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Carmichael O, Stuchlik P, Pillai S, Biessels GJ, Dhullipudi R, Madden-Rusnak A, Martin S, Hsia DS, Fonseca V, Bazzano L. High-Normal Adolescent Fasting Plasma Glucose Is Associated With Poorer Midlife Brain Health: Bogalusa Heart Study. J Clin Endocrinol Metab 2019; 104:4492-4500. [PMID: 31058974 PMCID: PMC6736207 DOI: 10.1210/jc.2018-02750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 04/30/2019] [Indexed: 12/24/2022]
Abstract
CONTEXT It is unclear how adolescent glycemic status relates to brain health in adulthood. OBJECTIVE To assess the association between adolescent fasting plasma glucose (FPG) and MRI-based brain measures in midlife. DESIGN Between 1973 and 1992, the Bogalusa Heart Study (BHS) collected FPG from children, 3 to 18 years old, and followed up between 1992 and 2018. Cognitive tests and brain MRI were collected in 2013 to 2016 and 2018. SETTING Observational longitudinal cohort study. PARTICIPANTS Of 1298 contacted BHS participants, 74 completed screening, and 50 completed MRI. MAIN OUTCOME MEASURES Mean FPG per participant at ages <20, 20 to 40, and over 40 years old; brain white matter hyperintensity (WMH) volume, gray matter volume, and functional MRI (fMRI) activation to a Stroop task; tests of logical and working memory, executive function, and semantic fluency. RESULTS At MRI, participants were middle aged (51.3 ± 4.4 years) and predominantly female (74%) and white (74%). Mean FPG was impaired for zero, two, and nine participants in pre-20, 20 to 40, and over-40 periods. The pre-20 mean FPG above the pre-20 median value (i.e., above 83.5 mg/dL) was associated with greater WMH volume [mean difference: 0.029% of total cranial volume, CI: (0.0059, 0.052), P = 0.015] and less fMRI activation [-1.41 units (-2.78, -0.05), P = 0.043] on midlife MRI compared with below-median mean FPG. In controlling for over-40 mean FPG status did not substantially modify the associations. Cognitive scores did not differ by pre-20 mean FPG. CONCLUSIONS High-normal adolescent FPG may be associated with preclinical brain changes in midlife.
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Affiliation(s)
- Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Correspondence and Reprint Requests: Owen Carmichael, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, Louisiana 70808. E-mail:
| | | | | | - Geert-Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, University Utrecht, Utrecht, Netherlands
| | - Ram Dhullipudi
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | | | - Shane Martin
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Daniel S Hsia
- Pennington Biomedical Research Center, Baton Rouge, Louisiana
| | - Vivian Fonseca
- Section of Endocrinology, Tulane University Health Sciences Center, New Orleans, Louisiana
| | - Lydia Bazzano
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
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102
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Nguyen L, Murphy K, Andrews G. Cognitive and neural plasticity in old age: A systematic review of evidence from executive functions cognitive training. Ageing Res Rev 2019; 53:100912. [PMID: 31154013 DOI: 10.1016/j.arr.2019.100912] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 05/01/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
Cognitive training is a popular intervention aimed at attenuating age-related cognitive decline, however, the effects of this intervention on brain structure and function have not been thoroughly explored. Core executive functions (working memory, inhibition, cognitive flexibility) are dependent upon prefrontal brain regions-one of the most vulnerable areas of age-related decline. They are also implicated in numerous cognitive processes and higher-order functions. Training executive functions should therefore promote cognitive and neural enhancements in old age. This systematic review examined the effects of executive functions training on brain and cognition amongst healthy older adults across 20 studies. Behavioral performance consistently improved on trained cognitive tasks, though mixed findings were reported for untrained tasks. Training-related structural changes were reported, evidenced through increases in grey matter and cortical volume. Functional changes were not consistent, though a general pattern of increased subcortical and decreased frontal and parietal activation emerged across studies, indicating that training may potentially reduce reliance on compensatory neural mechanisms. Training executive functions appears to promote cognitive and neural plasticity in old age, though further research is required to develop a more comprehensive framework which connects and elucidates the mechanisms underlying cognitive training, cognitive transfer, and cognitive aging.
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103
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Kaskikallio A, Karrasch M, Rinne JO, Tuokkola T, Parkkola R, Grönholm-Nyman P. Domain-specific cognitive effects of white matter pathology in old age, mild cognitive impairment and Alzheimer's disease. AGING NEUROPSYCHOLOGY AND COGNITION 2019; 27:453-470. [PMID: 31198088 DOI: 10.1080/13825585.2019.1628916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Concomitant white matter (WM) brain pathology is often present in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Cognitive effects of WM pathology on cognition in normal and pathological aging have been studied, but very little is known about possible group-specific effects in old age, MCI and AD. The purpose of the current study was to examine the relationship between WM pathology and cognitive functioning in four cognitive domains in old age, MCI and AD. The study utilized multi-domain neuropsychological data and visually rated MRI imaging data from a sample of 56 healthy older adults, 40 patients with MCI and 52 patients with AD (n = 148). After controlling for age and education, main effects of frontal WM pathology (especially in the left hemisphere) were found for cognitive performances in two domains, whereas a main effect of parieto-occipital WM pathology was only found for processing speed. In addition, with regard to processing speed, an interaction between group and WM changes was found: Patients with AD that had moderate or severe left frontal WM pathology were considerably slower than patients with AD that had milder cerebrovascular pathology. Frontal WM pathology, especially in the left hemisphere, seems to affect cognitive functions in many domains in all three groups. The results of the study increase our knowledge of cognitive repercussions stemming from frontal and/or parieto-occipital WM pathology in AD. Clinicians should be aware that patients with AD with prominent frontal cerebrovascular pathology can have considerably slowed cognitive processing.
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Affiliation(s)
- Alar Kaskikallio
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Mira Karrasch
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Juha O Rinne
- Turku PET-Centre, University of Turku, Turku, Finland.,Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University and University Hospital of Turku, Turku, Finland
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104
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Dolui S, Tisdall D, Vidorreta M, Jacobs DR, Nasrallah IM, Bryan RN, Wolk DA, Detre JA. Characterizing a perfusion-based periventricular small vessel region of interest. NEUROIMAGE-CLINICAL 2019; 23:101897. [PMID: 31233954 PMCID: PMC6595083 DOI: 10.1016/j.nicl.2019.101897] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 06/04/2019] [Accepted: 06/11/2019] [Indexed: 10/27/2022]
Abstract
The periventricular white matter (PVWM) is supplied by terminal distributions of small vessels and is particularly susceptible to developing white matter lesions (WML) associated with cerebral small vessel disease (CSVD). We obtained group-averaged cerebral blood flow (CBF) maps from Arterial Spin Labeled (ASL) perfusion MRI data obtained in 436 middle-aged (50.4 ± 3.5 years) subjects in the NHLBI CARDIA study and in 61 elderly (73.3 ± 6.9 years) cognitively normal subjects recruited from the Penn Alzheimer's Disease Center (ADC) and found that the lowest perfused brain voxels are located within the PVWM. We constructed a white matter periventricular small vessel (PSV) region of interest (ROI) by empirically thresholding the group averaged CARDIA CBF map at CBF < 15 ml/100 g/min. Thereafter we compared CBF in the PSV ROI and in the remaining white matter (RWM) with the location and volume of WML measured with Fluid Attenuated Inversion Recovery (FLAIR) MRI. WM CBF was lower within WML than outside WML voxels (p < <0.0001) in both the PSV and RWM ROIs, however this difference was much smaller (p < <0.0001) in the PSV ROI than in the RWM suggesting a more homogenous reduction of CBF in the PSV region. Normalized WML volumes were significantly higher in the PSV ROI than in the RWM and in the elderly cohort as compared to the middle-aged cohort (p < <0.0001). Additionally, the PSV ROI showed a significantly (p = .001) greater increase in lesion volume than the RWM in the elderly ADC cohort than the younger CARDIA cohort. Considerable intersubject variability in PSV CBF observed in both study cohorts likely represents biological variability that may be predictive of future WML and/or cognitive decline. In conclusion, a data-driven PSV ROI defined by voxels with low perfusion in middle age defines a region with homogeneously reduced CBF that is particularly susceptible to progressive ischemic injury in elderly controls. PSV CBF may provide a mechanistically specific biomarker of CSVD.
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Affiliation(s)
- Sudipto Dolui
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Dylan Tisdall
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Marta Vidorreta
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA; Siemens Healthcare S.L.U., Madrid, Spain
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - R Nick Bryan
- Department of Diagnostic Medicine, University of Texas, Austin, Austin, TX, USA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - John A Detre
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
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105
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Alosco ML, Sugarman MA, Besser LM, Tripodis Y, Martin B, Palmisano JN, Kowall NW, Au R, Mez J, DeCarli C, Stein TD, McKee AC, Killiany RJ, Stern RA. A Clinicopathological Investigation of White Matter Hyperintensities and Alzheimer's Disease Neuropathology. J Alzheimers Dis 2019; 63:1347-1360. [PMID: 29843242 DOI: 10.3233/jad-180017] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND White matter hyperintensities (WMH) on magnetic resonance imaging (MRI) have been postulated to be a core feature of Alzheimer's disease. Clinicopathological studies are needed to elucidate and confirm this possibility. OBJECTIVE This study examined: 1) the association between antemortem WMH and autopsy-confirmed Alzheimer's disease neuropathology (ADNP), 2) the relationship between WMH and dementia in participants with ADNP, and 3) the relationships among cerebrovascular disease, WMH, and ADNP. METHODS The sample included 82 participants from the National Alzheimer's Coordinating Center's Data Sets who had quantitated volume of WMH from antemortem FLAIR MRI and available neuropathological data. The Clinical Dementia Rating (CDR) scale (from MRI visit) operationalized dementia status. ADNP+ was defined by moderate to frequent neuritic plaques and Braak stage III-VI at autopsy. Cerebrovascular disease neuropathology included infarcts or lacunes, microinfarcts, arteriolosclerosis, atherosclerosis, and cerebral amyloid angiopathy. RESULTS 60/82 participants were ADNP+. Greater volume of WMH predicted increased odds for ADNP (p = 0.037). In ADNP+ participants, greater WMH corresponded with increased odds for dementia (CDR≥1; p = 0.038). WMH predicted cerebral amyloid angiopathy, microinfarcts, infarcts, and lacunes (ps < 0.04). ADNP+ participants were more likely to have moderate-severe arteriolosclerosis and cerebral amyloid angiopathy compared to ADNP-participants (ps < 0.04). CONCLUSIONS This study found a direct association between total volume of WMH and increased odds for having ADNP. In patients with Alzheimer's disease, FLAIR MRI WMH may be able to provide key insight into disease severity and progression. The association between WMH and ADNP may be explained by underlying cerebrovascular disease.
