA cohort, 13 of 95 patients (13.7%) had a nonlanguage mathematical and/or visuospatial LD; this rate was greater than that in the amnestic AD (1 of 100 [1.0%]; P < .001) and lvPPA (2 of 84 [2.4%]; P = .006) cohorts and greater than the 6.0% expected general population rate of mathematical LD (P = .003). Compared with the patients with PCA without LDs, the group with LDs had greater preservation of global cognition and a more right-lateralized pattern of atrophy. Conclusions and Relevance Nonlanguage mathematical and visuospatial LDs were associated with focal, visuospatial predominant neurodegenerative clinical syndromes. This finding supports the hypothesis that neurodevelopmental differences in specific brain networks are associated with phenotypic manifestation of later-life neurodegenerative disease.
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Affiliation(s)
- Zachary A Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Lynne Rosenberg
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Miguel A Santos-Santos
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Melanie Stephens
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Isabel E Allen
- Department of Biostatistics, University of California, San Francisco
| | - H Isabel Hubbard
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Averill Cantwell
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Maria Luisa Mandelli
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Lea T Grinberg
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco.,Department of Pathology, University of California, San Francisco
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco.,Department of Pathology, University of California, San Francisco
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Gil D Rabinovici
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
| | - Maria Luisa Gorno-Tempini
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco
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Santos-Santos MA, Rabinovici GD, Iaccarino L, Ayakta N, Tammewar G, Lobach I, Henry ML, Hubbard I, Mandelli ML, Spinelli E, Miller ZA, Pressman PS, O'Neil JP, Ghosh P, Lazaris A, Meyer M, Watson C, Yoon SJ, Rosen HJ, Grinberg L, Seeley WW, Miller BL, Jagust WJ, Gorno-Tempini ML. Rates of Amyloid Imaging Positivity in Patients With Primary Progressive Aphasia. JAMA Neurol 2019; 75:342-352. [PMID: 29309493 DOI: 10.1001/jamaneurol.2017.4309] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Importance The ability to predict the pathology underlying different neurodegenerative syndromes is of critical importance owing to the advent of molecule-specific therapies. Objective To determine the rates of positron emission tomography (PET) amyloid positivity in the main clinical variants of primary progressive aphasia (PPA). Design, Setting, and Participants This prospective clinical-pathologic case series was conducted at a tertiary research clinic specialized in cognitive disorders. Patients were evaluated as part of a prospective, longitudinal research study between January 2002 and December 2015. Inclusion criteria included clinical diagnosis of PPA; availability of complete speech, language, and cognitive testing; magnetic resonance imaging performed within 6 months of the cognitive evaluation; and PET carbon 11-labeled Pittsburgh Compound-B or florbetapir F 18 brain scan results. Of 109 patients referred for evaluation of language symptoms who underwent amyloid brain imaging, 3 were excluded because of incomplete language evaluations, 5 for absence of significant aphasia, and 12 for presenting with significant initial symptoms outside of the language domain, leaving a cohort of 89 patients with PPA. Main Outcomes and Measures Clinical, cognitive, neuroimaging, and pathology results. Results Twenty-eight cases were classified as imaging-supported semantic variant PPA (11 women [39.3%]; mean [SD] age, 64 [7] years), 31 nonfluent/agrammatic variant PPA (22 women [71.0%]; mean [SD] age, 68 [7] years), 26 logopenic variant PPA (17 women [65.4%]; mean [SD] age, 63 [8] years), and 4 mixed PPA cases. Twenty-four of 28 patients with semantic variant PPA (86%) and 28 of 31 patients with nonfluent/agrammatic variant PPA (90%) had negative amyloid PET scan results, while 25 of 26 patients with logopenic variant PPA (96%) and 3 of 4 mixed PPA cases (75%) had positive scan results. The amyloid positive semantic variant PPA and nonfluent/agrammatic variant PPA cases with available autopsy data (2 of 4 and 2 of 3, respectively) all had a primary frontotemporal lobar degeneration and secondary Alzheimer disease pathologic diagnoses, whereas autopsy of 2 patients with amyloid PET-positive logopenic variant PPA confirmed Alzheimer disease. One mixed PPA patient with a negative amyloid PET scan had Pick disease at autopsy. Conclusions and Relevance Primary progressive aphasia variant diagnosis according to the current classification scheme is associated with Alzheimer disease biomarker status, with the logopenic variant being associated with carbon 11-labeled Pittsburgh Compound-B positivity in more than 95% of cases. Furthermore, in the presence of a clinical syndrome highly predictive of frontotemporal lobar degeneration pathology, biomarker positivity for Alzheimer disease may be associated more with mixed pathology rather than primary Alzheimer disease.
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Affiliation(s)
- Miguel A Santos-Santos
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Autonomous University of Barcelona, Cerdanyola del Valles, Spain.,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute, L'Hospitalet de Llobregat, Barcelona, Spain.,Fundació Alzheimer Memory Clinic and Research Center, Institut Catalá de Neurociències Aplicades, Barcelona, Spain
| | - Gil D Rabinovici
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley
| | - Leonardo Iaccarino
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Vita-Salute San Raffaele University, Milan, Italy
| | - Nagehan Ayakta
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley
| | - Gautam Tammewar
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley
| | - Iryna Lobach
- Department of Epidemiology and Biostatistics, University of California San Francisco
| | - Maya L Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin
| | - Isabel Hubbard
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Maria Luisa Mandelli
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Edoardo Spinelli
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Vita-Salute San Raffaele University, Milan, Italy
| | - Zachary A Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Peter S Pressman
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,University of Colorado Denver, Denver
| | - James P O'Neil
- Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California
| | - Pia Ghosh
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Andreas Lazaris
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Marita Meyer
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Christa Watson
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Soo Jin Yoon
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Department of Neurology, Eulji University Hospital, Daejeon, South Korea
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - Lea Grinberg
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Department of Pathology, University of California San Francisco, California
| | - William W Seeley
- Department of Neurology, Memory and Aging Center, University of California San Francisco.,Department of Pathology, University of California San Francisco, California
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California San Francisco
| | - William J Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley.,Life Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, California
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Beydoun MA, Weiss J, Obhi H, Beydoun HA, Dore GA, Liang H, Evans MK, Zonderman AB. Cytokines are associated with longitudinal changes in cognitive performance among urban adults. Brain Behav Immun 2019; 80:474-487. [PMID: 30981715 PMCID: PMC6698146 DOI: 10.1016/j.bbi.2019.04.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 03/20/2019] [Accepted: 04/10/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chronic systemic inflammation has been positively associated with structural and functional brain changes representing early markers of Alzheimer's Disease (AD) and cognitive decline. The current study examined associations between systemic inflammation and cognitive performance among African-Americans and Whites urban adults. METHODS Participants were selected from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (2004-2013, baseline age: 30-64 y, mean ± SD follow-up time of 4.64 ± 0.93 y, N = 189-222, k = 1.5-1.7 observations/participant). Cytokines known to be positively linked to AD incidence among others were tested against cross-sectional and longitudinal cognitive function, stratifying by age group (≤50 y vs. >50 y), sex and race. A series of mixed-effects regression models were conducted, adjusting for key confounders. RESULTS Among key findings, IL1β was positively associated with a faster rate of decline on a test of executive functioning, among older adults (age >50 y, γ11 = +2.49 ± 0.89, p = 0.005), while in the total population, IL-6 was linked to a faster decline on a test of verbal memory (γ11 = -0.011 ± 0.004, p = 0.009). Among younger participants, IL-18 was linked to a poorer performance on a test of attention at baseline (age ≤50 y, γ01 = -0.007 ± 0.0025, p = 0.004) though a slower rate of decline with higher IL-18 was detected for a test of psychomotor speed in older adults (age >50 y, γ11 = +0.0010 ± 0.0004, p = 0.008). Finally, among Whites, unlike among African-Americans, IL-6 was associated with a better baseline performance on two tests of verbal and working memory. CONCLUSIONS Cytokines were shown to be associated with age-related cognitive decline among middle-aged and older urban adults in an age group and race-specific manner. Further longitudinal studies are needed to replicate our findings and mediation through relevant biological and psychosocial factors need to be studied as well.
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Affiliation(s)
- May A. Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD.,Corresponding author: May A. Beydoun, PhD, NIH Biomedical Research Center, National Institute on Aging, IRP, 251 Bayview Blvd., Suite 100, Room#: 04B118, Baltimore, MD 21224, , Fax:410-558-8236
| | - Jordan Weiss
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hardeep Obhi
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hind A. Beydoun
- Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD
| | - Gregory A. Dore
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Hailun Liang
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD
| | - Michele K. Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
| | - Alan B. Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD
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58
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Thibeau S, McDermott K, McFall GP, Rockwood K, Dixon RA. Frailty effects on non-demented cognitive trajectories are moderated by sex and Alzheimer's genetic risk. Alzheimers Res Ther 2019; 11:55. [PMID: 31221191 PMCID: PMC6587247 DOI: 10.1186/s13195-019-0509-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/29/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Age-related frailty reflects cumulative multisystem physiological and health decline. Frailty increases the risk of adverse brain and cognitive outcomes, including differential decline and dementia. In a longitudinal sample of non-demented older adults, we examine whether (a) the level and/or change in frailty predicts trajectories across three cognitive domains (memory, speed, and executive function (EF)) and (b) prediction patterns are modified by sex or Alzheimer's genetic risk (Apolipoprotein E (APOE)). METHODS Participants (n = 632; M age = 70.7, range 53-95; 3 waves) were from the Victoria Longitudinal Study. After computing a frailty index, we used latent growth modeling and path analysis to test the frailty effects on level and change in three latent variables of cognition. We tested two potential moderators by stratifying by sex and APOE risk (ε4+, ε4-). RESULTS First, frailty levels predicted speed and EF performance (level) and differential memory change slopes. Second, change in frailty predicted the rate of decline for both speed and EF. Third, sex moderation analyses showed that females were selectively sensitive to (a) frailty effects on memory change and (b) frailty change effects on speed change. In contrast, the frailty effects on EF change were stronger in males. Fourth, genetic moderation analyses showed that APOE risk (e4+) carriers were selectively sensitive to frailty effects on memory change. CONCLUSION In non-demented older adults, increasing frailty is strongly associated with the differential decline in cognitive trajectories. For example, higher (worse) frailty was associated with more rapid memory decline than was lower (better) frailty. These effects, however, are moderated by both genetic risk and sex.
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Affiliation(s)
- Sherilyn Thibeau
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB Canada
| | - Kirstie McDermott
- Neuroscience and Mental Health Institute, University of Alberta, 4-120 Katz Group Centre, Edmonton, AB Canada
| | - G. Peggy McFall
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB Canada
- Neuroscience and Mental Health Institute, University of Alberta, 4-120 Katz Group Centre, Edmonton, AB Canada
| | - Kenneth Rockwood
- Department of Geriatric Medicine, QEII Health Sciences Centre, Dalhousie University, VG Site, Suite 442 Bethune Building, 1276 South Park Street, Halifax, NS Canada
| | - Roger A. Dixon
- Department of Psychology, University of Alberta, P217 Biological Sciences Building, Edmonton, AB Canada
- Neuroscience and Mental Health Institute, University of Alberta, 4-120 Katz Group Centre, Edmonton, AB Canada
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59
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Factors that predict diagnostic stability in neurodegenerative dementia. J Neurol 2019; 266:1998-2009. [PMID: 31102021 DOI: 10.1007/s00415-019-09362-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/01/2019] [Accepted: 05/03/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the frequency and characteristics of clinical diagnostic change in frontotemporal dementia (FTD)-spectrum syndromes and Alzheimer's disease (AD)-type dementia. METHODS We reviewed records and categorized diagnostic changes in patients seen ≥ 2 times with behavioral variant FTD (bvFTD, n = 99), nonfluent and semantic variant primary progressive aphasia (nfvPPA, n = 32; svPPA, n = 59), corticobasal syndrome (CBS, n = 40), progressive supranuclear palsy-Richardson syndrome (PSP-RS, n = 34), and AD-type dementia (n = 49). For bvFTD, we compared patients with and without diagnostic change, and assessed predictors of diagnostic change by logistic regression. RESULTS Initial diagnoses changed infrequently at subsequent visits in svPPA (6.8%), PSP-RS (8.8%), and nfvPPA (12.5%), with rare changes largely involving clinicopathological overlap or diagnostic ambiguity. Changes in AD-type dementia (30.6%) and CBS (37.5%) were more common, but reflected greater specificity, predicted co-pathology, or overlapping syndromes. Diagnostic change in bvFTD was also common (32.3%), but more diverse, including motor neuron disease development, alternative neurodegenerative syndromes, and non-neurodegenerative diseases. Diagnostic change occurred more often in those who met possible rather than probable bvFTD criteria (70.6% vs 15.3%, p < 0.001). Patients with stable diagnoses showed greater overall impairment, bvFTD behavioral severity, and atrophy in core right-hemisphere bvFTD regions. Patients with diagnostic change had more severe depression (p < 0.05) and more frequent contributing, secondary diagnoses (p = 0.01), such as cerebrovascular disease. By logistic regression, the accuracy of predicting stable bvFTD diagnoses using first-visit data was 80%. CONCLUSION bvFTD displays more diverse diagnostic change than other neurodegenerative syndromes. First-visit bvFTD diagnoses may waver if based on meeting possible criteria only.