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Affiliation(s)
- Michael L Alosco
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Michael A Sugarman
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neuropsychology, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA
| | - Lilah M Besser
- National Alzheimer's Coordinating Center, University of Washington, Seattle, WA, USA
| | - Yorghos Tripodis
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Brett Martin
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Joseph N Palmisano
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA
| | - Neil W Kowall
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.,Neurology Service, VA Boston Healthcare System, Boston, MA, USA
| | - Rhoda Au
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Framingham Heart Study, National Heart, Lung, and Blood Institute, Framingham, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Charles DeCarli
- Department of Neurology, University of California at Davis Health System, Sacramento, CA, USA
| | - Thor D Stein
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA.,Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA.,U.S. Department of Veteran Affairs, VA Boston Healthcare System, Boston, MA, USA.,Department of Veterans Affairs Medical Center, Bedford, MA, USA
| | - Ronald J Killiany
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Center for Biomedical Imaging, Boston University School of Medicine, Boston, MA, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.,Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA
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106
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Steward KA, Kennedy R, Erus G, Nasrallah IM, Wadley VG. Poor awareness of IADL deficits is associated with reduced regional brain volume in older adults with cognitive impairment. Neuropsychologia 2019; 129:372-378. [PMID: 31059694 DOI: 10.1016/j.neuropsychologia.2019.04.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/25/2019] [Accepted: 04/27/2019] [Indexed: 12/12/2022]
Abstract
Performance of instrumental activities of daily living (IADLs) can become compromised in older adults with mild cognitive impairment (MCI). Patients' level of insight into their everyday functioning varies both amongst individuals and across domains assessed, with some individuals exhibiting complete unawareness of deficits. The current cross-sectional study examined the neuroanatomical substrates of self-awareness in order to help explain the variability in this phenomenon in older adults across a continuum of cognitive impairment. Eighty-five participants (ages 54-88, mean age = 73 years, 57% female, 89% Caucasian) diagnosed with MCI or mild probable dementia underwent structural magnetic resonance imaging. Level of self-awareness was assessed by calculating the discrepancy between objective and subjective performance across six IADLs (Financial Management, Driving, Grocery Shopping, Nutrition Evaluation, Medication Management, and Telephone Use). Over-estimation of current abilities occurred in 13-31% of the sample depending on which IADL was evaluated. Poor awareness was significantly related to reduced volume in the bilateral medial prefrontal cortex, middle and posterior cingulate cortex, right insular cortex, and cerebellum. No associations were found with total white matter lesion load. These findings were broadly consistent across all functional domains assessed, supporting the theory that cortical midline and cerebellar structures are involved in self-referential processing across a variety of different cognitive and behavioral skills. Longitudinal studies are needed to confirm this association.
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Affiliation(s)
- Kayla A Steward
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Richard Kennedy
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Guray Erus
- Department of Radiology, Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilya M Nasrallah
- Department of Radiology, Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Virginia G Wadley
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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107
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Luo DH, Tseng WYI, Chang YL. White matter microstructure disruptions mediate the adverse relationships between hypertension and multiple cognitive functions in cognitively intact older adults. Neuroimage 2019; 197:109-119. [PMID: 31029871 DOI: 10.1016/j.neuroimage.2019.04.063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/23/2019] [Accepted: 04/23/2019] [Indexed: 01/01/2023] Open
Abstract
Although hypertension is a prominent vascular risk factor for late-life cognitive decline, the underlying pathophysiological mechanism remains unclear. Accordingly, the aim of this study was to examine the role of white matter microstructural integrity in hypertension-related cognitive detriments. We recruited 66 cognitively normal older adults, comprising 41 hypertensive patients and 25 normotensive controls. All participants underwent a comprehensive neuropsychological battery. White matter microstructural integrity was assessed using a tract-based automatic analysis approach derived from diffusion spectrum imaging. Mediating effects of white matter integrity were evaluated using structural equation modeling analyses. The results revealed that hypertensive older adults displayed poorer processing speed, executive function, and memory encoding. Lower white matter microstructural integrity was observed in the hypertensive elderly patients, primarily in long-range association fiber bundles. In particular, low microstructural integrity in specific tract bundles connecting frontal and posterior cerebral regions was found to underlie the adverse relationships between hypertension and multiple cognitive domains, including processing speed, executive function, memory encoding, and memory retention. Our findings suggest that hypertension may impair multiple cognitive functions by undermining white matter microstructures, even in cognitively intact older adults, thus further highlighting the necessity of monitoring vascular health to prevent cognitive decline.
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Affiliation(s)
- Di-Hua Luo
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan
| | - Wen-Yih Isaac Tseng
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Graduate Institute of Medical Device and Imaging, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Graduate Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, 10051, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, 10617, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, 10617, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, 10617, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, 10048, Taiwan.
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108
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Wu X, Ge X, Du J, Wang Y, Sun Y, Han X, Ding W, Cao M, Xu Q, Zhou Y. Characterizing the Penumbras of White Matter Hyperintensities and Their Associations With Cognitive Function in Patients With Subcortical Vascular Mild Cognitive Impairment. Front Neurol 2019; 10:348. [PMID: 31031687 PMCID: PMC6474292 DOI: 10.3389/fneur.2019.00348] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 03/21/2019] [Indexed: 11/13/2022] Open
Abstract
Normal-appearing white matter (NAWM) surrounding white matter hyperintensities (WMHs), frequently known as the WMH penumbra, is associated with subtle white matter injury and has a high risk for future conversion to WMHs. The goal of this study was to define WMH penumbras and to further explore whether the diffusion and perfusion parameters of these penumbras could better reflect cognitive function alterations than WMHs in subjects with subcortical vascular mild cognitive impairment (svMCI). Seventy-three svMCI subjects underwent neuropsychological assessments and 3T MRI scans, including diffusion tensor imaging (DTI) and arterial spin labeling (ASL). To determine the extent of cerebral blood flow (CBF) and DTI penumbras. A NAWM layer mask was generated for periventricular WMHs (PVWMHs) and deep WMHs (DWMHs) separately. Mean values of CBF, fractional anisotropy (FA), mean diffusivity (MD) within the WMHs and their corresponding NAWM layer masks were computed and compared using paired t-tests. Pearson's partial correlations were used to assess the relations of the mean CBF, FA, and MD values within the corresponding penumbras with composite z-scores of global cognition and four cognitive domains controlling for age, sex, and education. For both PVWMHs and DWMHs, the CBF penumbras were wider than the DTI penumbras. Only the mean FA value of the PVWMH-FA penumbra was correlated with the composite z-scores of global cognition before correction (r = 0.268, p = 0.024), but that correlation did not survive after correcting the p-value for multiple comparisons. Our findings showed extensive white matter perfusion disturbances including white matter tissue, both with and without microstructural alterations. The imaging parameters investigated, however, did not correlate to cognition.
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Affiliation(s)
- Xiaowei Wu
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Ge
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Du
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yao Wang
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yawen Sun
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Han
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weina Ding
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Mengqiu Cao
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qun Xu
- Department of Neurology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Zhou
- Department of Radiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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109
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Cramer CK, Cummings TL, Andrews RN, Strowd R, Rapp SR, Shaw EG, Chan MD, Lesser GJ. Treatment of Radiation-Induced Cognitive Decline in Adult Brain Tumor Patients. Curr Treat Options Oncol 2019; 20:42. [PMID: 30963289 DOI: 10.1007/s11864-019-0641-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OPINION STATEMENT Patients with either primary or metastatic brain tumors quite often have cognitive impairment. Maintaining cognitive function is important to brain tumor patients and a decline in cognitive function is generally accompanied by a decline in functional independence and performance status. Cognitive decline can be a result of tumor progression, depression/anxiety, fatigue/sleep dysfunction, or the treatments they have received. It is our opinion that providers treating brain tumor patients should obtain pre-treatment and serial cognitive testing in their patients and offer mitigating and therapeutic interventions when appropriate. They should also support cognition-focused clinical trials.