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60
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Warren KN, Beason-Held LL, Carlson O, Egan JM, An Y, Doshi J, Davatzikos C, Ferrucci L, Resnick SM. Elevated Markers of Inflammation Are Associated With Longitudinal Changes in Brain Function in Older Adults. J Gerontol A Biol Sci Med Sci 2019; 73:770-778. [PMID: 29304217 DOI: 10.1093/gerona/glx199] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Indexed: 11/14/2022] Open
Abstract
Background Chronic inflammation has been linked to memory and other cognitive impairments, as well as Alzheimer's disease. Here, we investigate the association between inflammatory markers and changes in brain activity measured by regional cerebral blood flow (rCBF) to assess the relationship between inflammation and brain function in older individuals. Methods Annual 15O water resting-state positron emission tomography (PET) scans collected over a 5-year period were assessed in 138 cognitively normal older participants (77 males; mean age at baseline = 71.3; mean scans per participant = 3.5) in the Baltimore Longitudinal Study of Aging. Voxel-wise linear mixed models were used to investigate associations between rCBF and C-reactive protein (CRP) and interleukin-6 (IL-6) at the time of scanning. We examined relationships between baseline CRP and IL-6 levels and baseline rCBF, and relationships between baseline and mean inflammatory levels over time and longitudinal rCBF changes. Results Higher baseline CRP and IL-6 were each associated with lower baseline rCBF primarily in frontal and occipital regions, with only the lingual gyrus surviving atrophy correction. Higher baseline and mean CRP were also associated with greater rCBF declines over time in anterior cingulate and hippocampal regions, whereas higher baseline and mean IL-6 levels were associated with greater rCBF declines in orbitofrontal and hippocampal regions. Conclusions Higher levels of inflammation are associated with longitudinal changes in brain function in regions important for cognition. These results, along with previous studies, suggest that chronic inflammation in older adults may contribute to age-associated declines in cognitive function.
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Affiliation(s)
- Kristen N Warren
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Lori L Beason-Held
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Olga Carlson
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Josephine M Egan
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Yang An
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Jimit Doshi
- Department of Radiology, University of Pennsylvania, Philadelphia
| | | | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, NIH, Baltimore, Maryland
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61
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Bettcher BM, Johnson SC, Fitch R, Casaletto KB, Heffernan KS, Asthana S, Zetterberg H, Blennow K, Carlsson CM, Neuhaus J, Bendlin BB, Kramer JH. Cerebrospinal Fluid and Plasma Levels of Inflammation Differentially Relate to CNS Markers of Alzheimer's Disease Pathology and Neuronal Damage. J Alzheimers Dis 2019; 62:385-397. [PMID: 29439331 DOI: 10.3233/jad-170602] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Inflammatory markers have been shown to predict neurocognitive outcomes in aging adults; however, the degree to which peripheral markers mirror the central nervous system remains unknown. We investigated the association between plasma and cerebrospinal fluid (CSF) markers of inflammation, and explored whether these markers independently predict CSF indicators of Alzheimer's disease (AD) pathology or neuronal damage. Plasma and CSF samples were analyzed for inflammatory markers in a cohort of asymptomatic older adults (n = 173). CSF samples were analyzed for markers of AD pathology (Aβ42, phosphorylated tau [p-tau], sAβPPβ) or neuronal damage (total tau; neurofilament light chain) (n = 147). Separate linear models for each analyte were conducted with CSF and plasma levels entered simultaneously as predictors and markers of AD pathology or neuronal damage as outcome measures. Strong associations were noted between CSF and plasma MIP-1β levels, and modest associations were observed for remaining analytes. With respect to AD pathology, higher levels of plasma and CSF IL-8, CSF MIP-1β, and CSF IP-10 were associated with higher levels of p-tau. Higher levels of CSF IL-8 were associated with higher levels of CSF Aβ42. Higher CSF sAβPPβ levels were associated with higher plasma markers only (IL-8; MCP-1). In terms of neuronal injury, higher levels of plasma and CSF IL-8, CSF IP-10, and CSF MIP-1β were associated with higher levels of CSF total tau. Exploratory analyses indicated that CSF Aβ42 modifies the relationship between plasma inflammatory levels and CSF tau levels. Results suggest that both plasma and CSF inflammatory markers independently relay integral information about AD pathology and neuronal damage.
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Affiliation(s)
- Brianne M Bettcher
- Departments of Neurosurgery and Neurology, University of Colorado Anschutz Medical Campus, Rocky Mountain Alzheimer's Disease Center, Aurora, CO, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Ryan Fitch
- Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Kaitlin B Casaletto
- Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA, USA
| | - Kate S Heffernan
- Departments of Neurosurgery and Neurology, University of Colorado Anschutz Medical Campus, Rocky Mountain Alzheimer's Disease Center, Aurora, CO, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Cynthia M Carlsson
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research Education and Clinical Center, Wm. S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Joel H Kramer
- Department of Neurology, University of California San Francisco, Memory and Aging Center, San Francisco, CA, USA
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62
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Bettcher BM, Neuhaus J, Wynn MJ, Elahi FM, Casaletto KB, Saloner R, Fitch R, Karydas A, Kramer JH. Increases in a Pro-inflammatory Chemokine, MCP-1, Are Related to Decreases in Memory Over Time. Front Aging Neurosci 2019; 11:25. [PMID: 30814948 PMCID: PMC6381047 DOI: 10.3389/fnagi.2019.00025] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 01/29/2019] [Indexed: 12/28/2022] Open
Abstract
Objective: To determine the longitudinal relationship between monocyte chemotactic protein 1 (MCP-1)/CCL2 and memory function in older adults. Methods: We examined longitudinal plasma MCP-1/CCL2 levels and a longitudinal verbal memory measure (CVLT-II 20' recall) in a sample of 399 asymptomatic older adults (mean age = 72.1). Total visits ranged from 1 to 8, with an average time of 2.1 years between each visit, yielding 932 total observations. In order to isolate change over time, we decomposed MCP-1/CCL2 into subject-specific means and longitudinal deviations from the mean. The decomposed MCP-1/CCL2 variables were entered as predictors in linear mixed effects models, with age at baseline, sex, and education entered as covariates and recall as the longitudinal outcome. In follow-up analyses, we controlled for global cognition and APOE genotype, as well as baseline vascular risk factors. We also examined the specificity of findings by examining the longitudinal association between the MCP-1/CCL2 variables and non-memory cognitive tests. Results: Within-subject increases in MCP-1/CCL2 levels were associated with decreases in delayed recall (t = -2.65; p = 0.01) over time. Results were independent of global cognitive function and APOE status (t = -2.30, p = 0.02), and effects remained when controlling for baseline vascular risk factors (t = -1.92, p = 0.05). No associations were noted between within-subject increases in MCP-1/CCL2 levels and other cognitive domains. Conclusions: In an asymptomatic aging adult cohort, longitudinal increases in MCP-1/CCL2 levels were associated with longitudinal decline in memory. Results suggest that "healthy aging" is typified by early remodeling of the immune system, and that the chemokine, MCP-1/CCL2, may be associated with negative memory outcomes.
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Affiliation(s)
- Brianne M Bettcher
- Rocky Mountain Alzheimer's Disease Center, Departments of Neurosurgery and Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States
| | - Matthew J Wynn
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States
| | - Fanny M Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Kaitlin B Casaletto
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Rowan Saloner
- Department of Psychiatry, San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
- HIV Neurobehavioral Research Program, Department of Psychiatry, University of California, San Diego, San Diego, CA, United States
| | - Ryan Fitch
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Anna Karydas
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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Vinceti G, Olney N, Mandelli ML, Spina S, Hubbard HI, Santos-Santos MA, Watson C, Miller ZA, Lomen-Hoerth C, Nichelli P, Miller BL, Grinberg LT, Seeley WW, Gorno-Tempini ML. Primary progressive aphasia and the FTD-MND spectrum disorders: clinical, pathological, and neuroimaging correlates. Amyotroph Lateral Scler Frontotemporal Degener 2019; 20:146-158. [PMID: 30668155 DOI: 10.1080/21678421.2018.1556695] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Behavioral variant frontotemporal dementia (bvFTD), is commonly considered the cognitive presentation of the frontotemporal dementia-motor neuron disease (FTD-MND) spectrum disorder. We evaluated the prevalence of primary progressive aphasia in a series of pathologically confirmed cases of FTD-MND spectrum. Methods: Pathologically confirmed cases of frontotemporal lobar degeneration-motor neuron disease (FTLD-MND) were obtained from the UCSF brain bank. Cases were analyzed for presence of language impairment via retrospective chart review of research visits that include neurologic exam, in-depth cognitive testing and magnetic resonance imaging (MRI) imaging. Forty one cases were included. Thirty two were diagnosed with FTD-MND, while nine cases were diagnosed as MND-only from clinical evaluation. Results: Ten FTLD-MND cases (31%) presented with prominent or isolated language involvement consistent with a diagnosis of primary progressive aphasia (PPA), which we called progressive aphasia with motor neuron disease (PA-MND). Of these, three cases that mirrored the non-fluent variant of PPA (nfvPPA) were named nfvPA-MND. The imaging pattern of these nfvPA-MND showed atrophy strictly confined to the frontal and anterior temporal language cortical areas. Another group of seven cases that resembled patients with the semantic variant PPA (svPPA) were named svPA-MND. The group of svPPA-MND on imaging analysis showed selective atrophy of the temporal lobe and orbitofrontal cortex. Conclusions: Language impairment was a frequent phenotype of FTD-MND associated with focal atrophy patterns within the language networks. This data suggest patients with FTD-MND can present quite often with language phenotype of nfvPPA and svPPA, as opposed to exclusive bvFTD symptoms.
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Affiliation(s)
- Giulia Vinceti
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,b Department of Biomedical, Metabolic and Neural Science , University of Modena and Reggio Emilia , Modena , Italy
| | - Nicholas Olney
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,d UCSF ALS Center , University of California , San Francisco , CA , USA
| | - Maria Luisa Mandelli
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Salvatore Spina
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - H Isabel Hubbard
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,c Department of Communication Sciences and Disorders , University of Texas , Austin , TX, USA
| | - Miguel A Santos-Santos
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Christa Watson
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Zachary A Miller
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | | | - Paolo Nichelli
- b Department of Biomedical, Metabolic and Neural Science , University of Modena and Reggio Emilia , Modena , Italy
| | - Bruce L Miller
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
| | - Lea T Grinberg
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,e Department of Pathology , University of California , San Francisco , CA , USA
| | - William W Seeley
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA.,e Department of Pathology , University of California , San Francisco , CA , USA
| | - Maria Luisa Gorno-Tempini
- a Department of Neurology, Memory and Aging Center , University of California , San Francisco , CA , USA
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Zahodne LB, Kraal AZ, Sharifian N, Zaheed AB, Sol K. Inflammatory mechanisms underlying the effects of everyday discrimination on age-related memory decline. Brain Behav Immun 2019; 75:149-154. [PMID: 30367930 PMCID: PMC6279484 DOI: 10.1016/j.bbi.2018.10.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 09/04/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND/OBJECTIVES Previous research suggests that everyday discrimination is associated with worse episodic memory and partially mediates Black-White disparities in memory aging. The biological mechanisms underlying the link between everyday discrimination and memory are unclear but may involve inflammatory processes. This study aimed to determine whether systemic inflammation, indexed by blood levels of C-reactive protein (CRP), mediates associations between everyday discrimination and episodic memory over 6 years. DESIGN A longitudinal mediation model quantified associations between baseline everyday discrimination, 4-year change in CRP, and 6-year change in episodic memory. SETTING The Health and Retirement Study (HRS). PARTICIPANTS 12,624 HRS participants aged 51 and older. MEASUREMENTS Everyday Discrimination Scale, high-sensitivity CRP assays of dried blood spots, composite scores of immediate and delayed recall of a word list. RESULTS Black participants reported greater everyday discrimination. Greater discrimination was associated with lower baseline memory and faster memory decline. Higher CRP at baseline partially mediated the negative association between discrimination and baseline memory, but CRP change did not mediate the association between discrimination and memory decline. CONCLUSION This U.S.-representative longitudinal study provides evidence for deleterious effects of discrimination on subsequent episodic memory. The fact that elevated CRP only partially explained the concurrent association between discrimination and memory highlights the need for more comprehensive investigations of biological mechanisms underlying the link between social stress and age-related memory decline in order to better characterize potential intervention targets to reduce racial inequalities in memory aging.
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Omega-3 Polyunsaturated Fatty Acid Deficiency and Progressive Neuropathology in Psychiatric Disorders: A Review of Translational Evidence and Candidate Mechanisms. Harv Rev Psychiatry 2019; 27:94-107. [PMID: 30633010 PMCID: PMC6411441 DOI: 10.1097/hrp.0000000000000199] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Meta-analytic evidence indicates that mood and psychotic disorders are associated with both omega-3 polyunsaturated fatty acid (omega-3 PUFA) deficits and progressive regional gray and white matter pathology. Although the association between omega-3 PUFA insufficiency and progressive neuropathological processes remains speculative, evidence from translational research suggests that omega-3 PUFA insufficiency may represent a plausible and modifiable risk factor not only for enduring neurodevelopmental abnormalities in brain structure and function, but also for increased vulnerability to neurodegenerative processes. Recent evidence from human neuroimaging studies suggests that lower omega-3 PUFA intake/status is associated with accelerated gray matter atrophy in healthy middle-aged and elderly adults, particularly in brain regions consistently implicated in mood and psychotic disorders, including the amygdala, anterior cingulate, hippocampus, prefrontal cortex, and temporal cortex. Human neuroimaging evidence also suggests that both low omega-3 PUFA intake/status and psychiatric disorders are associated with reductions in white matter microstructural integrity and increased rates of white matter hyperintensities. Preliminary evidence suggests that increasing omega-3 PUFA status is protective against gray matter atrophy and deficits in white matter microstructural integrity in patients with mood and psychotic disorders. Plausible mechanisms mediating this relationship include elevated pro-inflammatory signaling, increased synaptic regression, and reductions in cerebral perfusion. Together these associations encourage additional neuroimaging research to directly investigate whether increasing omega-3 PUFA status can mitigate neuropathological processes in patients with, or at high risk for, psychiatric disorders.