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Affiliation(s)
- Christina K Cramer
- Department of Radiation Oncology, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
| | - Tiffany L Cummings
- Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Rachel N Andrews
- Department of Radiation Oncology, Section on Radiation Biology, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Roy Strowd
- Department of Hematology/Oncology, Wake Forest Baptist Medical Center, Winston-Salem, NC, 27157, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine and Division Public Health Sciences (Social Sciences and Health Policy), Wake Forest School of Medicine, Medical Center Blvd, Winston-Salem, NC, USA
| | - Edward G Shaw
- Memory Counseling Program, Section on Gerontology and Geriatric Medicine, Sticht Center on Healthy Aging and Alzheimer's Prevention, Wake Forest Baptist Health, Medical Center Boulevard, Winston-Salem, NC, 27157, USA
| | - Michael D Chan
- Department of Radiation Oncology, Wake Forest Baptist Medical Center, Medical Center Blvd, Winston-Salem, NC, 27157, USA
| | - Glenn J Lesser
- Oncology, Medical Neuro-Oncology and Neuro-Oncology Research Program, Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157-1082, USA
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110
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Damulina A, Pirpamer L, Seiler S, Benke T, Dal-Bianco P, Ransmayr G, Struhal W, Hofer E, Langkammer C, Duering M, Fazekas F, Schmidt R. White Matter Hyperintensities in Alzheimer’s Disease: A Lesion Probability Mapping Study. J Alzheimers Dis 2019; 68:789-796. [DOI: 10.3233/jad-180982] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Anna Damulina
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Lukas Pirpamer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Stephan Seiler
- Department of Neurology and Center for Neurosciences, Imaging of Dementia and Aging Laboratory, University of California at Davis, CA, USA
| | - Thomas Benke
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Peter Dal-Bianco
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Gerhard Ransmayr
- Department of Neurology, Kepler University Hospital, Linz, Austria
| | - Walter Struhal
- Department of Neurology, Kepler University Hospital, Linz, Austria
- Department of Neurology, Karl Landsteiner University of Health Sciences, Tulln, Austria
| | - Edith Hofer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | | | - Marco Duering
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
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111
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Schirmer MD, Giese AK, Fotiadis P, Etherton MR, Cloonan L, Viswanathan A, Greenberg SM, Wu O, Rost NS. Spatial Signature of White Matter Hyperintensities in Stroke Patients. Front Neurol 2019; 10:208. [PMID: 30941083 PMCID: PMC6433778 DOI: 10.3389/fneur.2019.00208] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/18/2019] [Indexed: 11/13/2022] Open
Abstract
Purpose: White matter hyperintensity (WMH) is a common phenotype across a variety of neurological diseases, particularly prevalent in stroke patients; however, vascular territory dependent variation in WMH burden has not yet been identified. Here, we sought to investigate the spatial specificity of WMH burden in patients with acute ischemic stroke (AIS). Materials and Methods: We created a novel age-appropriate high-resolution brain template and anatomically delineated the cerebral vascular territories. We used WMH masks derived from the clinical T2 Fluid Attenuated Inverse Recovery (FLAIR) MRI scans and spatial normalization of the template to discriminate between WMH volume within each subject's anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) territories. Linear regression modeling including age, sex, common vascular risk factors, and TOAST stroke subtypes was used to assess for spatial specificity of WMH volume (WMHv) in a cohort of 882 AIS patients. Results: Mean age of this cohort was 65.23 ± 14.79 years, 61.7% were male, 63.6% were hypertensive, 35.8% never smoked. Mean WMHv was 11.58c ± 13.49 cc. There were significant differences in territory-specific, relative to global, WMH burden. In contrast to PCA territory, age (0.018 ± 0.002, p < 0.001) and small-vessel stroke subtype (0.212 ± 0.098, p < 0.001) were associated with relative increase of WMH burden within the anterior (ACA and MCA) territories, whereas male sex (-0.275 ± 0.067, p < 0.001) was associated with a relative decrease in WMHv. Conclusions: Our data establish the spatial specificity of WMH distribution in relation to vascular territory and risk factor exposure in AIS patients and offer new insights into the underlying pathology.
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Affiliation(s)
- Markus D. Schirmer
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Computer Science and Artificial Intelligence Lab, MIT, Cambridge, MA, United States
- Department of Population Health Sciences, German Centre for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Anne-Katrin Giese
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, United States
| | - Panagiotis Fotiadis
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Mark R. Etherton
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Lisa Cloonan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Anand Viswanathan
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Steven M. Greenberg
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Ona Wu
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, United States
| | - Natalia S. Rost
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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112
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Wu D, Albert M, Soldan A, Pettigrew C, Oishi K, Tomogane Y, Ye C, Ma T, Miller MI, Mori S. Multi-atlas based detection and localization (MADL) for location-dependent quantification of white matter hyperintensities. NEUROIMAGE-CLINICAL 2019; 22:101772. [PMID: 30927606 PMCID: PMC6444296 DOI: 10.1016/j.nicl.2019.101772] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 02/05/2019] [Accepted: 03/10/2019] [Indexed: 02/07/2023]
Abstract
The extent and spatial location of white matter hyperintensities (WMH) on brain MRI may be relevant to the development of cognitive decline in older persons. Here, we introduce a new method, known as the Multi-atlas based Detection and Localization (MADL), to evaluate WMH on fluid-attenuated inversion recovery (FLAIR) data. This method simultaneously parcellates the whole brain into 143 structures and labels hyperintense areas within each WM structure. First, a multi-atlas library was established with FLAIR data of normal elderly brains; and then a multi-atlas fusion algorithm was developed by which voxels with locally abnormal intensities were detected as WMH. At the same time, brain segmentation maps were generated from the multi-atlas fusion process to determine the anatomical location of WMH. Areas identified using the MADL method agreed well with manual delineation, with an interclass correlation of 0.97 and similarity index (SI) between 0.55 and 0.72, depending on the total WMH load. Performance was compared to other state-of-the-art WMH detection methods, such as BIANCA and LST. MADL-based analyses of WMH in an older population revealed a significant association between age and WMH load in deep WM but not subcortical WM. The findings also suggested increased WMH load in selective brain regions in subjects with mild cognitive impairment compared to controls, including the inferior deep WM and occipital subcortical WM. The proposed MADL approach may facilitate location-dependent characterization of WMH in older individuals with memory impairment. We proposed a multi-atlas based method for simultaneous detection and location of WMH on FLAIR images. The method generates whole-brain segmentation for location-dependent WMH analysis. The method showed reasonably high detection accuracy in comparison with other methods. Results revealed a selective association between deep brain WMH and subject age. Results suggested increased WMH in the inferior white matter in MCI patients.
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Affiliation(s)
- Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China; Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenichi Oishi
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yusuke Tomogane
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Chenfei Ye
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ting Ma
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael I Miller
- Department of Biomedicine Engineering, Johns Hopkins University, Baltimore, MD, USA; Center of Imaging Science, Johns Hopkins University, Baltimore, MD, USA; Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Susumu Mori
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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Papadaki E, Kavroulakis E, Kalaitzakis G, Karageorgou D, Makrakis D, Maris TG, Simos PG. Age‐related deep white matter changes in myelin and water content: A T
2
relaxometry study. J Magn Reson Imaging 2019; 50:1393-1404. [DOI: 10.1002/jmri.26707] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/16/2019] [Accepted: 02/19/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Efrosini Papadaki
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
| | | | - Georgios Kalaitzakis
- Department of Medical PhysicsSchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Dimitra Karageorgou
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Dimitrios Makrakis
- Department of RadiologySchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Thomas G. Maris
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
- Department of Medical PhysicsSchool of Medicine, University of Crete Heraklion, Crete Greece
| | - Panagiotis G. Simos
- Institute of Computer ScienceFoundation of Research and Technology Heraklion Greece
- Department of PsychiatrySchool of Medicine, University of Crete Heraklion, Crete Greece
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114
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Nishioka C, Liang HF, Barsamian B, Sun SW. Amyloid-beta induced retrograde axonal degeneration in a mouse tauopathy model. Neuroimage 2019; 189:180-191. [PMID: 30630081 DOI: 10.1016/j.neuroimage.2019.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/27/2018] [Accepted: 01/04/2019] [Indexed: 12/12/2022] Open
Abstract
White matter abnormalities, revealed by Diffusion Tensor Imaging (DTI), are observed in patients with Alzheimer's Disease (AD), representing neural network deficits that underlie gradual cognitive decline in patients. However, how DTI changes related to the development of Amyloid beta (Aβ) and tau pathology, two key hallmarks of AD, remain elusive. We hypothesized that tauopathy induced by Aβ could initiate an axonal degeneration, leading to DTI-detectable white matter abnormalities. We utilized the visual system of the transgenic p301L tau mice as a model system. Aβ was injected in Lateral Geniculate Nucleus (LGN), where the Retinal Ganglion Cell (RGC) axons terminate. Longitudinal DTI was conducted to detect changes in the optic tract (OT) and optic nerve (ON), containing the distal and proximal segments of RGC axons, respectively. Our results showed DTI changes in OT (significant 13.2% reduction in axial diffusion, AxD vs. vehicle controls) followed by significant alterations in ON AxD and fractional anisotropy, FA. Histology data revealed loss of synapses, RGC axons and cell bodies resulting from the Aβ injection. We further tested whether microtubule-stabilizing compound Epothilone D (EpoD) could ameliorate the damage. EpoD co-treatment with Aβ was sufficient to prevent Aβ-induced axon and cell loss. Using an acute injection paradigm, our data suggest that EpoD may mediate its protective effect by blocking localized, acute Aβ-induced tau phosphorylation. This study demonstrates white matter disruption resulting from localized Aβ, the importance of tau pathology induction to changes in white matter connectivity, and the use of EpoD as a potential therapeutic avenue to prevent the axon loss in AD.
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Affiliation(s)
- Christopher Nishioka
- Basic Sciences, School of Medicine, Loma Linda University, CA, USA; Neuroscience Graduate Program, University of California, Riverside, USA
| | - Hsiao-Fang Liang
- Basic Sciences, School of Medicine, Loma Linda University, CA, USA
| | - Barsam Barsamian
- Basic Sciences, School of Medicine, Loma Linda University, CA, USA; Neuroscience Graduate Program, University of California, Riverside, USA
| | - Shu-Wei Sun
- Basic Sciences, School of Medicine, Loma Linda University, CA, USA; Neuroscience Graduate Program, University of California, Riverside, USA; Pharmaceutical Science, School of Pharmacy, Loma Linda University, CA, USA.