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66
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Jacomb I, Stanton C, Vasudevan R, Powell H, O'Donnell M, Lenroot R, Bruggemann J, Balzan R, Galletly C, Liu D, Weickert CS, Weickert TW. C-Reactive Protein: Higher During Acute Psychotic Episodes and Related to Cortical Thickness in Schizophrenia and Healthy Controls. Front Immunol 2018; 9:2230. [PMID: 30364161 PMCID: PMC6192380 DOI: 10.3389/fimmu.2018.02230] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 09/07/2018] [Indexed: 12/30/2022] Open
Abstract
There is increasing evidence for the role of inflammation in schizophrenia, yet the stability of increased peripheral inflammation in acute psychosis and the degree to which peripheral inflammation relates to cortical thickness, a measure of the degree of neuropathology, are unknown. In independent samples, we assessed the peripheral inflammation marker C-reactive protein (CRP) to determine the extent to which: (1) CRP was elevated and stable across admissions for acute psychosis, (2) cognition, daily function and symptom severity are characteristic of chronically ill patients with schizophrenia displaying elevated CRP, and (3) CRP levels predict cortical thickness. Study 1 assessed peripheral CRP (primary outcome) and other blood measures in 174/280 people with acute psychosis while Study 2 assessed peripheral CRP, cognition and cortical thickness (primary outcomes), symptoms, and daily function in 85/97 chronically ill patients with schizophrenia and 71/87 healthy controls. In acute psychosis, CRP and neutrophil-to-lymphocyte ratio were significantly elevated relative to a normal cutoff (with 59.8% of patients having elevated CRP) which remained elevated across admissions. CRP was significantly elevated in 43% of chronically ill patients with schizophrenia compared to 20% in controls. Elevated CRP patients displayed significantly worse working memory and CRP was inversely correlated with cortical thickness in frontal, insula, and temporal brain regions. This work supports the role of inflammation in psychotic illnesses and suggests that use of peripheral markers (e.g., CRP) in conjunction with diagnosis could be used to identify patients with more cortical neuropathology and cognitive deficits.
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Affiliation(s)
- Isabella Jacomb
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia
| | - Clive Stanton
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,Prince of Wales Hospital, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | | | - Hugh Powell
- Prince of Wales Hospital, Randwick, NSW, Australia
| | - Maryanne O'Donnell
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,Prince of Wales Hospital, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | - Rhoshel Lenroot
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,Prince of Wales Hospital, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | - Jason Bruggemann
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
| | - Ryan Balzan
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia.,College of Education, Psychology and Social Work, Flinders University, Adelaide, SA, Australia
| | - Cherrie Galletly
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia.,Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Dennis Liu
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia.,Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Cynthia S Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia.,Department of Neuroscience and Physiology, Upstate Medical University, Syracuse, NY, United States
| | - Thomas W Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, NSW, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
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67
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Beydoun MA, Dore GA, Canas JA, Liang H, Beydoun HA, Evans MK, Zonderman AB. Systemic Inflammation Is Associated With Longitudinal Changes in Cognitive Performance Among Urban Adults. Front Aging Neurosci 2018; 10:313. [PMID: 30356710 PMCID: PMC6189312 DOI: 10.3389/fnagi.2018.00313] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 09/18/2018] [Indexed: 01/07/2023] Open
Abstract
Objectives/Background: Systemic inflammation can affect cognitive performance over time. The current study examined associations between systemic inflammation and cognitive performance among African Americans and Whites urban adults, stratifying by sex, and age group and by race. Patients/Methods: Among 1,555-1,719 White and African-American urban adults [Agebase: 30-64y, 2004-2013, mean±SD follow-up time(y): 4.64 ± 0.93y], conducted linear mixed-effects regression models were conducted to test associations of inflammatory markers [C-reactive protein, Erythrocyte Sedimentation Rate (ESR), albumin, iron, and an inflammation composite score (ICS)] with longitudinal cognitive performance. Results: Among key findings, CRP was linked to poorer baseline mental status among younger women (≤50y, γ01 = -0.03 ± 0.01, p = 0.002) and poorer attention in older women (>50y, γ01 = -0.024 ± 0.007, p < 0.004) and African-Americans (γ01 = -0.029 ± 0.008, p < 0.001). ESR was related to faster decline on verbal memory among older men (>50y, γ11 = -0.008 ± 0.003, P = 0.009); with poorer performance on attention tests overall (γ01 = -0.010 ± 0.003, P = 0.003) and among African-Americans (γ01 = -0.013 ± 0.004, P = 0.002); on verbal fluency among older women (>50y,γ01 = -0.037 ± 0.013, P = 0.004) and on executive function: overall (γ01 = +0.62 ± 0.21, P = 0.004), older men (>50y, γ01 = +1.69 ± 0.53, P = 0.001) and African-Americans (γ01 = +0.84 ± 0.28, P = 0.002). Albumin was linked to slower attention decline among older men (>50y, γ11 = +0.329 ± 0.103, P = 0.009), over-time improvement in executive function overall (γ11 = -6.00 ± 2.26, P = 0.008), and better baseline psychomotor speed among African-Americans (γ01 = +0.56 ± 0.19, P = 0.003). Finally, ICS predicted faster decline on visual memory/visuo-constructive abilities among older men (>50y, γ11 = +0.17 ± 0.06, p = 0.003). Conclusion: In sum, strong associations between systemic inflammation and longitudinal cognitive performance were detected, largely among older individuals (>50y) and African-Americans. Randomized trials targeting inflammation are warranted.
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Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging (NIA), National Institutes of Health Intramural Research Program, Baltimore, MD, United States
| | - Gregory A Dore
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging (NIA), National Institutes of Health Intramural Research Program, Baltimore, MD, United States
| | - Jose-Atilio Canas
- Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States
| | - Hailun Liang
- Institute on Social Welfare, Renmin University of China, Beijing, China
| | - Hind A Beydoun
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Michele K Evans
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging (NIA), National Institutes of Health Intramural Research Program, Baltimore, MD, United States
| | - Alan B Zonderman
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging (NIA), National Institutes of Health Intramural Research Program, Baltimore, MD, United States
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68
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Loprinzi PD, Frith E. Obesity and episodic memory function. J Physiol Sci 2018; 68:321-331. [PMID: 29667132 PMCID: PMC10717800 DOI: 10.1007/s12576-018-0612-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 04/10/2018] [Indexed: 12/30/2022]
Abstract
Obesity-related lifestyle factors, such as physical activity behavior and dietary intake, have been shown to be associated with episodic memory function. From animal work, there is considerable biological plausibility linking obesity with worse memory function. There are no published systematic reviews evaluating the effects of obesity on episodic memory function among humans, and examining whether physical activity and diet influences this obesity-memory link. Thus, the purpose of this systematic review was to evaluate the totality of research examining whether obesity is associated with episodic memory function, and whether physical activity and dietary behavior confounds this relationship. A review approach was employed, using PubMed, PsychInfo, and Sports Discus databases. Fourteen studies met our criteria. Among these 14 reviewed studies, eight were cross-sectional, four were prospective, and two employed a randomized controlled experimental design. Twelve of the 14 studies did not take into consideration dietary behavior in their analysis, and similarly, nine of the 14 studies did not take into consideration participant physical activity behavior. Among the 14 studies, ten found an inverse association of weight status on memory function, but for one of these studies, this association was attenuated after controlling for physical activity. Among the 14 evaluated studies, four did not find a direct effect of weight status on memory. Among the four null studies, one, however, found an indirect effect of BMI on episodic memory and another found a moderation effect of BMI and age on memory function. It appears that obesity may be associated with worse memory function, with the underlying mechanisms discussed herein. At this point, it is uncertain whether adiposity, itself, is influencing memory changes, or rather, whether adiposity-related lifestyle behaviors (e.g., physical inactivity and diet) are driving the obesity-memory relationship.
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Affiliation(s)
- Paul D Loprinzi
- Exercise Psychology Laboratory, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA.
| | - Emily Frith
- Exercise Psychology Laboratory, Physical Activity Epidemiology Laboratory, Department of Health, Exercise Science and Recreation Management, The University of Mississippi, University, MS, 38677, USA
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69
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Watson E, Ding D, Khattar NK, Everhart DE, James RF. Neurocognitive outcomes after aneurysmal subarachnoid hemorrhage: Identifying inflammatory biomarkers. J Neurol Sci 2018; 394:84-93. [PMID: 30240942 DOI: 10.1016/j.jns.2018.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 06/21/2018] [Accepted: 06/24/2018] [Indexed: 12/19/2022]
Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) is a severe type of stroke which carries a high case-fatality rate. Those who survive the ictus of aneurysm rupture harbor substantial risks of neurological morbidity, functional disability, and cognitive dysfunction. Although the pervasiveness of cognitive impairment is widely acknowledged as a long-term sequela of aSAH, the mechanisms underlying its development are poorly understood. The onset of aSAH elicits activation of the inflammatory cascade, and ongoing neuroinflammation is suspected to contribute to secondary complications, such as vasospasm and delayed cerebral ischemia. In this review, we analyze the extant literature regarding the relationship between neuroinflammation and cognitive dysfunction after aSAH. Pro-inflammatory cytokines appear to play a role in maintaining normal cognitive function in adults unaffected by aSAH. However, in the setting of aSAH, elevated cytokine levels may correlate with worse neuropsychological outcomes. This seemingly dichotomous relationship between neuroinflammation and cognition suggests that the action of cytokines varies, depending on their physiologic environment. Experimental therapies which suppress the immune response to aSAH appear to have a beneficial effect on cognitive outcomes. However, further studies are necessary to determine the utility of inflammatory mediators as biomarkers of neurocognitive outcomes, as well as their role in the management of aSAH.
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Affiliation(s)
- Eric Watson
- Icahn School of Medicine at Mount Sinai, Department of Rehabilitation Medicine, 1 Gustave L. Levy Place, New York, NY 10029, United States
| | - Dale Ding
- Department of Neurosurgery, University of Louisville School of Medicine, 220 Abraham Flexner Way, Suite 1500, Louisville, KY 40202, United States
| | - Nicolas K Khattar
- Department of Neurosurgery, University of Louisville School of Medicine, 220 Abraham Flexner Way, Suite 1500, Louisville, KY 40202, United States
| | - D Erik Everhart
- Department of Psychology, East Carolina University, 104 Rawl Building, Greenville, NC 27858, United States
| | - Robert F James
- Department of Neurosurgery, University of Louisville School of Medicine, 220 Abraham Flexner Way, Suite 1500, Louisville, KY 40202, United States.
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70
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Abstract
SIGNIFICANCE Oxidative stress increases in the brain with aging and neurodegenerative diseases. Previous work emphasized irreversible oxidative damage in relation to cognitive impairment. This research has evolved to consider a continuum of alterations, from redox signaling to oxidative damage, which provides a basis for understanding the onset and progression of cognitive impairment. This review provides an update on research linking redox signaling to altered function of neural circuits involved in information processing and memory. Recent Advances: Starting in middle age, redox signaling triggers changes in nervous system physiology described as senescent physiology. Hippocampal senescent physiology involves decreased cell excitability, altered synaptic plasticity, and decreased synaptic transmission. Recent studies indicate N-methyl-d-aspartate and ryanodine receptors and Ca2+ signaling molecules as molecular substrates of redox-mediated senescent physiology. CRITICAL ISSUES We review redox homeostasis mechanisms and consider the chemical character of reactive oxygen and nitrogen species and their role in regulating different transmitter systems. In this regard, senescent physiology may represent the co-opting of pathways normally responsible for feedback regulation of synaptic transmission. Furthermore, differences across transmitter systems may underlie differential vulnerability of brain regions and neuronal circuits to aging and disease. FUTURE DIRECTIONS It will be important to identify the intrinsic mechanisms for the shift in oxidative/reductive processes. Intrinsic mechanism will depend on the transmitter system, oxidative stressors, and expression/activity of antioxidant enzymes. In addition, it will be important to identify how intrinsic processes interact with other aging factors, including changes in inflammatory or hormonal signals. Antioxid. Redox Signal. 28, 1724-1745.
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Affiliation(s)
- Ashok Kumar
- 1 Department of Neuroscience, McKnight Brain Institute, University of Florida , Gainesville, Florida
| | - Brittney Yegla
- 1 Department of Neuroscience, McKnight Brain Institute, University of Florida , Gainesville, Florida
| | - Thomas C Foster
- 1 Department of Neuroscience, McKnight Brain Institute, University of Florida , Gainesville, Florida.,2 Genetics and Genomics Program, Genetics Institute, University of Florida , Gainesville, Florida
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71
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Corlier F, Hafzalla G, Faskowitz J, Kuller LH, Becker JT, Lopez OL, Thompson PM, Braskie MN. Systemic inflammation as a predictor of brain aging: Contributions of physical activity, metabolic risk, and genetic risk. Neuroimage 2018; 172:118-129. [PMID: 29357308 PMCID: PMC5954991 DOI: 10.1016/j.neuroimage.2017.12.027] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 12/01/2017] [Accepted: 12/11/2017] [Indexed: 12/17/2022] Open
Abstract
Inflammatory processes may contribute to risk for Alzheimer's disease (AD) and age-related brain degeneration. Metabolic and genetic risk factors, and physical activity may, in turn, influence these inflammatory processes. Some of these risk factors are modifiable, and interact with each other. Understanding how these processes together relate to brain aging will help to inform future interventions to treat or prevent cognitive decline. We used brain magnetic resonance imaging (MRI) to scan 335 older adult humans (mean age 77.3 ± 3.4 years) who remained non-demented for the duration of the 9-year longitudinal study. We used structural equation modeling (SEM) in a subset of 226 adults to evaluate whether measures of baseline peripheral inflammation (serum C-reactive protein levels; CRP), mediated the baseline contributions of genetic and metabolic risk, and physical activity, to regional cortical thickness in AD-relevant brain regions at study year 9. We found that both baseline metabolic risk and AD risk variant apolipoprotein E ε4 (APOE4), modulated baseline serum CRP. Higher baseline CRP levels, in turn, predicted thinner regional cortex at year 9, and mediated an effect between higher metabolic risk and thinner cortex in those regions. A higher polygenic risk score composed of variants in immune-associated AD risk genes (other than APOE) was associated with thinner regional cortex. However, CRP levels did not mediate this effect, suggesting that other mechanisms may be responsible for the elevated AD risk. We found interactions between genetic and environmental factors and structural brain health. Our findings support the role of metabolic risk and peripheral inflammation in age-related brain decline.
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Affiliation(s)
- Fabian Corlier
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - George Hafzalla
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - Joshua Faskowitz
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA
| | - Lewis H Kuller
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - James T Becker
- Departments of Neurology, Psychiatry, and Psychology, University of Pittsburgh, Pittsburgh, PA 15139, USA
| | - Oscar L Lopez
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Paul M Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA; Depts. of Neurology, Psychiatry, Engineering, Radiology, & Ophthalmology, Keck/USC School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Meredith N Braskie
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA 90292, USA.
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Reddan JM, White DJ, Macpherson H, Scholey A, Pipingas A. Glycerophospholipid Supplementation as a Potential Intervention for Supporting Cerebral Structure in Older Adults. Front Aging Neurosci 2018; 10:49. [PMID: 29563868 PMCID: PMC5845902 DOI: 10.3389/fnagi.2018.00049] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 02/15/2018] [Indexed: 01/13/2023] Open
Abstract
Modifying nutritional intake through supplementation may be efficacious for altering the trajectory of cerebral structural decline evident with increasing age. To date, there have been a number of clinical trials in older adults whereby chronic supplementation with B vitamins, omega-3 fatty acids, or resveratrol, has been observed to either slow the rate of decline or repair cerebral tissue. There is also some evidence from animal studies indicating that supplementation with glycerophospholipids (GPL) may benefit cerebral structure, though these effects have not yet been investigated in adult humans. Despite this paucity of research, there are a number of factors predicting poorer cerebral structure in older humans, which GPL supplementation appears to beneficially modify or protect against. These include elevated concentrations of homocysteine, unbalanced activity of reactive oxygen species both increasing the risk of oxidative stress, increased concentrations of pro-inflammatory messengers, as well as poorer cardio- and cerebrovascular function. As such, it is hypothesized that GPL supplementation will support cerebral structure in older adults. These cerebral effects may influence cognitive function. The current review aims to provide a theoretical basis for future clinical trials investigating the effects of GPL supplementation on cerebral structural integrity in older adults.
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Affiliation(s)
- Jeffery M Reddan
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - David J White
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Helen Macpherson
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, VIC, Australia
| | - Andrew Scholey
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Andrew Pipingas
- Centre for Human Psychopharmacology, Swinburne University of Technology, Melbourne, VIC, Australia
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Abstract
OBJECTIVE To examine whether changes in memory over a 10-year period could predict a change in C-reactive protein (CRP) levels. METHOD A mixed model analysis was first conducted to obtain the estimates for change in memory over the 10-year period using data from the Health and Retirement Study. Then a multivariate regression to determine whether a change in episodic memory could predict subsequent CRP levels was conducted. Furthermore, a general linear model was conducted to determine differences in CRP levels among different rates of change in episodic memory. RESULTS Greater declines in episodic memory were associated with higher levels of subsequent CRP (Estimate = -0.32, SE = 0.12, β = -.03, p = .008). The general linear model revealed that those with greater memory declines were more likely to have higher levels of CRP, F = 26.50, p < .001. DISCUSSION These results highlight the notion that memory decline and inflammation may be intertwined, and we discuss various avenues that warrant further investigation.
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Affiliation(s)
| | - Ross Andel
- 1 University of South Florida, Tampa, USA.,2 St. Anne's University Hospital Brno, Czech Republic
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Perry DC, Brown JA, Possin KL, Datta S, Trujillo A, Radke A, Karydas A, Kornak J, Sias AC, Rabinovici GD, Gorno-Tempini ML, Boxer AL, De May M, Rankin KP, Sturm VE, Lee SE, Matthews BR, Kao AW, Vossel KA, Tartaglia MC, Miller ZA, Seo SW, Sidhu M, Gaus SE, Nana AL, Vargas JNS, Hwang JHL, Ossenkoppele R, Brown AB, Huang EJ, Coppola G, Rosen HJ, Geschwind D, Trojanowski JQ, Grinberg LT, Kramer JH, Miller BL, Seeley WW. Clinicopathological correlations in behavioural variant frontotemporal dementia. Brain 2017; 140:3329-3345. [PMID: 29053860 PMCID: PMC5841140 DOI: 10.1093/brain/awx254] [Citation(s) in RCA: 213] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/27/2017] [Accepted: 08/07/2017] [Indexed: 12/12/2022] Open
Abstract
Accurately predicting the underlying neuropathological diagnosis in patients with behavioural variant frontotemporal dementia (bvFTD) poses a daunting challenge for clinicians but will be critical for the success of disease-modifying therapies. We sought to improve pathological prediction by exploring clinicopathological correlations in a large bvFTD cohort. Among 438 patients in whom bvFTD was either the top or an alternative possible clinical diagnosis, 117 had available autopsy data, including 98 with a primary pathological diagnosis of frontotemporal lobar degeneration (FTLD), 15 with Alzheimer's disease, and four with amyotrophic lateral sclerosis who lacked neurodegenerative disease-related pathology outside of the motor system. Patients with FTLD were distributed between FTLD-tau (34 patients: 10 corticobasal degeneration, nine progressive supranuclear palsy, eight Pick's disease, three frontotemporal dementia with parkinsonism associated with chromosome 17, three unclassifiable tauopathy, and one argyrophilic grain disease); FTLD-TDP (55 patients: nine type A including one with motor neuron disease, 27 type B including 21 with motor neuron disease, eight type C with right temporal lobe presentations, and 11 unclassifiable including eight with motor neuron disease), FTLD-FUS (eight patients), and one patient with FTLD-ubiquitin proteasome system positive inclusions (FTLD-UPS) that stained negatively for tau, TDP-43, and FUS. Alzheimer's disease was uncommon (6%) among patients whose only top diagnosis during follow-up was bvFTD. Seventy-nine per cent of FTLD-tau, 86% of FTLD-TDP, and 88% of FTLD-FUS met at least 'possible' bvFTD diagnostic criteria at first presentation. The frequency of the six core bvFTD diagnostic features was similar in FTLD-tau and FTLD-TDP, suggesting that these features alone cannot be used to separate patients by major molecular class. Voxel-based morphometry revealed that nearly all pathological subgroups and even individual patients share atrophy in anterior cingulate, frontoinsula, striatum, and amygdala, indicating that degeneration of these regions is intimately linked to the behavioural syndrome produced by these diverse aetiologies. In addition to these unifying features, symptom profiles also differed among pathological subtypes, suggesting distinct anatomical vulnerabilities and informing a clinician's prediction of pathological diagnosis. Data-driven classification into one of the 10 most common pathological diagnoses was most accurate (up to 60.2%) when using a combination of known predictive factors (genetic mutations, motor features, or striking atrophy patterns) and the results of a discriminant function analysis that incorporated clinical, neuroimaging, and neuropsychological data.
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Affiliation(s)
- David C Perry
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jesse A Brown
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine L Possin
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Samir Datta
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Andrew Trujillo
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Anneliese Radke
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- University of California Davis, Davis, CA, USA
| | - Anna Karydas
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Ana C Sias
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Gil D Rabinovici
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Maria Luisa Gorno-Tempini
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Adam L Boxer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Mary De May
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Katherine P Rankin
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Virginia E Sturm
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Suzee E Lee
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Brandy R Matthews
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aimee W Kao
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Keith A Vossel
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, University of Minnesota, Minneapolis, MN, USA
| | - Maria Carmela Tartaglia
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Canada
| | - Zachary A Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Sang Won Seo
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Manu Sidhu
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Stephanie E Gaus
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Alissa L Nana
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Jose Norberto S Vargas
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Ji-Hye L Hwang
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Rik Ossenkoppele
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Neurology and Alzheimer Center, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Alainna B Brown
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- University of Washington School of Medicine, Seattle, WA, USA
| | - Eric J Huang
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Giovanni Coppola
- Neurogenetics program, Department of Neurology, and Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Howard J Rosen
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Daniel Geschwind
- Neurogenetics program, Department of Neurology, and Semel Institute for Neuroscience and Human Behaviour, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lea T Grinberg
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Joel H Kramer
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L Miller
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - William W Seeley
- Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Department of Pathology and Laboratory Medicine, University of California, San Francisco, San Francisco, CA, USA
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75
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Walker KA, Hoogeveen RC, Folsom AR, Ballantyne CM, Knopman DS, Windham BG, Jack CR, Gottesman RF. Midlife systemic inflammatory markers are associated with late-life brain volume: The ARIC study. Neurology 2017; 89:2262-2270. [PMID: 29093073 PMCID: PMC5705246 DOI: 10.1212/wnl.0000000000004688] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/08/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To clarify the temporal relationship between systemic inflammation and neurodegeneration, we examined whether a higher level of circulating inflammatory markers during midlife was associated with smaller brain volumes in late life using a large biracial prospective cohort study. METHODS Plasma levels of systemic inflammatory markers (fibrinogen, albumin, white blood cell count, von Willebrand factor, and Factor VIII) were assessed at baseline in 1,633 participants (mean age 53 [5] years, 60% female, 27% African American) enrolled in the Atherosclerosis Risk in Communities Study. Using all 5 inflammatory markers, an inflammation composite score was created for each participant. We assessed episodic memory and regional brain volumes, using 3T MRI, 24 years later. RESULTS Each SD increase in midlife inflammation composite score was associated with 1,788 mm3 greater ventricular (p = 0.013), 110 mm3 smaller hippocampal (p = 0.013), 519 mm3 smaller occipital (p = 0.009), and 532 mm3 smaller Alzheimer disease signature region (p = 0.008) volumes, and reduced episodic memory (p = 0.046) 24 years later. Compared to participants with no elevated (4th quartile) midlife inflammatory markers, participants with elevations in 3 or more markers had, on average, 5% smaller hippocampal and Alzheimer disease signature region volumes. The association between midlife inflammation and late-life brain volume was modified by age and race, whereby younger participants and white participants with higher levels of systemic inflammation during midlife were more likely to show reduced brain volumes subsequently. CONCLUSIONS Our prospective findings provide evidence for what may be an early contributory role of systemic inflammation in neurodegeneration and cognitive aging.
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Affiliation(s)
- Keenan A Walker
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson.
| | - Ron C Hoogeveen
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - Aaron R Folsom
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - Christie M Ballantyne
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - David S Knopman
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - B Gwen Windham
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - Clifford R Jack
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
| | - Rebecca F Gottesman
- From the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Section of Cardiology (R.C.H., C.M.B.), Baylor College of Medicine; Center for Cardiovascular Disease Prevention (R.C.H., C.M.B.), Houston Methodist DeBakey Heart and Vascular Center, TX; Division of Epidemiology and Community Health (A.R.F.), School of Public Health, University of Minnesota, Minneapolis; Departments of Neurology (D.S.K.) and Radiology (C.R.J.), Mayo Clinic, Rochester, MN; and Department of Medicine (B.G.W.), University of Mississippi Medical Center, Jackson
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76
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Tsai CL, Huang TH, Tsai MC. Neurocognitive performances of visuospatial attention and the correlations with metabolic and inflammatory biomarkers in adults with obesity. Exp Physiol 2017; 102:1683-1699. [DOI: 10.1113/ep086624] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 09/26/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies; National Cheng Kung University; Tainan Taiwan
| | - Tsang-Hai Huang
- Institute of Physical Education, Health and Leisure Studies; National Cheng Kung University; Tainan Taiwan
| | - Meng-Che Tsai
- Division of Genetics, Endocrinology and Metabolism, Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine; National Cheng Kung University; Tainan Taiwan
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77
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Sha SJ, Miller ZA, Min SW, Zhou Y, Brown J, Mitic LL, Karydas A, Koestler M, Tsai R, Corbetta-Rastelli C, Lin S, Hare E, Fields S, Fleischmann KE, Powers R, Fitch R, Martens LH, Shamloo M, Fagan AM, Farese RV, Pearlman R, Seeley W, Miller BL, Gan L, Boxer AL. An 8-week, open-label, dose-finding study of nimodipine for the treatment of progranulin insufficiency from GRN gene mutations. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2017; 3:507-512. [PMID: 29124108 PMCID: PMC5671622 DOI: 10.1016/j.trci.2017.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Frontotemporal lobar degeneration-causing mutations in the progranulin (GRN) gene reduce progranulin protein (PGRN) levels, suggesting that restoring PGRN in mutation carriers may be therapeutic. Nimodipine, a Food and Drug Administration-approved blood-brain barrier-penetrant calcium channel blocker, increased PGRN levels in PGRN-deficient murine models. We sought to assess safety and tolerability of oral nimodipine in human GRN mutation carriers. METHODS We performed an open-label, 8-week, dose-finding, phase 1 clinical trial in eight GRN mutation carriers to assess the safety and tolerability of nimodipine and assayed fluid and radiologic markers to investigate therapeutic endpoints. RESULTS There were no serious adverse events; however, PGRN concentrations (cerebrospinal fluid and plasma) did not change significantly following treatment (percent changes of -5.2 ± 10.9% in plasma and -10.2 ± 7.8% in cerebrospinal fluid). Measurable atrophy within the left middle frontal gyrus was observed over an 8-week period. DISCUSSION While well tolerated, nimodipine treatment did not alter PGRN concentrations or secondary outcomes.