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115
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Li RR, He YS, Liu M, Nie ZY, Huang LH, Lu Z, Jin LJ, Li YX. Analysis of correlation between cerebral perfusion and KIM score of white matter lesions in patients with Alzheimer's disease. Neuropsychiatr Dis Treat 2019; 15:2705-2714. [PMID: 31571886 PMCID: PMC6756364 DOI: 10.2147/ndt.s207069] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/05/2019] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This study aimed to characterize white matter lesions (WMLs) and regional cerebral perfusion, and evaluate their correlations with cognitive deficits in Alzheimer's disease (AD) patients. PATIENT AND METHODS One hundred and twenty-eight patients with AD (AD group) and 75 subjects without AD (control group) were recruited. The medical information was collected from each subject. Montreal cognitive assessment (MoCA) was employed for the assessment of cognition. Cranial MRI was performed, and the KIM scoring system was used to evaluate the white matter hyperintensity. The CT perfusion (CTP) imaging was employed to assess the whole cerebral perfusion, and the region of interest (ROI) was selected to determine the blood perfusion at different parts. RESULTS The education level and MoCA score in AD group were significantly lower than in control group (P<0.001). The KIM score of juxtaventricular WML (JVWMLs) was significantly different between two groups (P<0.05) and AD group showed a higher incidence of severe JVWML and periventricular WML (PVWMLs); in AD group, the total KIM score and KIM scores of JVWMLs, PVWMLs and deep WML (DWMLs) showed negative relationships with the MoCA score (P<0.001). As compared to control group, the blood perfusion of either whole brain or different parts in the AD group reduced significantly (P<0.05). In the AD group, there was a negative correlations of blood perfusion at JVWM and PVWM with corresponding KIM scores (P<0.05 or 0.01). In the AD group, the blood perfusions of the whole brain, JVWMLs, PVWMLs and deep WML were negatively related to MoCA score (P<0.05). CONCLUSION In conclusion, the cognitive deficits in the AD patients are associated with the degree of WMLs, especially the JVWML, PVWML and DWML as well as with the reduced perfusion of JVWM, PVWM and deep WM.
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Affiliation(s)
- Ren-Ren Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Yu-Sheng He
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Meng Liu
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Zhi-Yu Nie
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Li-He Huang
- School of Foreign Languages, Research Center for Ageing, Language and Care, Tongji University, Shanghai 200092, People's Republic of China
| | - Zheng Lu
- Department of Psychiatry, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Ling-Jing Jin
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
| | - Yun-Xia Li
- Department of Neurology, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, People's Republic of China
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116
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Neuropsychological correlates of instrumental activities of daily living in neurocognitive disorders: a possible role for executive dysfunction and mood changes. Int Psychogeriatr 2018; 30:1871-1881. [PMID: 29789032 DOI: 10.1017/s1041610218000455] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTSince baseline executive dysfunction predicts worsening Instrumental Activities of Daily Living (i-ADL) over time and progression to Alzheimer's Disease (AD), we aimed to analyze the role of neuropsychological variables to outline which factors can contribute to functional impairment. Specific attention to executive functions (EFs) has been given.A total of 144 subjects complaining of different cognitive deficits - ranging from "MCI likely due to AD" to "mild AD patients" - underwent an overall neuropsychological assessment. The Behavioral Assessment of the Dysexecutive Syndrome was used to analyze EFs. We conducted multiple linear regression analyses to study whether the level of independent living skills - assessed with the Lawton-scale - could be associated with cognitive and behavioral measurements.We found a significant association between i-ADL and specific EFs measured by Rule Shift Cards (p = 0.04) and Modified Six Elements (p = 0.02). Moreover, considering i-ADL scores, we observed an involvement of mood changes and a reduced awareness of deficits in terms of Hamilton Depression Rating Scale (p = 0.02) and Awareness of Deficit Questionnaire - Dementia scale (p < 0.0001), respectively.Our results suggest the importance of considering the association between a reduction in i-ADL and executive dysfunction in patients who have AD etiopathology, for which the ability to inhibit a response, self-monitoring, set-shifting and mood deflection play a key role. Besides, no straightforward associations between i-ADL scores and global cognition, memory, language comprehension, attention, and perspective taking abilities were found.
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117
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Forsberg KME, Zhang Y, Reiners J, Ander M, Niedermayer A, Fang L, Neugebauer H, Kassubek J, Katona I, Weis J, Ludolph AC, Del Tredici K, Braak H, Yilmazer-Hanke D. Endothelial damage, vascular bagging and remodeling of the microvascular bed in human microangiopathy with deep white matter lesions. Acta Neuropathol Commun 2018; 6:128. [PMID: 30470258 PMCID: PMC6260986 DOI: 10.1186/s40478-018-0632-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 11/08/2018] [Indexed: 11/29/2022] Open
Abstract
White matter lesions (WMLs) are a common manifestation of small vessel disease (SVD) in the elderly population. They are associated with an enhanced risk of developing gait abnormalities, poor executive function, dementia, and stroke with high mortality. Hypoperfusion and the resulting endothelial damage are thought to contribute to the development of WMLs. The focus of the present study was the analysis of the microvascular bed in SVD patients with deep WMLs (DWMLs) by using double- and triple-label immunohistochemistry and immunofluorescence. Simultaneous visualization of collagen IV (COLL4)-positive membranes and the endothelial glycocalyx in thick sections allowed us to identify endothelial recession in different types of string vessels, and two new forms of small vessel/capillary pathology, which we called vascular bagging and ghost string vessels. Vascular bags were pouches and tubes that were attached to vessel walls and were formed by multiple layers of COLL4-positive membranes. Vascular bagging was most severe in the DWMLs of cases with pure SVD (no additional vascular brain injury, VBI). Quantification of vascular bagging, string vessels, and the density/size of CD68-positive cells further showed widespread pathological changes in the frontoparietal and/or temporal white matter in SVD, including pure SVD and SVD with VBI, as well as a significant effect of the covariate age. Plasma protein leakage into vascular bags and the white matter parenchyma pointed to endothelial damage and basement membrane permeability. Hypertrophic IBA1-positive microglial cells and CD68-positive macrophages were found in white matter areas covered with networks of ghost vessels in SVD, suggesting phagocytosis of remnants of string vessels. However, the overall vessel density was not altered in our SVD cohort, which might result from continuous replacement of vessels. Our findings support the view that SVD is a progressive and generalized disease process, in which endothelial damage and vascular bagging drive remodeling of the microvasculature.
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118
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Liu Y, Braidy N, Poljak A, Chan DKY, Sachdev P. Cerebral small vessel disease and the risk of Alzheimer's disease: A systematic review. Ageing Res Rev 2018; 47:41-48. [PMID: 29898422 DOI: 10.1016/j.arr.2018.06.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/10/2018] [Accepted: 06/05/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Cerebral small vessel disease (CSVD) comprises a variety of disorders affecting small arteries and microvessels of the brain, manifesting as white matter hyperintensities (WMHs), cerebral microbleeds (CMBs), and deep brain infarcts. In addition to its contribution to vascular dementia (VaD), it has also been suggested to contribute to the pathogenesis of Alzheimer's disease (AD). METHOD A systematic review of the literature available on Medline, Embase and Pubmed was undertaken, whereby CSVD was divided into WMHs, CMBs and deep brain infarcts. Biomarkers of AD pathology in the cerebrospinal fluid or plasma, or positron emission tomographic imaging for amyloid and/or tau deposition were used for AD pathology. RESULTS A total of 4117 articles were identified and 41 articles met criteria for inclusion. These consisted of 17 articles on vascular risk factors for clinical AD, 21 articles on Aβ pathology and 15 articles on tau pathology, permitting ten meta-analyses. CMBs or lobar CMBs were associated with pooled relative risk (RR) of AD at 1.546, (95%CI 0.842-2.838, z = 1.41 p = 0.160) and 1.526(95%CI 0.760-3.063, z = 1.19, p = 0.235) respectively, both non-significant. Microinfarcts were associated with significantly increased AD risk, with pooled odds ratio OR at 1.203(95%CI 1.014-1.428, 2.12 p = 0.034). Aβ pathology was significantly associated with WMHs in AD patients but not in normal age-matched controls. The pooled β (linear regression) for total WMHs with CSF Aβ42 in AD patients was -0.19(95%CI -0.26-0.11, z = 4.83 p = 0.000) and the pooled r (correlation coefficient) for WMHs and PiB in the normal population was -0.10 (95%CI -0.11-0.30, 0.93 p = 0.351). CMBs were significantly associated with Aβ pathology in AD patients. The pooled standardized mean difference (SMD) was -0.453, 95%CI -0.697- -0.208, z = 3.63 p = 0.000. There was no significant relationship between the incidence of lacunes and levels of CSFAβ, with a pooled β of 0.057 (95%CI -0.050-0.163, z = 1.05 p = 0.295). No significant relationship was found between CMBs and the levels of CSFt-tau/CSFp-tau in AD patients (-0.014, 95%CI -0.556-0.529, z = 0.05 p = 0.960; -0.058, 95%CI -0.630-0.515, z = 0.20 p = 0.844) and cortical CMBs and CSF p-tau in the normal population (0.000, 95%CI -0.706-0.706, z = 0.00 p = 0.999). CONCLUSIONS Some CSVD markers were significantly associated with clinical AD pathology and may be associated with Aβ/tau pathology. WMHs and microinfarcts were associated with increased risk of AD. It remains unclear whether they precede or follow AD pathology.
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Affiliation(s)
- Yue Liu
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nady Braidy
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia.
| | - Anne Poljak
- Mark Wainwright Analytical Centre, University of New South Wales, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Daniel K Y Chan
- Department of Aged Care and Rehabilitation, Bankstown Hospital, Bankstown, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Euroa Centre, Prince of Wales Hospital, Sydney, Australia
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119
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Vesperman CJ, Pozorski V, Dougherty RJ, Law LL, Boots E, Oh JM, Gallagher CL, Carlsson CM, Rowley HA, Ma Y, Bendlin BB, Asthana S, Sager MA, Hermann BP, Johnson SC, Cook DB, Okonkwo OC. Cardiorespiratory fitness attenuates age-associated aggregation of white matter hyperintensities in an at-risk cohort. Alzheimers Res Ther 2018; 10:97. [PMID: 30249285 PMCID: PMC6154903 DOI: 10.1186/s13195-018-0429-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/06/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Age is the cardinal risk factor for Alzheimer's disease (AD), and white matter hyperintensities (WMH), which are more prevalent with increasing age, may contribute to AD. Higher cardiorespiratory fitness (CRF) has been shown to be associated with cognitive health and decreased burden of AD-related brain alterations in older adults. Accordingly, the aim of this study was to determine whether CRF attenuates age-related accumulation of WMH in middle-aged adults at risk for AD. METHODS One hundred and seven cognitively unimpaired, late-middle-aged adults from the Wisconsin Registry for Alzheimer's Prevention underwent 3 T magnetic resonance imaging and performed graded maximal treadmill exercise testing from which we calculated the oxygen uptake efficiency slope (OUES) as our measure of CRF. Total WMH were quantified using the Lesion Segmentation Tool and scaled to intracranial volume. Linear regression adjusted for APOE4 carriage, family history, body mass index, systolic blood pressure, and sex was used to examine relationships between age, WMH, and CRF. RESULTS As expected, there was a significant association between age and WMH (p < .001). Importantly, there was a significant interaction between age and OUES on WMH (p = .015). Simple main effects analyses revealed that the effect of age on WMH remained significant in the Low OUES group (p < .001) but not in the High OUES group (p = .540), indicating that higher CRF attenuates the deleterious age association with WMH. CONCLUSIONS Higher CRF tempers the adverse effect of age on WMH. This suggests a potential pathway through which increased aerobic fitness facilitates healthy brain aging, especially among individuals at risk for AD.