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Affiliation(s)
- Sharon J. Sha
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Zachary A. Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Sang-won Min
- Gladstone Institute of Neurodegenerative Disease, San Francisco, CA
| | - Yungui Zhou
- Gladstone Institute of Neurodegenerative Disease, San Francisco, CA
| | - Jesse Brown
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Laura L. Mitic
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
- Bluefield Project to Cure Frontotemporal Dementia, San Francisco, CA
| | - Anna Karydas
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Mary Koestler
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Richard Tsai
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Chiara Corbetta-Rastelli
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Sophie Lin
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Emma Hare
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Scott Fields
- Investigational Drug Service, UCSF Medical Center, San Francisco, CA
| | | | - Ryan Powers
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Ryan Fitch
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | | | - Mehrdad Shamloo
- Institute for Neuro-Innovation and Translational Neurosciences, Stanford, CA
| | - Anne M. Fagan
- Alzheimer's Disease Research Center, Washington University School of Medicine, St. Louis, MO
| | - Robert V. Farese
- Gladstone Institute of Cardiovascular Disease, San Francisco, CA
| | - Rodney Pearlman
- Bluefield Project to Cure Frontotemporal Dementia, San Francisco, CA
| | - William Seeley
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
| | - Li Gan
- Gladstone Institute of Neurodegenerative Disease, San Francisco, CA
| | - Adam L. Boxer
- Memory and Aging Center, Department of Neurology, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA
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Gu Y, Vorburger R, Scarmeas N, Luchsinger JA, Manly JJ, Schupf N, Mayeux R, Brickman AM. Circulating inflammatory biomarkers in relation to brain structural measurements in a non-demented elderly population. Brain Behav Immun 2017; 65:150-160. [PMID: 28457809 PMCID: PMC5537030 DOI: 10.1016/j.bbi.2017.04.022] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022] Open
Abstract
The aim of this investigation was to determine whether circulating inflammatory biomarkers c-reactive protein (CRP), interleukin-6 (IL6), and alpha 1-antichymotrypsin (ACT) were related to structural brain measures assessed by magnetic resonance imaging (MRI). High-resolution structural MRI was collected on 680 non-demented elderly (mean age 80.1years) participants of a community-based, multiethnic cohort. Approximately three quarters of these participants also had peripheral inflammatory biomarkers (CRP, IL6, and ACT) measured using ELISA. Structural measures including brain volumes and cortical thickness (with both global and regional measures) were derived from MRI scans, and repeated MRI measures were obtained after 4.5years. Mean fractional anisotropy was used as the indicator of white matter integrity assessed with diffusion tensor imaging. We examined the association of inflammatory biomarkers with brain volume, cortical thickness, and white matter integrity using regression models adjusted for age, gender, ethnicity, education, APOE genotype, and intracranial volume. A doubling in CRP (b=-2.48, p=0.002) was associated with a smaller total gray matter volume, equivalent to approximately 1.5years of aging. A doubling in IL6 was associated with smaller total brain volume (b=-14.96, p<0.0001), equivalent to approximately 9years of aging. Higher IL6 was also associated with smaller gray matter (b=-6.52, p=0.002) and white matter volumes (b=-7.47, p=0.004). The volumes of most cortical regions including frontal, occipital, parietal, temporal, as well as subcortical regions including pallidum and thalamus were associated with IL6. In a model additionally adjusted for depression, vascular factors, BMI, and smoking status, the association between IL6 and brain volumes remained, and a doubling in ACT was marginally associated with 0.054 (p=0.001) millimeter thinner mean cortical thickness, equivalent to that of approximately 2.7years of aging. None of the biomarkers was associated with mean fractional anisotropy or longitudinal change of brain volumes and thickness. Among older adults, increased circulating inflammatory biomarkers were associated with smaller brain volume and cortical thickness but not the white matter tract integrity. Our preliminary findings suggest that peripheral inflammatory processes may be involved in the brain atrophy in the elderly.
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Affiliation(s)
- Yian Gu
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, United States; The Department of Neurology, Columbia University, New York, NY, United States.
| | - Robert Vorburger
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY
| | - Nikolaos Scarmeas
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,The Gertrude H. Sergievsky Center, Columbia University, New York, NY,National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - José A. Luchsinger
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY,The Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY
| | - Jennifer J. Manly
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,The Gertrude H. Sergievsky Center, Columbia University, New York, NY
| | - Nicole Schupf
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,The Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY
| | - Richard Mayeux
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,The Gertrude H. Sergievsky Center, Columbia University, New York, NY,The Department of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY
| | - Adam M. Brickman
- The Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY,The Department of Neurology, Columbia University, New York, NY,The Gertrude H. Sergievsky Center, Columbia University, New York, NY
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79
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A systematic review on the association between inflammatory genes and cognitive decline in non-demented elderly individuals. Eur Neuropsychopharmacol 2017; 27:568-588. [PMID: 26718789 DOI: 10.1016/j.euroneuro.2015.12.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/27/2015] [Accepted: 12/01/2015] [Indexed: 01/15/2023]
Abstract
Cognitive impairment, or decline, is not only a feature of Alzheimer׳s disease and other forms of dementia but also normal ageing. Abundant evidence from epidemiological studies points towards perturbed inflammatory mechanisms in aged individuals, though the cause-effect nature of this apparent relationship is difficult to establish. Genetic association studies focusing on polymorphism in and around inflammatory genes represent a viable approach to establish whether inflammatory mechanisms might play a causal role in cognitive decline, whilst also enabling the identification of specific genes potentially influencing specific cognitive facets. Thus, here we provide a review of published genetic association studies investigating inflammatory genes in the context of cognitive decline in elderly, non-demented, samples. Numerous candidate gene association studies have been performed to date, focusing almost exclusively on genes encoding major cytokines. Some of these studies report significant cognitive domain-specific associations implicating Interleukin 1β (IL1β) (rs16944), Tumour Necrosis Factor α (TNFα) (rs1800629) and C-reactive protein (CRP) in various domains of cognitive function. However, the majority of these studies are lacking in statistical power and have other methodological limitations, suggesting some of them may have yielded false positive results. Genome-wide association studies have implicated less direct and less obvious regulators of inflammatory processes (i.e., PDE7A, HS3ST4, SPOCK3), indicating that a shift away from the major cytokine-encoding genes in future studies will be important. Furthermore, better cohesion across studies with regards to the cognitive test batteries administered to participants along with the continued application of longitudinal designs will be vital.
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80
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Santos-Santos MA, Mandelli ML, Binney RJ, Ogar J, Wilson SM, Henry ML, Hubbard HI, Meese M, Attygalle S, Rosenberg L, Pakvasa M, Trojanowski JQ, Grinberg LT, Rosen H, Boxer AL, Miller BL, Seeley WW, Gorno-Tempini ML. Features of Patients With Nonfluent/Agrammatic Primary Progressive Aphasia With Underlying Progressive Supranuclear Palsy Pathology or Corticobasal Degeneration. JAMA Neurol 2017; 73:733-42. [PMID: 27111692 DOI: 10.1001/jamaneurol.2016.0412] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE We provide novel evidence of specific clinical and neuroimaging features that may help for the in vivo prediction of underlying pathology in patients with nonfluent/agrammatic primary progressive aphasia (nfvPPA) and progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD) proved by autopsy. OBJECTIVE To characterize the neurological, cognitive, and neuroimaging features of patients with nfvPPA-in whom either PSP or CBD was eventually confirmed at autopsy-at initial presentation and at 1-year follow-up. DESIGN, SETTING, AND PARTICIPANTS A prospective longitudinal clinical-pathological study was conducted in a tertiary research clinic that specialized in cognitive disorders. Fourteen patients were evaluated between January 2002 and December 2014. Inclusion criteria for the study were a clinical diagnosis of nfvPPA; the availability of speech, language, and cognitive testing for at least 1 evaluation; magnetic resonance imaging within 6 months of initial evaluation; and a postmortem pathological diagnosis of PSP or CBD. Ten matched healthy control participants were also included. MAIN OUTCOMES AND MEASURES Clinical, cognitive, and neuroimaging longitudinal data were analyzed to characterize the whole nfvPPA-4-repeat-tau group and identify differences between nfvPPA-PSP and nfvPPA-CBD both at presentation and longitudinally. RESULTS Patient groups did not differ significantly in age, sex, or handedness (nfvPPA-PSP group: median [interquartile range (IQR)] age, 74 [67-76] years; 1 of 5 male [20%]; 1 of 5 left-handed [20%]; and nfvPPA-CBD group: mean [IQR] age, 65 [54-81] years; 3 of 9 male [33%]; 0 left-handed). Motor speech impairment and left frontal white matter atrophy were the most prominent common features. At presentation, dysarthria (Motor Speech Examination median [IQR] score: nfvPPA-PSP, 4 [2-7]; nfvPPA-CBD, 0 [0-4]; P = .02), depression (Geriatric Depression Scale median [IQR] score: nfvPPA-PSP, 19 [3-28]; nfvPPA-CBD, 4 [0-16]; P = .04), and relatively selective white matter atrophy were typical of the nfvPPA-PSP group, while greater gray matter atrophy and a trend toward greater sentence comprehension deficits (median [IQR] sentence comprehension correct: nfvPPA-PSP, 98% [80-100]; nfvPPA-CBD, 81% [65-98]; P = .08) were found in the nfvPPA-CBD group. At follow-up after 1 year, we observed no significant differences in any speech or language measures. Furthermore, atrophy in patients with PSP progressed within the subcortical/brainstem motor system generating greater oculomotors deficits and swallowing difficulty; atrophy in patients with CBD spread anteriorly in prefrontal regions consistent with their greater working memory impairment and development of behavioral symptoms. CONCLUSIONS AND RELEVANCE In patients presenting with nfvPPA, presence of early severe dysarthria, relatively selective white matter atrophy at presentation, and a greater rate of change in the brainstem measured by longitudinal imaging may be useful for differentiating underlying PSP from CBD pathology during life.
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Affiliation(s)
| | - Maria Luisa Mandelli
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Richard J Binney
- Department of Communication Sciences and Disorders, Temple University, Philadelphia, Pennsylvania
| | - Jennifer Ogar
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Stephen M Wilson
- Department of Speech, Language, and Hearing Sciences, University of Arizona, Tucson
| | - Maya L Henry
- Department of Communication Sciences and Disorders, University of Texas, Austin
| | - H Isabel Hubbard
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Minerva Meese
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Suneth Attygalle
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Lynne Rosenberg
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Mikhail Pakvasa
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - John Q Trojanowski
- Center for Neurodegenerative Disease Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Lea T Grinberg
- Department of Neurology, Memory Aging Center, University of California, San Francisco6Department of Pathology, University of California, San Francisco
| | - Howie Rosen
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Adam L Boxer
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - Bruce L Miller
- Department of Neurology, Memory Aging Center, University of California, San Francisco
| | - William W Seeley
- Department of Neurology, Memory Aging Center, University of California, San Francisco6Department of Pathology, University of California, San Francisco
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81
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Guillemot-Legris O, Muccioli GG. Obesity-Induced Neuroinflammation: Beyond the Hypothalamus. Trends Neurosci 2017; 40:237-253. [DOI: 10.1016/j.tins.2017.02.005] [Citation(s) in RCA: 292] [Impact Index Per Article: 41.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 12/21/2022]
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82
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Kure C, Timmer J, Stough C. The Immunomodulatory Effects of Plant Extracts and Plant Secondary Metabolites on Chronic Neuroinflammation and Cognitive Aging: A Mechanistic and Empirical Review. Front Pharmacol 2017; 8:117. [PMID: 28344556 PMCID: PMC5344987 DOI: 10.3389/fphar.2017.00117] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 02/24/2017] [Indexed: 01/25/2023] Open
Abstract
Advances in healthcare have considerably improved the life expectancy of the human population over the last century and this has brought about new challenges. As we live longer the capacity for cognitive aging increases. Consequently, it has been noted that decline in cognitive performance in the elderly in domains of reasoning, problem solving skills, attention, processing speed, working memory and episodic memory is a significant societal problem. Despite the enormity of this issue there are relatively few interventions for cognitive aging. This may be due to our current state of knowledge on biological factors that underpin cognitive aging. One of the biological contributors to cognitive aging is chronic neuroinflammation. This review will provide an overview of the peripheral and central mechanisms involved in chronic neuroinflammation and how neuroinflammation may be related to age-associated cognitive decline. Plant based extracts including herbal and nutritional supplements with anti-inflammatory properties will be examined in relation to their utility in treating age-related cognitive decline. Plant based extracts in particular offer interesting pharmacological properties that may be quickly utilized to prevent cognitive aging.
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Affiliation(s)
| | | | - Con Stough
- Swinburne Centre for Human Psychopharmacology, Swinburne UniversityHawthorn, VIC, Australia
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83
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Dev SI, Moore RC, Soontornniyomkij B, Achim CL, Jeste DV, Eyler LT. Peripheral inflammation related to lower fMRI activation during a working memory task and resting functional connectivity among older adults: a preliminary study. Int J Geriatr Psychiatry 2017; 32:341-349. [PMID: 27094339 PMCID: PMC5071119 DOI: 10.1002/gps.4482] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Peripheral inflammation has been associated with adverse effects on cognition and brain structure in late life, a process called 'inflammaging.' Identifying biomarkers of preclinical cognitive decline is critical in the development of preventative therapies, and peripheral inflammation may be able to serve as an indicator of cognitive decline. However, little is known regarding the relationship between peripheral inflammation and brain structure and function among older adults. METHODS Twenty-four older adults (mean age = 78) underwent a functional magnetic resonance imaging (fMRI) resting state functional connectivity scan, and a subset (n = 14) completed the n-Back working memory task in the scanner. All participants completed a blood draw, and inflammation was measured with interleukin 6 (IL-6) and C-Reactive Protein (CRP). RESULTS Surprisingly, age was unrelated to measures of inflammation (IL-6, CRP) or brain function (default mode network (DMN) connectivity; working memory performance; blood oxygenation level dependent (BOLD) activation with higher working memory load). However, lower functional connectivity between the left parietal seed and all other DMN regions was associated with higher levels of IL-6 and CRP. Additionally, greater plasma concentration of IL-6 was associated with lower BOLD activation in the left middle frontal gyrus in response to increased working memory load. CONCLUSIONS These preliminary findings support the importance of IL-6 and CRP in brain function among older adults. Frontal and parietal regions may be particularly sensitive to the effects of inflammation. Additionally, these findings provide preliminary evidence of inflammatory contributions to level of neural activity, even after accounting for vascular risk factors.
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Affiliation(s)
- Sheena I. Dev
- Department of Psychiatry, University of California, San Diego,San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
| | - Raeanne C. Moore
- Department of Psychiatry, University of California, San Diego,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA,VA San Diego Healthcare System, San Diego, California
| | | | | | - Dilip V. Jeste
- Department of Psychiatry, University of California, San Diego,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA
| | - Lisa T. Eyler
- Department of Psychiatry, University of California, San Diego,Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA,VA San Diego Healthcare System, San Diego, California
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84
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Bojar I, Gujski M, Pinkas J, Raczkiewicz D, Owoc A, Humeniuk E. Interaction between C-reactive protein and cognitive functions according to APOE gene polymorphism in post-menopausal women. Arch Med Sci 2016; 12:1247-1255. [PMID: 27904515 PMCID: PMC5108386 DOI: 10.5114/aoms.2016.62868] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/20/2016] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION A potential factor increasing the risk of the development of cognitive impairment with age is apolipoprotein E (APOE) ε4 carrier status. A subsequent factor which may increase the risk of development of cognitive impairment at an older age is the concentration of C-reactive protein (CRP). The objective of the study was to examine the relationship between cognitive functions and the concentration of CRP in post-menopausal women who were carriers of particular apolipoprotein E gene (APOE) polymorphisms. MATERIAL AND METHODS A group of 402 women was recruited to the study. The inclusion criteria were: minimum two years after the last menstruation, follicle-stimulating hormone (FSH) concentration 30 U/ml, no dementi signs on Montreal Cognitive Assessment (MoCA). The computerized battery of the Central Nervous System Vital Signs (CNS VS) test was used to diagnose cognitive functions. APOE genotyping was performed by multiplex PCR. The blood plasma CRP levels were determined. Statistical analysis was performed using Statistica software. RESULTS The level of neurocognitive index (NCI) and cognitive functions in post-menopausal women depends on apolipoprotein E gene polymorphism (p < 0.001) and the concentration of CRP (p < 0.05). A negative correlation was found between CRP and NCI (p = 0.018), and the reaction time (p = 0.008) of women with APOE ε2/ε3. A positive correlation was observed between CRP and visual memory (p = 0.025) in women with APOE ε3/ε3, and verbal memory (p = 0.023) in women with APOE ε3/ε4 or ε4/ε4. CONCLUSIONS Apolipoprotein E gene polymorphism may modify the relationship between CRP concentration and cognitive functions in post-menopausal women.
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Affiliation(s)
- Iwona Bojar
- Department for Women Health, Institute of Rural Health, Lublin, Poland
| | - Mariusz Gujski
- Department of Public Health, University of Warsaw, Warsaw, Poland
| | - Jarosław Pinkas
- School of Public Health, Center of Postgraduate Medical Education, Warsaw, Poland
| | - Dorota Raczkiewicz
- Institute of Statistics and Demography, School of Economics, Warsaw, Poland
| | - Alfred Owoc
- Center for Public Health and Health Promotion, Institute of Rural Health, Lublin, Poland
| | - Ewa Humeniuk
- Department of Pathology and Rehabilitation of Speech, Medical University, Lublin, Poland
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Das S, Nanda SK, Bisoi AK, Wadhawan AN. Effect of preoperative statin therapy on early postoperative memory impairment after off-pump coronary artery bypass surgery. Ann Card Anaesth 2016; 19:38-44. [PMID: 26750672 PMCID: PMC4900397 DOI: 10.4103/0971-9784.173018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Context: Frequent incidence of early postoperative memory impairment (POMI) after cardiac surgery remains a concern because of associated morbidity, impaired quality of life, and increased health care cost. Aim: To assess the effect of preoperative statin therapy on POMI in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. Setting and Design: Prospective observational study in a tertiary level hospital.
Methods: Sixty patients aged 45–65 years undergoing OPCAB surgery were allocated into two groups of 30 each. Group A patients were receiving statin and Group B patients were not receiving statins. All patients underwent memory function assessment preoperatively after admission to hospital and on the 6th postoperative day using postgraduate institute memory scale. Statistical Analysis: Appropriate tests were applied with SPSS 20 to compare both groups. The value P < 0.05 was considered statistically significant. Multiple regression analysis was performed with confounding factors to determine the effect on memory impairment. Results: Patients in Group A showed significant postoperative deterioration in 6 of the 10 functions and in Group B showed deterioration in 9 of 10 functions tested compared to preoperative scores. Intergroup comparison detected less POMI in Group A compared to Group B and was statistically significant in 8 memory functions. Multiple regression analysis detected statin as an independent factor in preventing memory impairment. Conclusions: Preoperative statin therapy attenuates the early POMI in patients undergoing OPCAB. Future long-term studies will define the efficacy of statin on POMI.
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Affiliation(s)
- Sambhunath Das
- Department of Cardiac Anaesthesia, All India Institute of Medical Sciences, New Delhi, India
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86
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Bulzacka E, Boyer L, Schürhoff F, Godin O, Berna F, Brunel L, Andrianarisoa M, Aouizerate B, Capdevielle D, Chéreau-Boudet I, Chesnoy-Servanin G, Danion JM, Dubertret C, Dubreucq J, Faget C, Gabayet F, Le Gloahec T, Llorca PM, Mallet J, Misdrahi D, Rey R, Richieri R, Passerieux C, Roux P, Yazbek H, Leboyer M, Fond G. Chronic Peripheral Inflammation is Associated With Cognitive Impairment in Schizophrenia: Results From the Multicentric FACE-SZ Dataset. Schizophr Bull 2016; 42:1290-302. [PMID: 27143795 PMCID: PMC4988740 DOI: 10.1093/schbul/sbw029] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Inflammation, measured by abnormal blood C-reactive protein (CRP) level, has been described in schizophrenia (SZ), being inconsistently related to impaired cognitive functions. The aim of the present study is to investigate cognitive impairment associated with abnormal CRP levels in a large multi-centric sample of community-dwelling SZ patients, using a comprehensive neuropsychological battery. METHOD Three hundred sixty-nine community-dwelling stable SZ subjects (76.2% men, mean age 32.7 y) were included and tested with a comprehensive battery of neuropsychological tests. Abnormal CRP level was defined as >3mg/L. RESULTS Multiple factor analysis revealed that abnormal CRP levels, found in 104 patients (28.2%), were associated with impaired General Intellectual Ability and Abstract Reasoning (aOR = 0.56, 95% CI 0.35-0.90, P = .014), independently of age, sex, education level, psychotic symptomatology, treatments, and addiction comorbidities. Abnormal CRP levels were also associated with the decline of all components of working memory (respectively effect size [ES] = 0.25, P = .033; ES = 0.27, P = .04; ES = 0.33, P = .006; and ES = 0.38, P = .004) and a wide range of other impaired cognitive functions, including memory (ES = 0.26, P = .026), learning abilities (ES = 0.28, P = .035), semantic memory (ES = 0.26, P = .026), mental flexibility (ES = 0.26, P = .044), visual attention (ES = 0.23, P = .004) and speed of processing (ES = 0.23, P = .043). CONCLUSION Our results suggest that abnormal CRP level is associated with cognitive impairment in SZ. Evaluating the effectiveness of neuroprotective anti-inflammatory strategies is needed in order to prevent cognitive impairment in SZ.
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Affiliation(s)
- Ewa Bulzacka
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Laurent Boyer
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Pôle psychiatrie universitaire, CHU Sainte-Marguerite, F-13274 Marseille cedex 09, France
| | - Franck Schürhoff
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Ophélia Godin
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France, INSERM, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, F-75013, Paris, France
| | - Fabrice Berna
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Lore Brunel
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Méja Andrianarisoa
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Bruno Aouizerate
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France;,Inserm, Neurocentre Magendie, Physiopathologie de la Plasticité Neuronale, U862, F-33000 Bordeaux, France
| | - Delphine Capdevielle
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Isabelle Chéreau-Boudet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Gabrielle Chesnoy-Servanin
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39—95 bd Pinel—69678 BRON Cedex, France
| | - Jean-Marie Danion
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, INSERM U1114, Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France
| | - Caroline Dubertret
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - Julien Dubreucq
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Catherine Faget
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Franck Gabayet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Référent de Réhabilitation Psychosociale, CH Alpes Isère, Grenoble, France
| | - Tifenn Le Gloahec
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Pierre-Michel Llorca
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,CMP B, CHU, EA 7280 Faculté de Médecine, Université d’Auvergne, BP 69 63003 Clermont-Ferrand Cedex 1, France
| | - Jasmina Mallet
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,AP-HP, Department of Psychiatry, Louis Mourier Hospital, Colombes, Inserm U894, Université Paris Diderot, Sorbonne Paris Cité, Faculté de médecine, France
| | - David Misdrahi
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Centre Hospitalier Charles Perrens, Université de Bordeaux, F-33076 Bordeaux, France;,CNRS UMR 5287 - Institut de Neurosciences cognitives et intégratives d'Aquitaine (INCIA), Bordeaux, France
| | - Romain Rey
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Université Claude Bernard Lyon 1/Centre Hospitalier Le Vinatier Pole Est BP 300 39—95 bd Pinel—69678 BRON Cedex, France
| | - Raphaëlle Richieri
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Assistance Publique des Hôpitaux de Marseille (AP-HM), pôle universitaire de psychiatrie, Marseille, France
| | - Christine Passerieux
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Paul Roux
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service de psychiatrie d’adulte, Centre Hospitalier de Versailles, UFR des Sciences de la Santé Simone Veil, Université Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Hanan Yazbek
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,Service Universitaire de Psychiatrie Adulte, Hôpital la Colombière, CHRU Montpellier, Université Montpellier 1, Inserm 1061, Montpellier, France
| | - Marion Leboyer
- Fondation FondaMental, RTRS santé mentale, Créteil, France;,INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France
| | - Guillaume Fond
- Fondation FondaMental, RTRS santé mentale, Créteil, France; INSERM U955, Translational Psychiatry Team, Créteil, France, Paris Est University, DHU Pe-PSY, Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, Créteil, France;
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Febo M, Foster TC. Preclinical Magnetic Resonance Imaging and Spectroscopy Studies of Memory, Aging, and Cognitive Decline. Front Aging Neurosci 2016; 8:158. [PMID: 27468264 PMCID: PMC4942756 DOI: 10.3389/fnagi.2016.00158] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/16/2016] [Indexed: 01/14/2023] Open
Abstract
Neuroimaging provides for non-invasive evaluation of brain structure and activity and has been employed to suggest possible mechanisms for cognitive aging in humans. However, these imaging procedures have limits in terms of defining cellular and molecular mechanisms. In contrast, investigations of cognitive aging in animal models have mostly utilized techniques that have offered insight on synaptic, cellular, genetic, and epigenetic mechanisms affecting memory. Studies employing magnetic resonance imaging and spectroscopy (MRI and MRS, respectively) in animal models have emerged as an integrative set of techniques bridging localized cellular/molecular phenomenon and broader in vivo neural network alterations. MRI methods are remarkably suited to longitudinal tracking of cognitive function over extended periods permitting examination of the trajectory of structural or activity related changes. Combined with molecular and electrophysiological tools to selectively drive activity within specific brain regions, recent studies have begun to unlock the meaning of fMRI signals in terms of the role of neural plasticity and types of neural activity that generate the signals. The techniques provide a unique opportunity to causally determine how memory-relevant synaptic activity is processed and how memories may be distributed or reconsolidated over time. The present review summarizes research employing animal MRI and MRS in the study of brain function, structure, and biochemistry, with a particular focus on age-related cognitive decline.