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Affiliation(s)
- Clayton J. Vesperman
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Vincent Pozorski
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Ryan J. Dougherty
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Department of Kinesiology, University of Wisconsin School of Education, Madison, WI 53792 USA
| | - Lena L. Law
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Elizabeth Boots
- Department of Psychology, University of Illinois-Chicago, Chicago, IL 60607 USA
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612 USA
| | - Jennifer M. Oh
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Catherine L. Gallagher
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Cynthia M. Carlsson
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Howard A. Rowley
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Yue Ma
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Barbara B. Bendlin
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Mark A. Sager
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Bruce P. Hermann
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Sterling C. Johnson
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
| | - Dane B. Cook
- Department of Kinesiology, University of Wisconsin School of Education, Madison, WI 53792 USA
- Research Service, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
| | - Ozioma C. Okonkwo
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705 USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705 USA
- Department of Medicine and Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
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Lao PJ, Brickman AM. Multimodal neuroimaging study of cerebrovascular disease, amyloid deposition, and neurodegeneration in Alzheimer's disease progression. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:638-646. [PMID: 30417071 PMCID: PMC6215981 DOI: 10.1016/j.dadm.2018.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Introduction Cerebrovascular disease (CVD) is not currently considered a core pathological feature of Alzheimer's disease (AD), but mounting evidence suggests that concurrent CVD may exacerbate AD progression. The purpose of this study was first to examine the relationship among amyloid, CVD, and neurodegeneration and second to examine the extent to which amyloid and CVD pathology drive subsequent neurodegeneration over time. Methods Six hundred eight (224 normal controls, 291 mild cognitive impairment, 93 AD) subjects from the Alzheimer's Disease Neuroimaging Initiative with longitudinal AV45 positron emission tomography imaging and MR imaging were investigated. Results Amyloid and white matter hyperintensity (WMH) burden increased across clinical diagnosis groups (normal control < mild cognitive impairment < AD). Amyloid pathology and WMH volume were related to lower cortical thickness, while WMH burden was associated with neurodegenerative/atrophic changes over time in key AD-related brain regions. Discussion CVD and AD may be etiologically independent, but our findings suggest that CVD should be considered explicitly for its effect on AD progression. There is a pathological overlap between small vessel cerebrovascular disease, as measured by white matter hyperintensities, and Alzheimer's disease, as measured by amyloid positron emission tomography, even in a cohort with low-to-moderate vascular risk. Amyloid deposition and white matter hyperintensities additively contribute to the cortical thickness in key Alzheimer's disease–associated brain regions, and high white matter hyperintensity burden may promote cortical thinning over time.
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Affiliation(s)
- Patrick J. Lao
- Corresponding author. Tel.: +1 212-342-1399; Fax: +1 212-342-1838.
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Djabelkhir-Jemmi L, Wu YH, Boubaya M, Marlats F, Lewis M, Vidal JS, Lenoir H, Charlieux B, Isabet B, Rigaud AS. Differential effects of a computerized cognitive stimulation program on older adults with mild cognitive impairment according to the severity of white matter hyperintensities. Clin Interv Aging 2018; 13:1543-1554. [PMID: 30214174 PMCID: PMC6121770 DOI: 10.2147/cia.s152225] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to explore whether a computerized cognitive stimulation program (CCS) induced differential effects in older adults with mild cognitive impairment (MCI) according to the severity of white matter hyperintensities (WMH), which are associated with cognitive impairment and increased risk of progression to Alzheimer’s disease because of the damage they cause to cortical and subcortical networks. Patients and methods Twenty-nine MCI patients with no or little WMH (MCI-non-WMH) and 22 MCI patients with moderate or severe WMH (MCI-WMH) attended a 24-session CCS program (two sessions per week for a duration of 3 months) focused on executive functions, attention, and processing speed. Cognitive and psychosocial assessments were performed at baseline, postintervention, and 3 months after the intervention. Results Both groups improved on several cognitive measures after the intervention. However, the MCI-non-WMH group improved on a higher number of cognitive measures than the MCI-WMH group. At postintervention assessment, CCS had a more beneficial effect on the MCI-non-WMH group than on the MCI-WMH group with regard to improving categorical fluency (4.6±6.8 vs 0.4±6.4; effect size=0.37; p=0.002). During the 3-month follow-up assessment, significantly higher score improvements were observed in the MCI-non-WMH group for the paired-associate learning test (6.4±3 vs 4.7±3.5 points; effect size=0.43; p=0.005) as well as categorical fluency (3.8±7.8 vs −0.7±6 points; effect size=0.55; p=0.0003). Conclusions These findings suggest that WMH severity was related to cognitive improvement induced by a CCS program and highlight the importance of considering WMH in interventional studies on subjects with MCI.
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Affiliation(s)
- Leila Djabelkhir-Jemmi
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Ya-Huei Wu
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | | | - Fabienne Marlats
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Manon Lewis
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Jean-Sébastien Vidal
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Hermine Lenoir
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
| | - Benoit Charlieux
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Baptiste Isabet
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France,
| | - Anne-Sophie Rigaud
- Department of Clinical Gerontology, Broca Hospital-APHP, Paris, France, .,Research Team EA 4468, Alzheimer's Disease, Vascular Risk Factors and Diagnostic Markers, Care and Support for Patients and Families, Institute of Psychology of Paris Descartes University, Paris, France,
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Affect of APOE on information processing speed in non-demented elderly population: a preliminary structural MRI study. Brain Imaging Behav 2018; 11:977-985. [PMID: 27444731 DOI: 10.1007/s11682-016-9571-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
APOE is one of the strongest genetic factors associated with information processing speed (IPS). Herein, we explored the neural substrates underlying APOE-related IPS alteration by measuring lobar distribution of white matter hyperintensities (WMH), cortical grey matter volume (GMV) and thickness. Using the ADNI database, we evaluated 178 cognitively normal elderly individuals including 34 APOE ε2 carriers, 54 APOE ε4 carriers and 90 ε3 homozygotes. IPS was determined using Trail Making Tests (TMT). We quantified lobar distribution of WMH, cortical GM lobar volume, cortical thickness among three groups. Finally, we used Pearson's correlation and general linear models to examine structural MRI markers in relation to IPS. There were significant differences of IPS among groups, with ε4 carriers displaying the worst performance. Across groups, significant differences in frontal and parietal WMH load were observed (the highest in ε4 carriers); however, no significant differences in cortical GMV and thickness were found. Pearson's correlation analysis showed parietal WMH volume was significantly related with IPS, especially in ε4 carriers. Subsequently a general linear model demonstrated that parietal WMH volume, age and the interaction between parietal WMH volume and age, was significantly associated with IPS, even after adjusting total intracranial volume (TIV), gender and vascular risk factors. Disruption of WM structure, rather than atrophy of GM, plays a more critical role in APOE ε4 allele-specific IPS. Moreover, specific WMH loci are closely associated with IPS; increased parietal WMH volume, especially in ε4 carriers, was independently contributed to slower IPS.
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Beauchet O, Sekhon H, Barden J, Liu-Ambrose T, Chester VL, Szturm T, Grenier S, Léonard G, Bherer L, Allali G. Association of Motoric Cognitive Risk Syndrome with Cardiovascular Disease and Risk Factors: Results from an Original Study and Meta-Analysis. J Alzheimers Dis 2018; 64:875-887. [DOI: 10.3233/jad-180203] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Olivier Beauchet
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre of Excellence on Longevity of McGill integrated University Health Network, Quebec, Canada
| | - Harmehr Sekhon
- Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
- Faculty of Medicine, Division of Experimental Medicine, McGill University, Montreal, Quebec, Canada
| | - John Barden
- Neuromechanical Research Centre, Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, University of British Columbia, Vancouver, British Columbia, Canada
| | - Victoria L. Chester
- Andrew and Marjorie McCain Human Performance Laboratory, Richard J. Currie Center, Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sébastien Grenier
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
| | - Guillaume Léonard
- Research Center on Aging, Sherbrooke university, Sherbrooke, Québec, Canada
| | - Louis Bherer
- Centre de recherche, Institut universitaire de gériatrie de Montréal (CRIUGM), Montréal, Québec, Canada
- Montreal Heart Institute Research Center and Departement of Medicine, University of Montréal, Montréal, Québec, Canada
| | - Gilles Allali
- Department of Neurology, Geneva University Hospital and University of Geneva, Switzerland
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Delafontaine-Martel P, Lefebvre J, Tardif PL, Lévy BI, Pouliot P, Lesage F. Whole brain vascular imaging in a mouse model of Alzheimer's disease with two-photon microscopy. JOURNAL OF BIOMEDICAL OPTICS 2018; 23:1-10. [PMID: 29998647 DOI: 10.1117/1.jbo.23.7.076501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
Given known correlations between vascular health and cognitive impairment, the development of tools to image microvasculature in the whole brain could help investigate these correlations. We explore the feasibility of using an automated serial two-photon microscope to image fluorescent gelatin-filled whole rodent brains in three-dimensions (3-D) with the goal of carrying group studies. Vascular density (VD) was computed using automatic segmentation combined with coregistration techniques to build a group-level vascular metric in the whole brain. Focusing on the medial prefrontal cortex, cerebral cortex, the olfactory bulb, and the hippocampal formation, we compared the VD of three age groups (2-, 4.5-, and 8-months-old), for both wild type mice and a transgenic model (APP/PS1) with pathology resembling Alzheimer's disease (AD). We report a general loss of VD caused by the aging process with a small VD increase in the diseased animals in the somatomotor and somatosensory cortical regions and the olfactory bulb, partly supported by MRI perfusion data. This study supports previous observations that AD transgenic mice show a higher VD in specific regions compared with WT mice during the early and late stages of the disease (4.5 to 8 months), extending results to whole brain mapping.
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Affiliation(s)
| | - Joel Lefebvre
- Ecole Polytechnique Montréal, Department of Electrical Engineering, Quebec, Canada
| | - Pier-Luc Tardif
- Ecole Polytechnique Montréal, Department of Electrical Engineering, Quebec, Canada
| | - Bernard I Lévy
- Vessels and Blood Institute, Inserm U970 and Hôpital Lariboisière, Paris, France
| | - Philippe Pouliot
- Ecole Polytechnique Montréal, Department of Electrical Engineering, Quebec, Canada
- Montreal Heart Institute, Research Centre, Montreal, Quebec, Canada
| | - Frédéric Lesage
- Ecole Polytechnique Montréal, Department of Electrical Engineering, Quebec, Canada
- Montreal Heart Institute, Research Centre, Montreal, Quebec, Canada
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Gavett BE, Fletcher E, Harvey D, Farias ST, Olichney J, Beckett L, DeCarli C, Mungas D. Ethnoracial differences in brain structure change and cognitive change. Neuropsychology 2018; 32:529-540. [PMID: 29648842 PMCID: PMC6023745 DOI: 10.1037/neu0000452] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The purpose of this study was to examine longitudinal associations between structural MRI and cognition in a diverse sample. METHOD Older adults (n = 444; Mage = 74.5)-121 African Americans, 212 Whites, and 111 Hispanics-underwent an average of 5.3 annual study visits. Approximately half were cognitively normal at baseline (global Clinical Dementia Rating M = 0.5). Of the patients with dementia, most (79%) were diagnosed with Alzheimer's disease (AD). MRI measures of gray matter volume (baseline and change), and hippocampal and white matter hyperintensity (WMH) volumes (baseline), were used to predict change in global cognition. Multilevel latent variable modeling was used to test the hypothesis that brain effects on cognitive change differed across ethnoracial groups. RESULTS In a multivariable model, global gray matter change was the strongest predictor of cognitive decline in Whites and African Americans and specific temporal lobe change added incremental explanatory power in Whites. Baseline WMH volume was the strongest predictor of cognitive decline in Hispanics and made an incremental contribution in Whites. CONCLUSIONS We found ethnoracial group differences in associations of brain variables with cognitive decline. The unique patterns in Whites appeared to suggest a greater influence of AD in this group. In contrast, cognitive decline in African Americans and Hispanics was most uniquely attributable to global gray matter change and baseline WMH, respectively. Brain changes underlying cognitive decline in older adults are heterogeneous and depend on fixed and modifiable risk factors that differ based on ethnicity and race. (PsycINFO Database Record
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Affiliation(s)
- Brandon E. Gavett
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Evan Fletcher
- Department of Neurology, University of California Davis, Davis, CA, USA
| | - Danielle Harvey
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | | | - John Olichney
- Department of Neurology, University of California Davis, Davis, CA, USA
| | - Laurel Beckett
- Department of Public Health Sciences, University of California Davis, Davis, CA, USA
| | - Charles DeCarli
- Department of Neurology, University of California Davis, Davis, CA, USA
| | - Dan Mungas
- Department of Neurology, University of California Davis, Davis, CA, USA
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Haley AP, Oleson S, Pasha E, Birdsill A, Kaur S, Thompson J, Tanaka H. Phenotypic heterogeneity of obesity-related brain vulnerability: one-size interventions will not fit all. Ann N Y Acad Sci 2018; 1428:89-102. [PMID: 29741211 DOI: 10.1111/nyas.13673] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 02/10/2018] [Accepted: 02/17/2018] [Indexed: 01/07/2023]
Abstract
Intact memory and problem solving are key to functional independence and quality of life in older age. Considering the unprecedented demographic shift toward a greater number of older adults than children in the United States in the next few decades, it is critically important for older adults to maintain work productivity and functional independence for as long as possible. Implementing early interventions focused on modifiable risk factors for cognitive decline at midlife is a strategy with the highest chance of success at present, bearing in mind the current lack of dementia cures. We present a selective, narrative review of evidence linking nutrition, body composition, vascular health, and brain function in midlife to highlight the phenotypic heterogeneity of obesity-related brain vulnerability and to endorse the development of individually tailored lifestyle modification plans for primary prevention of cognitive decline.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas.,Imaging Research Center, The University of Texas at Austin, Austin, Texas
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Evan Pasha
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
| | - Alex Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Sonya Kaur
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Janelle Thompson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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Fletcher E, Gavett B, Harvey D, Farias ST, Olichney J, Beckett L, DeCarli C, Mungas D. Brain volume change and cognitive trajectories in aging. Neuropsychology 2018; 32:436-449. [PMID: 29494196 PMCID: PMC6525569 DOI: 10.1037/neu0000447] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Examine how longitudinal cognitive trajectories relate to brain baseline measures and change in lobar volumes in a racially/ethnically and cognitively diverse sample of older adults. METHOD Participants were 460 older adults enrolled in a longitudinal aging study. Cognitive outcomes were measures of episodic memory, semantic memory, executive function, and spatial ability derived from the Spanish and English Neuropsychological Assessment Scales (SENAS). Latent variable multilevel modeling of the four cognitive outcomes as parallel longitudinal processes identified intercepts for each outcome and a second order global change factor explaining covariance among the highly correlated slopes. We examined how baseline brain volumes (lobar gray matter, hippocampus, and white matter hyperintensity) and change in brain volumes (lobar gray matter) were associated with cognitive intercepts and global cognitive change. Lobar volumes were dissociated into global and specific components using latent variable methods. RESULTS Cognitive change was most strongly associated with brain gray matter volume change, with strong independent effects of global gray matter change and specific temporal lobe gray matter change. Baseline white matter hyperintensity and hippocampal volumes had significant incremental effects on cognitive decline beyond gray matter change. Baseline lobar gray matter was related to cognitive decline, but did not contribute beyond gray matter change. CONCLUSION Cognitive decline was strongly influenced by gray matter volume change and, especially, temporal lobe change. The strong influence of temporal lobe gray matter change on cognitive decline may reflect involvement of temporal lobe structures that are critical for late life cognitive health but also are vulnerable to diseases of aging. (PsycINFO Database Record
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Rizvi B, Narkhede A, Last BS, Budge M, Tosto G, Manly JJ, Schupf N, Mayeux R, Brickman AM. The effect of white matter hyperintensities on cognition is mediated by cortical atrophy. Neurobiol Aging 2018; 64:25-32. [PMID: 29328963 PMCID: PMC5831564 DOI: 10.1016/j.neurobiolaging.2017.12.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/13/2017] [Accepted: 12/08/2017] [Indexed: 12/22/2022]
Abstract
White matter hyperintensities (WMH) have been linked to cognitive dysfunction and dementia, although the reasons are unclear. One possibility is that WMH promote neurodegeneration, which, in turn, affects cognition. We examined whether cortical thickness, a marker of neurodegeneration, mediates the relationship between WMH and cognition among 519 older adults. Using conditional process analysis modeling techniques, we examined the association between WMH volume and global cognition and tested whether cortical thickness mediates this relationship statistically. We also tested specific regional hypotheses to determine whether cortical thickness or volume in the medial temporal lobe mediates the relationship between WMH volume and memory. Increased total WMH volume was associated with poorer global cognition and memory. Global cortical thickness and medial temporal lobe thickness/volume mediated the relationship of WMH volume on global cognition and memory functioning. The mediating relationship was similar across racial and ethnic groups and across diagnostic groups (i.e., mild cognitive impairment/Alzheimer's disease). The findings suggest that WMH promote atrophy, which, in turn, drives cognitive decline and highlight a potential pathway in which small vessel cerebrovascular disease affects cognition by promoting neurodegenerative changes directly.
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Affiliation(s)
- Batool Rizvi
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Atul Narkhede
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Briana S Last
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Mariana Budge
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Giuseppe Tosto
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
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Ball S, Al-Bachari S, Parkes LM, Emsley HC, McCollum CN. Extracranial arterial wall volume is increased and shows relationships with vascular MRI measures in idiopathic Parkinson’s disease. Clin Neurol Neurosurg 2018; 167:54-58. [DOI: 10.1016/j.clineuro.2018.02.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 01/02/2018] [Accepted: 02/09/2018] [Indexed: 10/18/2022]
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Park BY, Lee MJ, Lee SH, Cha J, Chung CS, Kim ST, Park H. DEWS (DEep White matter hyperintensity Segmentation framework): A fully automated pipeline for detecting small deep white matter hyperintensities in migraineurs. Neuroimage Clin 2018; 18:638-647. [PMID: 29845012 PMCID: PMC5964963 DOI: 10.1016/j.nicl.2018.02.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 02/10/2018] [Accepted: 02/28/2018] [Indexed: 01/03/2023]
Abstract
Migraineurs show an increased load of white matter hyperintensities (WMHs) and more rapid deep WMH progression. Previous methods for WMH segmentation have limited efficacy to detect small deep WMHs. We developed a new fully automated detection pipeline, DEWS (DEep White matter hyperintensity Segmentation framework), for small and superficially-located deep WMHs. A total of 148 non-elderly subjects with migraine were included in this study. The pipeline consists of three components: 1) white matter (WM) extraction, 2) WMH detection, and 3) false positive reduction. In WM extraction, we adjusted the WM mask to re-assign misclassified WMHs back to WM using many sequential low-level image processing steps. In WMH detection, the potential WMH clusters were detected using an intensity based threshold and region growing approach. For false positive reduction, the detected WMH clusters were classified into final WMHs and non-WMHs using the random forest (RF) classifier. Size, texture, and multi-scale deep features were used to train the RF classifier. DEWS successfully detected small deep WMHs with a high positive predictive value (PPV) of 0.98 and true positive rate (TPR) of 0.70 in the training and test sets. Similar performance of PPV (0.96) and TPR (0.68) was attained in the validation set. DEWS showed a superior performance in comparison with other methods. Our proposed pipeline is freely available online to help the research community in quantifying deep WMHs in non-elderly adults.