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Affiliation(s)
- Marcelo Febo
- Department of Psychiatry, William L. and Evelyn F. McKnight Brain Institute, University of Florida Gainesville, FL, USA
| | - Thomas C Foster
- Department of Neuroscience, William L. and Evelyn F. McKnight Brain Institute, University of Florida Gainesville, FL, USA
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Maharani A, Tampubolon G. National Economic Development Status May Affect the Association between Central Adiposity and Cognition in Older Adults. PLoS One 2016; 11:e0148406. [PMID: 26863443 PMCID: PMC4749166 DOI: 10.1371/journal.pone.0148406] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/16/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is becoming a global problem, rather than one found only in developed countries. Although recent studies have suggested a detrimental effect of obesity on cognition, studies of the relationship between obesity and cognition among older adults have been limited to developed countries. We aimed to examine the associations between central obesity, as measured by waist circumference, and cognition level in adults aged 50 years and older in England and Indonesia. METHODS We used linear regression models to analyse these associations and multiple imputation to manage missing data. The 2006 English Longitudinal Study of Ageing Wave 3 is the source of data from England, while data from Indonesia is sourced from the 2007 Indonesian Family Life Survey Wave 4. FINDINGS Centrally obese respondents had lower cognition levels than non-centrally obese respondents in England. In contrast, central adiposity had a statistically significant positive association with cognition in Indonesia. Higher levels of education and higher economic status were associated with higher cognitive ability, while age was associated with lower cognition in both countries. Elevated C-reactive protein (CRP) concentrations and smoking behaviour, both linked to higher risk of obesity, were negatively associated with cognitive ability among older adults in England, but they had no statistically significant association with cognition among Indonesians. INTERPRETATION The contradictory findings on obesity and cognition in England and Indonesia not only create a puzzle, but they may also have different policy implications in these countries. Reducing the prevalence of obesity may be the main focus in England and other developed countries to maintain older adults' cognition. However, Indonesia and other developing countries should place more emphasis on education, in addition to continued efforts to tackle the double burden of malnutrition, in order to prevent cognitive impairment among older adults.
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Affiliation(s)
- Asri Maharani
- Medical Faculty, Brawijaya University, Malang, Indonesia
- Cathie Marsh Institute for Social Research, University of Manchester, Humanities Bridgeford Street Building, Oxford Road, Manchester, M13 9PL, United Kingdom
| | - Gindo Tampubolon
- Cathie Marsh Institute for Social Research, University of Manchester, Humanities Bridgeford Street Building, Oxford Road, Manchester, M13 9PL, United Kingdom
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89
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Cognitive Changes during Prolonged Stay at High Altitude and Its Correlation with C-Reactive Protein. PLoS One 2016; 11:e0146290. [PMID: 26731740 PMCID: PMC4701497 DOI: 10.1371/journal.pone.0146290] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/15/2015] [Indexed: 01/05/2023] Open
Abstract
Hypersensitive C-reaction protein (hsCRP) may be a risk factor for cognitive impairment resulting from Alzheimer's disease (AD), stroke, and vascular dementia. This study explored the correlation of peripheral blood hsCRP level with cognitive decline due to high altitude exposure. The study was conducted on 100 male military participants who had never been to high altitude. Cerebral oxygen saturation monitoring, event related potentials (P300, N200) detection, and neurocognitive assessment was performed and total hsCRP, interleukin-6 (IL-6), and homocysteine was estimated at 500 m altitude, 3650 m altitude, 3 day, 1, and 3 month post arriving at the base camp (4400 m), and 1 month after coming back to the 500 m altitude. High altitude increased brain oxygen saturation, prolonged P300 and N200 latencies, injured cognitive functions, and raised plasma hsCRP levels. But they all recovered in varying degrees at 1 and 3 month post arriving at the base camp (4400 m). P300 latencies and hsCRP levels were strongly correlated to cognitive performances. These results suggested that cognitive deterioration occurred during the acute period of exposure to high altitude and may recover probably owning to acclimatization after extended stay at high altitude. Plasma hsCRP is inversely correlated to neurological cognition and it may be a potential biomarker for the prediction of high altitude induced cognitive dysfunction.
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90
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Naasan G, Rabinovici GD, Ghosh P, Elofson JD, Miller BL, Coppola G, Karydas A, Fong J, Perry D, Lee SE, Yokoyama JS, Seeley WW, Kramer JH, Weiner MW, Schuff N, Jagust WJ, Grinberg LT, Pribadi M, Yang Z, Sears R, Klein E, Wojta K, Rosen HJ. Amyloid in dementia associated with familial FTLD: not an innocent bystander. Neurocase 2016; 22:76-83. [PMID: 26040468 PMCID: PMC4662906 DOI: 10.1080/13554794.2015.1046458] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Patients with frontotemporal lobar degeneration (FTLD) can show superimposed amyloid pathology, though the impact of amyloid on the clinical presentation of FTLD is not well characterized. This cross-sectional case-control study compared clinical features, fluorodeoxyglucose-positron emission tomography metabolism and gray matter volume loss in 30 patients with familial FTLD in whom amyloid status was confirmed with autopsy or Pittsburgh compound B-PET. Compared to the amyloid-negative patients, the amyloid-positive patients performed significantly worse on several cognitive tests and showed hypometabolism and volume loss in more temporoparietal regions. Our results suggest that in FTLD amyloid positivity is associated with a more Alzheimer's disease-like pattern of neurodegeneration.
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Affiliation(s)
- Georges Naasan
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Gil D Rabinovici
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Pia Ghosh
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Jonathan D Elofson
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Bruce L Miller
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Giovanni Coppola
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Anna Karydas
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Jamie Fong
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - David Perry
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Suzee E Lee
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Jennifer S Yokoyama
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - William W Seeley
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Joel H Kramer
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Michael W Weiner
- b Department of Radiology , University of California , San Francisco , CA , USA
| | - Norbert Schuff
- b Department of Radiology , University of California , San Francisco , CA , USA
| | - William J Jagust
- c School of Public Health , University of California Berkeley and Lawrence Berkeley National Laboratory , Berkeley , CA , USA
| | - Lea T Grinberg
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
| | - Mochtar Pribadi
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Zhongan Yang
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Renee Sears
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Eric Klein
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Kevin Wojta
- d Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine , University of California , Los Angeles , CA , USA
| | - Howard J Rosen
- a Memory and Aging Center, Department of Neurology , University of California , San Francisco , CA , USA
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Tegeler C, O'Sullivan JL, Bucholtz N, Goldeck D, Pawelec G, Steinhagen-Thiessen E, Demuth I. The inflammatory markers CRP, IL-6, and IL-10 are associated with cognitive function--data from the Berlin Aging Study II. Neurobiol Aging 2015; 38:112-117. [PMID: 26827649 DOI: 10.1016/j.neurobiolaging.2015.10.039] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/20/2015] [Accepted: 10/31/2015] [Indexed: 12/22/2022]
Abstract
Inflammation may be an underlying mechanism in cognitive decline. The present study investigated the relationship between cognitive function and the inflammatory markers C-reactive protein (CRP), interleukin (IL)-6, and IL-10 in a nonclinical sample of elderly adults. Serum levels of CRP, IL-6, and IL-10 were measured in n = 1312 elderly adults (60-85 years, 50.5% females) who underwent comprehensive neuropsychological testing. Multiple linear regression analysis was conducted and adjusted for various demographic and clinical factors. Levels of IL-6, IL-10, and CRP were negatively associated with a composite score of executive function and processing speed, whereas the IL-6 to IL-10 ratio was not predictive for executive function and processing speed. No associations were found between inflammatory markers and verbal episodic memory. These findings suggest a relationship between higher proinflammatory and anti-inflammatory activation of the innate immune system and executive function within the normal range. Further research is needed to examine the relevance of an inflammatory pathway as a potential therapeutic target.
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Affiliation(s)
- Christina Tegeler
- Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Nina Bucholtz
- Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - David Goldeck
- Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Tübingen, Germany
| | - Graham Pawelec
- Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Tübingen, Germany
| | - Elisabeth Steinhagen-Thiessen
- Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Lipid Clinic at the Interdisciplinary Metabolism Center, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ilja Demuth
- Research Group on Geriatrics, Charité-Universitätsmedizin Berlin, Berlin, Germany; Institute of Medical and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
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92
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Schrepf A, Lutgendorf SK, Pyter LM. Pre-treatment effects of peripheral tumors on brain and behavior: neuroinflammatory mechanisms in humans and rodents. Brain Behav Immun 2015; 49:1-17. [PMID: 25958011 PMCID: PMC4567396 DOI: 10.1016/j.bbi.2015.04.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/14/2015] [Accepted: 04/17/2015] [Indexed: 12/12/2022] Open
Abstract
Cancer patients suffer high levels of affective and cognitive disturbances, which have been attributed to diagnosis-related distress, impairment of quality of life, and side effects of primary treatment. An inflammatory microenvironment is also a feature of the vast majority of solid tumors. However, the ability of tumor-associated biological processes to affect the central nervous system (CNS) has only recently been explored in the context of symptoms of depression and cognitive disturbances. In this review, we summarize the burgeoning evidence from rodent cancer models that solid tumors alter neurobiological pathways and subsequent behavioral processes with relevance to affective and cognitive disturbances reported in human cancer populations. We consider, in parallel, the evidence from human clinical cancer research demonstrating that affective and cognitive disturbances are common in some malignancies prior to diagnosis and treatment. We further consider the underlying neurobiological pathways, including altered neuroinflammation, tryptophan metabolism, prostaglandin synthesis and associated neuroanatomical changes, that are most strongly implicated in the rodent literature and supported by analogous evidence from human cancer populations. We focus on the implications of these findings for behavioral researchers and clinicians, with particular emphasis on methodological issues and areas of future research.
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Affiliation(s)
- Andrew Schrepf
- Department of Psychology, University of Iowa, Iowa City, IA 52242, USA
| | - Susan K Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, IA 52242, USA; Departments of Urology and Obstetrics and Gynecology, University of Iowa, Iowa City, IA 52242, USA
| | - Leah M Pyter
- Institute for Behavioral Medicine Research, Departments of Psychiatry and Behavioral Health and Neuroscience, Ohio State University, Columbus, OH 43210, USA.
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93
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Valera E, Masliah E. Combination therapies: The next logical Step for the treatment of synucleinopathies? Mov Disord 2015; 31:225-34. [PMID: 26388203 DOI: 10.1002/mds.26428] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 08/11/2015] [Indexed: 01/13/2023] Open
Abstract
Currently there are no disease-modifying alternatives for the treatment of most neurodegenerative disorders. The available therapies for diseases such as Parkinson's disease (PD), PD dementia (PDD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA), in which the protein alpha-synuclein (α-Syn) accumulates within neurons and glial cells with toxic consequences, are focused on managing the disease symptoms. However, using strategic drug combinations and/or multi-target drugs might increase the treatment efficiency when compared with monotherapies. Synucleinopathies are complex disorders that progress through several stages, and toxic α-Syn aggregates exhibit prion-like behavior spreading from cell to cell. Therefore, it follows that these neurodegenerative disorders might require equally complex therapeutic approaches to obtain significant and long-lasting results. Hypothetically, therapies aimed at reducing α-Syn accumulation and cell-to-cell transfer, such as immunotherapy against α-Syn, could be combined with agents that reduce neuroinflammation with potential synergistic outcomes. Here we review the current evidence supporting this type of approach, suggesting that such rational therapy combinations, together with the use of multi-target drugs, may hold promise as the next logical step for the treatment of synucleinopathies.
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Affiliation(s)
- Elvira Valera
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA
| | - Eliezer Masliah
- Department of Neurosciences, University of California, San Diego, La Jolla, California, USA.,Department of Pathology, University of California, San Diego, La Jolla, California, USA
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94
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Goldstein FC, Zhao L, Steenland K, Levey AI. Inflammation and cognitive functioning in African Americans and Caucasians. Int J Geriatr Psychiatry 2015; 30:934-41. [PMID: 25503371 PMCID: PMC4682666 DOI: 10.1002/gps.4238] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 10/28/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To examine associations between inflammation and cognitive performance in African Americans and Caucasians. METHODS The sample included 59 African Americans and 219 Caucasians ≥ 50 years old who had a baseline visit at the Emory/Georgia Tech Center for Health Discovery and Well Being. Peripheral levels of inflammation (interleukin-6, interleukin-8, C-reactive protein, and tumor necrosis factor-α) were examined in relation to performance on tests of visual processing (Identify the Odd Pattern), attention (Digit Span Forward), visuomotor set shifting (Digit Symbol Substitution), verbal set shifting (Digit Span Backwards), and memory (Recall a Pattern). RESULTS Multiple regression models adjusting for potential demographic and vascular/metabolic confounders were conducted, with markers of inflammation included as either continuous or categorical (quartiles) variables. There were significant interactions between IL-8 and race for the Recall a Pattern (p = .006) and the Digit Symbol Substitution (p = .014) tests. Race-specific analyses (using a continuous variable for IL-8) demonstrated slower response times on the Recall a Pattern and Digit Symbol Substitution tests for African Americans but not for Caucasians. Categorical analyses among African Americans indicated that all of the top three quartiles of IL-8 were associated with slower reaction times on the Recall a Pattern test compared to the lowest quartile, while for Digit Symbol, the highest quartile of IL-8 was associated with the slowest cognitive performance. CONCLUSIONS These preliminary findings suggest a stronger association between IL-8 and cognitive performance in African Americans than Caucasians. This relationship should be further examined in larger samples that are followed over time.