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Affiliation(s)
- Bo-Yong Park
- Department of Electronic, Electrical and Computer Engineering, Sungkyunkwan University, Suwon, 16419, Republic of Korea; Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, Republic of Korea
| | - Mi Ji Lee
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Seung-Hak Lee
- Department of Electronic, Electrical and Computer Engineering, Sungkyunkwan University, Suwon, 16419, Republic of Korea; Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, Republic of Korea
| | - Jihoon Cha
- Department of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Chin-Sang Chung
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Republic of Korea
| | - Hyunjin Park
- Center for Neuroscience Imaging Research, Institute for Basic Science (IBS), Suwon, 16419, Republic of Korea; School of Electronic and Electrical Engineering, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
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131
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Sudre CH, Gomez Anson B, Davagnanam I, Schmitt A, Mendelson AF, Prados F, Smith L, Atkinson D, Hughes AD, Chaturvedi N, Cardoso MJ, Barkhof F, Jaeger HR, Ourselin S. Bullseye's representation of cerebral white matter hyperintensities. J Neuroradiol 2018; 45:114-122. [PMID: 29132940 PMCID: PMC5867449 DOI: 10.1016/j.neurad.2017.10.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 10/03/2017] [Accepted: 10/17/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Visual rating scales have limited capacities to depict the regional distribution of cerebral white matter hyperintensities (WMH). We present a regional-zonal volumetric analysis alongside a visualization tool to compare and deconstruct visual rating scales. MATERIALS AND METHODS 3D T1-weighted, T2-weighted spin-echo and FLAIR images were acquired on a 3T system, from 82 elderly participants in a population-based study. Images were automatically segmented for WMH. Lobar boundaries and distance to ventricular surface were used to define white matter regions. Regional-zonal WMH loads were displayed using bullseye plots. Four raters assessed all images applying three scales. Correlations between visual scales and regional WMH as well as inter and intra-rater variability were assessed. A multinomial ordinal regression model was used to predict scores based on regional volumes and global WMH burdens. RESULTS On average, the bullseye plot depicted a right-left symmetry in the distribution and concentration of damage in the periventricular zone, especially in frontal regions. WMH loads correlated well with the average visual rating scores (e.g. Kendall's tau [Volume, Scheltens]=0.59 CI=[0.53 0.62]). Local correlations allowed comparison of loading patterns between scales and between raters. Regional measurements had more predictive power than global WMH burden (e.g. frontal caps prediction with local features: ICC=0.67 CI=[0.53 0.77], global volume=0.50 CI=[0.32 0.65], intra-rater=0.44 CI=[0.23 0.60]). CONCLUSION Regional-zonal representation of WMH burden highlights similarities and differences between visual rating scales and raters. The bullseye infographic tool provides a simple visual representation of regional lesion load that can be used for rater calibration and training.
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Affiliation(s)
- C H Sudre
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK; Dementia Research Centre, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - B Gomez Anson
- Santa Creu i Sant Pau Hospital, Universitat Autonòma Barcelona, 08041 Barcelona, Spain.
| | - I Davagnanam
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, WCN1 3BG London, UK; Brain Repair and Rehabilitation, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - A Schmitt
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, WCN1 3BG London, UK.
| | - A F Mendelson
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK.
| | - F Prados
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK.
| | - L Smith
- Cardiometabolic Phenotyping Group, UCL Institute of Cardiovascular Science, W1CE 6HX London, UK.
| | - D Atkinson
- Centre for Medical Imaging, UCL Faculty of Medical Science, NW1 2PG London, UK.
| | - A D Hughes
- Cardiometabolic Phenotyping Group, UCL Institute of Cardiovascular Science, W1CE 6HX London, UK.
| | - N Chaturvedi
- Cardiometabolic Phenotyping Group, UCL Institute of Cardiovascular Science, W1CE 6HX London, UK.
| | - M J Cardoso
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK; Dementia Research Centre, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - F Barkhof
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK; Brain Repair and Rehabilitation, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - H R Jaeger
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, WCN1 3BG London, UK; Brain Repair and Rehabilitation, UCL Institute of Neurology, WC1N 3BG London, UK.
| | - S Ourselin
- Translational Imaging Group, CMIC, Department of Medical Physics and Biomedical Engineering, University College London, Room 8.04 8th floor Malet Place Engineering Building, 2, Malet Place, WC1E 7JE London, UK; Dementia Research Centre, UCL Institute of Neurology, WC1N 3BG London, UK.
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Ishibashi M, Kimura N, Aso Y, Matsubara E. Effects of white matter lesions on brain perfusion in patients with mild cognitive impairment. Clin Neurol Neurosurg 2018; 168:7-11. [PMID: 29499394 DOI: 10.1016/j.clineuro.2018.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effects of white matter lesions on regional cerebral blood flow in subjects with amnestic mild cognitive impairment. PATIENTS AND METHODS Seventy-five subjects with mild cognitive impairment (36 men and 39 women; mean age, 78.1 years) were included in the study. We used the Mini-Mental State Examination to assess cognitive function. All subjects underwent brain magnetic resonance imaging and 99mTc ethylcysteinate dimer single photon emission computed tomography. Subjects were stratified based on the presence or absence of white matter lesions on magnetic resonance imaging. Statistical parametric mapping of differences in regional cerebral blood flow between the two groups were assessed by voxel-by-voxel group analysis using SPM8. RESULTS Of all 75 subjects with mild cognitive impairment, 46 (61.3%) had mild to moderate white matter lesions. The prevalence of hypertension tended to be higher in subjects with white matter lesions than in those without white matter lesions. Mini-Mental State Examination scores were significantly lower in subjects with white matter lesions than in those without white matter lesions. Subjects with white matter lesions had decreased regional cerebral blood flow mainly in the frontal, parietal, and medial temporal lobes, as well as the putamen, compared to those without white matter lesions. CONCLUSION In subjects with mild cognitive impairment, white matter lesions were associated with cognitive impairment and mainly frontal lobe brain function.
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Affiliation(s)
- Masato Ishibashi
- Department of Neurology, Oita University, Faculty of Medicine, Japan
| | - Noriyuki Kimura
- Department of Neurology, Oita University, Faculty of Medicine, Japan.
| | - Yasuhiro Aso
- Department of Neurology, Oita University, Faculty of Medicine, Japan
| | - Etsuro Matsubara
- Department of Neurology, Oita University, Faculty of Medicine, Japan
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133
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Olivo G, Latini F, Wiemerslage L, Larsson EM, Schiöth HB. Disruption of Accumbens and Thalamic White Matter Connectivity Revealed by Diffusion Tensor Tractography in Young Men with Genetic Risk for Obesity. Front Hum Neurosci 2018. [PMID: 29520227 PMCID: PMC5826967 DOI: 10.3389/fnhum.2018.00075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: Neurovascular coupling is associated with white matter (WM) structural integrity, and it is regulated by specific subtypes of dopaminergic receptors. An altered activity of such receptors, highly expressed in reward-related regions, has been reported in carriers of obesity-risk alleles of the fat mass and obesity associated (FTO) gene. Among the reward-related regions, the thalamus and the nucleus accumbens are particularly vulnerable to blood pressure dysregulation due to their peculiar anatomo-vascular characteristics, and have been consistently reported to be altered in early-stage obesity. We have thus hypothesized that a disruption in thalamus and nucleus accumbens WM microstructure, possibly on neurovascular basis, could potentially be a predisposing factor underlying the enhanced risk for obesity in the risk-allele carriers. Methods: We have tested WM integrity in 21 male participants genotyped on the FTO risk single nucleotide polymorphisms (SNP) rs9939609, through a deterministic tractography analysis. Only homozygous participants (9 AA, 12 TT) were included. 11 tracts were selected and categorized as following according to our hypothesis: “risk tracts”, “obesity-associated tracts”, and a control tract (forcpes major). We investigated whether an association existed between genotype, body mass index (BMI) and WM microstructural integrity in the “risk-tracts” (anterior thalamic radiation and accumbofrontal fasciculus) compared to other tracts. Moreover, we explored whether WM diffusivity could be related to specific personality traits in terms of punishment and reward sensitivity, as measure by the BIS/BAS questionnaire. Results: An effect of the genotype and an interaction effect of genotype and BMI were detected on the fractional anisotropy (FA) of the “risk tracts”. Correlations between WM diffusivity parameters and measures of punishment and reward sensitivity were also detected in many WM tracts of both networks. Conclusions: A disruption of the structural connectivity from the nucleus accumbens and the thalamus might occur early in carriers of the FTO AA risk-allele, and possibly act as a predisposing factor to the development of obesity.