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Affiliation(s)
| | - Liping Zhao
- Department of Environmental and Occupational Health, School of Public Health, Emory University, Atlanta, GA, USA
| | - Kyle Steenland
- Department of Environmental and Occupational Health, School of Public Health, Emory University, Atlanta, GA, USA
| | - Allan I. Levey
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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95
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Marsland AL, Gianaros PJ, Kuan DCH, Sheu LK, Krajina K, Manuck SB. Brain morphology links systemic inflammation to cognitive function in midlife adults. Brain Behav Immun 2015; 48:195-204. [PMID: 25882911 PMCID: PMC4508197 DOI: 10.1016/j.bbi.2015.03.015] [Citation(s) in RCA: 192] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 03/27/2015] [Accepted: 03/28/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Inflammation is linked to cognitive decline in midlife, but the neural basis for this link is unclear. One possibility is that inflammation associates with adverse changes in brain morphology, which accelerates cognitive aging and later dementia risk. Clear evidence is lacking, however, regarding whether inflammation relates to cognition in midlife via changes in brain morphology. Accordingly, the current study examines whether associations of inflammation with cognitive function are mediated by variation in cortical gray matter volume among midlife adults. METHODS Plasma levels of interleukin (IL)-6 and C-reactive protein (CRP), relatively stable markers of peripheral systemic inflammation, were assessed in 408 community volunteers aged 30-54 years. All participants underwent structural neuroimaging to assess global and regional brain morphology and completed neuropsychological tests sensitive to early changes in cognitive function. Measurements of brain morphology (regional tissue volumes and cortical thickness and surface area) were derived using Freesurfer. RESULTS Higher peripheral inflammation was associated with poorer spatial reasoning, short term memory, verbal proficiency, learning and memory, and executive function, as well as lower cortical gray and white matter volumes, hippocampal volume and cortical surface area. Mediation models with age, sex and intracranial volume as covariates showed cortical gray matter volume to partially mediate the association of inflammation with cognitive performance. Exploratory analyses of body mass suggested that adiposity may be a source of the inflammation linking brain morphology to cognition. CONCLUSIONS Inflammation and adiposity might relate to cognitive decline via influences on brain morphology.
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Affiliation(s)
- Anna L. Marsland
- Corresponding Author: All correspondence concerning this manuscript should be addressed to Anna L. Marsland, Behavioral Immunology Laboratory, Department of Psychology, 3943 O’Hara Street, Pittsburgh, PA 15260 Telephone: (412) 624-4530; FAX: (412) 624-9108;
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96
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Layé S, Madore C, St-Amour I, Delpech JC, Joffre C, Nadjar A, Calon F. N-3 polyunsaturated fatty acid and neuroinflammation in aging and Alzheimer’s disease. ACTA ACUST UNITED AC 2015. [DOI: 10.3233/nua-150049] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Sophie Layé
- Nutrition et Neurobiologie Intégrée, Bordeaux Cedex, France
- University of Bordeaux, Bordeaux, France
- OptiNutriBrain International associated Laboratory (NutriNeuro France-INAF Canada)
| | - Charlotte Madore
- Nutrition et Neurobiologie Intégrée, Bordeaux Cedex, France
- University of Bordeaux, Bordeaux, France
| | - Isabelle St-Amour
- Faculté de Pharmacie, Université Laval; Centre de Recherche du CHU de Québec, Québec, Canada
| | - Jean-Christophe Delpech
- Nutrition et Neurobiologie Intégrée, Bordeaux Cedex, France
- University of Bordeaux, Bordeaux, France
| | - Corinne Joffre
- Nutrition et Neurobiologie Intégrée, Bordeaux Cedex, France
- University of Bordeaux, Bordeaux, France
- OptiNutriBrain International associated Laboratory (NutriNeuro France-INAF Canada)
| | - Agnès Nadjar
- Nutrition et Neurobiologie Intégrée, Bordeaux Cedex, France
- University of Bordeaux, Bordeaux, France
- OptiNutriBrain International associated Laboratory (NutriNeuro France-INAF Canada)
| | - Frédéric Calon
- Faculté de Pharmacie, Université Laval; Centre de Recherche du CHU de Québec, Québec, Canada
- OptiNutriBrain International associated Laboratory (NutriNeuro France-INAF Canada)
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97
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Sha SJ, Ghosh PM, Lee SE, Corbetta-Rastelli C, Jagust WJ, Kornak J, Rankin KP, Grinberg LT, Vinters HV, Mendez MF, Dickson DW, Seeley WW, Gorno-Tempini M, Kramer J, Miller BL, Boxer AL, Rabinovici GD. Predicting amyloid status in corticobasal syndrome using modified clinical criteria, magnetic resonance imaging and fluorodeoxyglucose positron emission tomography. ALZHEIMERS RESEARCH & THERAPY 2015; 7:8. [PMID: 25733984 PMCID: PMC4346122 DOI: 10.1186/s13195-014-0093-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 12/22/2014] [Indexed: 12/11/2022]
Abstract
Introduction Group comparisons demonstrate greater visuospatial and memory deficits and temporoparietal-predominant degeneration on neuroimaging in patients with corticobasal syndrome (CBS) found to have Alzheimer’s disease (AD) pathology versus those with underlying frontotemporal lobar degeneration (FTLD). The value of these features in predicting underlying AD pathology in individual patients is unknown. The goal of this study is to evaluate the utility of modified clinical criteria and visual interpretations of magnetic resonance imaging (MRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) for predicting amyloid deposition (as a surrogate of Alzheimer’s disease neuropathology) in patients presenting with CBS. Methods In total, 25 patients meeting CBS core criteria underwent amyloid (Pittsburgh compound B; PIB) PET scans. Clinical records, MRI, and FDG scans were reviewed blinded to PIB results. Modified clinical criteria were used to classify CBS patients as temporoparietal variant CBS (tpvCBS) or frontal variant CBS (fvCBS). MRI and FDG-PET were classified based on the predominant atrophy/hypometabolism pattern (frontal or temporoparietal). Results A total of 9 out of 13 patients classified as tpvCBS were PIB+, compared to 2out of 12 patients classified as fvCBS (P < 0.01, sensitivity 82%, specificity 71% for PIB+ status). Visual MRI reads had 73% sensitivity and 46% specificity for PIB+ status with moderate intra-rater reliability (Cohen’s kappa = 0.42). Visual FDG reads had higher sensitivity (91%) for PIB+ status with perfect intra-rater reliability (kappa = 1.00), though specificity was low (50%). PIB results were confirmed in all 8 patients with available histopathology (3 PIB+ with confirmed AD, 5 PIB- with FTLD). Conclusions Splitting CBS patients into frontal or temporoparietal clinical variants can help predict the likelihood of underlying AD, but criteria require further refinement. Temporoparietal-predominant neuroimaging patterns are sensitive but not specific for AD. Electronic supplementary material The online version of this article (doi:10.1186/s13195-014-0093-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sharon J Sha
- Department of Neurology and Neurological Sciences, Stanford University, 300 Pasteur Drive, Rm A343, Stanford, CA 94305 USA
| | - Pia M Ghosh
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA ; Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA USA
| | - Suzee E Lee
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Chiara Corbetta-Rastelli
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA ; Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA USA
| | - Willian J Jagust
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA ; Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA USA ; Lawrence Berkeley National Laboratory, Berkeley, CA USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA USA
| | - Katherine P Rankin
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Lea T Grinberg
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Harry V Vinters
- Department of Neurology, University of California, Los Angeles, CA USA ; Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA USA
| | - Mario F Mendez
- Department of Neurology, University of California, Los Angeles, CA USA
| | - Dennis W Dickson
- Department of Laboratory Medicine & Pathology, Mayo Clinic, Jacksonville, FL USA
| | - William W Seeley
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Marilu Gorno-Tempini
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Joel Kramer
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Bruce L Miller
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Adam L Boxer
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA
| | - Gil D Rabinovici
- Department of Neurology, University of California, San Francisco, San Francisco, CA USA ; Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA USA ; Lawrence Berkeley National Laboratory, Berkeley, CA USA
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98
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Chen JM, Cui GH, Jiang GX, Xu RF, Tang HD, Wang G, Chen SD, Cheng Q. Cognitive impairment among elderly individuals in Shanghai suburb, China: association of C-reactive protein and its interactions with other relevant factors. Am J Alzheimers Dis Other Demen 2014; 29:712-7. [PMID: 24928820 PMCID: PMC10852731 DOI: 10.1177/1533317514534758] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To investigate the association between serum C-reactive protein (CRP) concentration and cognitive impairment as well as interactions between CRP and other relevant factors. METHODS Patients with cognitive impairment and 1 to 2 age- and sex-matched controls nested from a population-based study among residents aged 60 years and older in Shanghai suburb. The associations of serum CRP concentration and other relevant factors were examined with logistic regression analysis. RESULTS The mean CRP in patients with cognitive impairment was higher than that in controls (P < .001). The highest quartile of CRP (>4.77 mg/L), abdomen obesity, hypertriglyceridemia, and hyperglycemia was associated with cognitive impairment. Significant interactions were found between increased CRP and hypertriglyceridemia as well as between increased CRP and hyperglycemia on cognitive impairment; and the attributable proportion due to interaction was 82% (P < .0001) and 37% (P = .007), respectively. CONCLUSIONS Increased CRP was associated with cognitive impairment, and additive effects of increased CRP with hypertriglyceridemia and hyperglycemia on cognitive impairment were observed among elderly individuals.
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Affiliation(s)
- Jin-Mei Chen
- Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China School of Public Health, Shanghai Jiao Tong University, China
| | - Guo-Hong Cui
- Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China School of Public Health, Shanghai Jiao Tong University, China
| | - Guo-Xin Jiang
- School of Public Health, Shanghai Jiao Tong University, China Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Rui-Fang Xu
- Center for Disease Control and Prevention of Qingpu District, Shanghai, China
| | - Hui-Dong Tang
- Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China
| | - Gang Wang
- Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China
| | - Sheng-Di Chen
- Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China
| | - Qi Cheng
- School of Public Health, Shanghai Jiao Tong University, China Department of Neurology, Ruijin Hospital affiliated with the School of Medicine, Shanghai Jiao Tong University, China
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Regional brain shrinkage over two years: individual differences and effects of pro-inflammatory genetic polymorphisms. Neuroimage 2014; 103:334-348. [PMID: 25264227 DOI: 10.1016/j.neuroimage.2014.09.042] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 08/29/2014] [Accepted: 09/17/2014] [Indexed: 02/04/2023] Open
Abstract
We examined regional changes in brain volume in healthy adults (N=167, age 19-79years at baseline; N=90 at follow-up) over approximately two years. With latent change score models, we evaluated mean change and individual differences in rates of change in 10 anatomically-defined and manually-traced regions of interest (ROIs): lateral prefrontal cortex (LPFC), orbital frontal cortex (OF), prefrontal white matter (PFw), hippocampus (Hc), parahippocampal gyrus (PhG), caudate nucleus (Cd), putamen (Pt), insula (In), cerebellar hemispheres (CbH), and primary visual cortex (VC). Significant mean shrinkage was observed in the Hc, CbH, In, OF, and PhG, and individual differences in change were noted in all regions, except the OF. Pro-inflammatory genetic variants modified shrinkage in PhG and CbH. Carriers of two T alleles of interleukin-1β (IL-1β C-511T, rs16944) and a T allele of methylenetetrahydrofolate reductase (MTHFR C677T, rs1801133) polymorphisms showed increased PhG shrinkage. No effects of a pro-inflammatory polymorphism for C-reactive protein (CRP-286C>A>T, rs3091244) or apolipoprotein (APOE) ε4 allele were noted. These results replicate the pattern of brain shrinkage observed in previous studies, with a notable exception of the LPFC, thus casting doubt on the unique importance of prefrontal cortex in aging. Larger baseline volumes of CbH and In were associated with increased shrinkage, in conflict with the brain reserve hypothesis. Contrary to previous reports, we observed no significant linear effects of age and hypertension on regional brain shrinkage. Our findings warrant further investigation of the effects of neuroinflammation on structural brain change throughout the lifespan.
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100
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Bettcher BM, Kramer JH. Longitudinal inflammation, cognitive decline, and Alzheimer's disease: a mini-review. Clin Pharmacol Ther 2014; 96:464-9. [PMID: 25009982 DOI: 10.1038/clpt.2014.147] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 07/02/2014] [Indexed: 01/06/2023]
Abstract
The role of inflammation in cognitive decline has generated considerable interest, although few longitudinal evaluations have been conducted. A review of the literature yields mixed findings but suggests that inflammatory dysregulation is evident and may be related to clinical outcomes. The directionality, magnitude, and progression of these associations remain unclear. Future studies employing multiple time points of inflammatory data along with Alzheimer's disease (AD) biomarkers are critical for explication of longitudinal inflammation in cognitive decline.
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Affiliation(s)
- B M Bettcher
- Neurology Department, Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
| | - J H Kramer
- Neurology Department, Memory and Aging Center, University of California, San Francisco, San Francisco, California, USA
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