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Affiliation(s)
- Gaia Olivo
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Francesco Latini
- Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lyle Wiemerslage
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Elna-Marie Larsson
- Neuroradiology, Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Functional Pharmacology, Department of Neuroscience, Uppsala University, Uppsala, Sweden
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134
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Keegan AP, Paris D, Luis CA, Abdullah L, Ait-Ghezala G, Beaulieu-Abdelahad D, Pryor M, Chaykin J, Crynen G, Crawford F, Mullan M. Plasma cytokine IL-6 levels and subjective cognitive decline: preliminary findings. Int J Geriatr Psychiatry 2018. [PMID: 28639714 DOI: 10.1002/gps.4752] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Detection of Alzheimer's disease (AD) prior to clinical inception will be paramount for introducing disease modifying treatments. We have begun collecting baseline characteristics of a community cohort for longitudinal assessment and testing of antecedent blood-based biomarkers. We describe the baseline visit from the first 131 subjects in relationship to a commonly described cytokine, interleukin 6 (IL-6). METHODS Subjects from the community presented for a free memory screening with varying degrees of memory concern. We quantified the baseline plasma levels of the cytokine IL-6 and assessed cognition (Montreal Cognitive Assessment, MoCA) and mood (Geriatric Depression Scale, GDS) in relationship to their memory concern. RESULTS Baseline MoCA scores were inversely related to age, and this association was influenced by an AD risk factor, Apolipoprotein E (APOE4) carrier status. The degree of subjective cognitive decline correlated with GDS and was inversely related to MoCA scores. Interleukin 6 levels were related to age, body mass index, and years of education. CONCLUSIONS It will be important to assess how these baseline IL-6 levels and forthcoming novel biomarkers relate to future cognitive decline. Copyright © 2017 John Wiley & Sons, Ltd.
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135
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Santiago C, Herrmann N, Swardfager W, Saleem M, Oh PI, Black SE, Bradley J, Lanctôt KL. Subcortical hyperintensities in the cholinergic system are associated with improvements in executive function in older adults with coronary artery disease undergoing cardiac rehabilitation. Int J Geriatr Psychiatry 2018; 33:279-287. [PMID: 28474775 PMCID: PMC5811800 DOI: 10.1002/gps.4729] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/24/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Coronary artery disease (CAD) is frequently accompanied by white matter hyperintensities and executive dysfunction. Because acetylcholine is important in executive function, these symptoms may be exacerbated by subcortical hyperintensities (SH) located in cholinergic (CH) tracts. This study investigated the effects of SH on cognitive changes in CAD patients undergoing a 48-week cardiac rehabilitation program. METHODS Fifty patients (age 66.5 ± 7.1 years, 84% male) underwent the National Institute of Neurological Disorders and Stroke - Canadian Stroke Network neurocognitive battery at baseline and 48 weeks. Patients underwent a 48-week cardiac program and completed neuroimaging at baseline. Subcortical hyperintensities in CH tracts were measured using Lesion Explorer. Repeated measures general linear models were used to examine interactions between SH and longitudinal cognitive outcomes, controlling for age, education, and max VO2 change as a measure of fitness. RESULTS In patients with SH in CH tracts, there was a significant interaction with the Trail Making Test (TMT) part A and part B over time. Patients without SH improved on average 16.6 and 15.0% on the TMT-A and TMT-B, respectively. Patients with SH on average showed no improvements in either TMT-A or TMT-B over time. There were no significant differences in other cognitive measures. CONCLUSION These results suggest that CAD patients with SH in CH tracts improve less than those without SH in CH tracts, over 48 weeks of cardiac rehabilitation. Thus, SH in CH tracts may contribute to longitudinal cognitive decline following a cardiac event and may represent a vascular risk factor of cognitive decline. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Calvin Santiago
- Neuropsychopharmacology Research GroupSunnybrook Research InstituteTorontoOntarioCanada,Toronto Rehabilitation InstituteTorontoOntarioCanada
| | - Nathan Herrmann
- Neuropsychopharmacology Research GroupSunnybrook Research InstituteTorontoOntarioCanada,Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Canadian Partnership for Stroke RecoverySunnybrook Research InstituteTorontoOntarioCanada
| | - Walter Swardfager
- Canadian Partnership for Stroke RecoverySunnybrook Research InstituteTorontoOntarioCanada,Department of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
| | - Mahwesh Saleem
- Neuropsychopharmacology Research GroupSunnybrook Research InstituteTorontoOntarioCanada,Department of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada
| | - Paul I. Oh
- Toronto Rehabilitation InstituteTorontoOntarioCanada
| | - Sandra E. Black
- Canadian Partnership for Stroke RecoverySunnybrook Research InstituteTorontoOntarioCanada,Department of Medicine (Neurology)Sunnybrook Health Sciences Centre and University of TorontoTorontoOntarioCanada,Brain Sciences Research ProgramSunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
| | - Janelle Bradley
- Neuropsychopharmacology Research GroupSunnybrook Research InstituteTorontoOntarioCanada
| | - Krista L. Lanctôt
- Neuropsychopharmacology Research GroupSunnybrook Research InstituteTorontoOntarioCanada,Toronto Rehabilitation InstituteTorontoOntarioCanada,Department of PsychiatryUniversity of TorontoTorontoOntarioCanada,Canadian Partnership for Stroke RecoverySunnybrook Research InstituteTorontoOntarioCanada,Department of Pharmacology and ToxicologyUniversity of TorontoTorontoOntarioCanada,Brain Sciences Research ProgramSunnybrook Research Institute, Sunnybrook Health Sciences CentreTorontoOntarioCanada
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136
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Mito R, Raffelt D, Dhollander T, Vaughan DN, Tournier JD, Salvado O, Brodtmann A, Rowe CC, Villemagne VL, Connelly A. Fibre-specific white matter reductions in Alzheimer’s disease and mild cognitive impairment. Brain 2018; 141:888-902. [DOI: 10.1093/brain/awx355] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/08/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Remika Mito
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3084, Australia
| | - David Raffelt
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
| | - Thijs Dhollander
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
| | - David N Vaughan
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3084, Australia
- Department of Neurology, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - J-Donald Tournier
- Department of Biomedical Engineering, Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, WC2R 2LS, UK
- Centre for the Developing Brain, King’s College London, London, WC2R 2LS, UK
| | - Olivier Salvado
- CSIRO, Health and Biosecurity, The Australian eHealth Research Centre, Brisbane, Queensland, 4029, Australia
| | - Amy Brodtmann
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3084, Australia
- Eastern Clinical Research Unit, Monash University, Box Hill Hospital, Melbourne, Victoria, 3128, Australia
| | - Christopher C Rowe
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, 3084, Australia
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - Victor L Villemagne
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
- Department of Medicine, Austin Health, University of Melbourne, Heidelberg, Victoria, 3084, Australia
- Department of Molecular Imaging and Therapy, Austin Health, Heidelberg, Victoria, 3084, Australia
| | - Alan Connelly
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, 3084, Australia
- Florey Department of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, 3084, Australia
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Hirsiger S, Koppelmans V, Mérillat S, Erdin C, Narkhede A, Brickman AM, Jäncke L. Executive Functions in Healthy Older Adults Are Differentially Related to Macro- and Microstructural White Matter Characteristics of the Cerebral Lobes. Front Aging Neurosci 2017; 9:373. [PMID: 29249957 PMCID: PMC5715235 DOI: 10.3389/fnagi.2017.00373] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 10/31/2017] [Indexed: 01/13/2023] Open
Abstract
Aging is associated with microstructural white matter (WM) changes. WM microstructural characteristics, measured with diffusion tensor imaging (DTI), are different in normal appearing white matter (NAWM) and WM hyperintensities (WMH). It is largely unknown how the microstructural properties of WMH are associated with cognition and if there are regional effects for specific cognitive domains. We therefore examined within 200 healthy older participants (a) differences in microstructural characteristics of NAWM and WMH per cerebral lobe; and (b) the association of macrostructural (WMH volume) and microstructural characteristics (within NAWM and WMH separately) of each lobe with measures of executive function and processing speed. Multi-modal imaging (i.e., T1, DTI, and FLAIR) was used to assess WM properties. The Stroop and the Trail Making Test were used to measure inhibition, task-switching (both components of executive function), and processing speed. We observed that age was associated with deterioration of white matter microstructure of the NAWM, most notably in the frontal lobe. Older participants had larger WMH volumes and lowest fractional anisotropy values within WMH were found in the frontal lobe. Task-switching was associated with cerebral NAWM volume and NAWM volume of all lobes. Processing speed was associated with total NAWM volume, and microstructural properties of parietal NAWM, the parietal WMH, and the temporal NAWM. Task-switching was related to microstructural properties of WMH of the frontal lobe and WMH volume of the parietal lobe. Our results confirm that executive functioning and processing speed are uniquely associated with macro- and microstructural properties of NAWM and WMH. We further demonstrate for the first time that these relationships differ by lobar region. This warrants the consideration of these distinct WM indices when investigating cognitive function.
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Affiliation(s)
- Sarah Hirsiger
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Vincent Koppelmans
- Department of Psychiatry, University of Utah, Salt Lake City, UT, United States.,School of Kinesiology, University of Michigan, Ann Arbor, MI, United States
| | - Susan Mérillat
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Cornelia Erdin
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland
| | - Atul Narkhede
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, United States
| | - Lutz Jäncke
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.,Division of Neuropsychology, University of Zurich, Zurich, Switzerland.,Department of Special Education, King Abdulaziz University, Jeddah, Saudi Arabia
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138
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Svärd D, Nilsson M, Lampinen B, Lätt J, Sundgren PC, Stomrud E, Minthon L, Hansson O, van Westen D. The effect of white matter hyperintensities on statistical analysis of diffusion tensor imaging in cognitively healthy elderly and prodromal Alzheimer's disease. PLoS One 2017; 12:e0185239. [PMID: 28934374 PMCID: PMC5608410 DOI: 10.1371/journal.pone.0185239] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 09/09/2017] [Indexed: 11/20/2022] Open
Abstract
Diffusion tensor imaging (DTI) has been used to study microstructural white matter alterations in a variety of conditions including normal aging and Alzheimer's disease (AD). White matter hyperintensities (WMH) are common in cognitively healthy elderly as well as in AD and exhibit elevated mean diffusivity (MD) and reduced fractional anisotropy (FA). However, the effect of WMH on statistical analysis of DTI estimates has not been thoroughly studied. In the present study we address this in two ways. First, we investigate the effect of WMH on MD and FA in the dorsal and ventral cingulum, the superior longitudinal fasciculus, and the corticospinal tract, by comparing two matched groups of cognitively healthy elderly (n = 21 + 21) with unequal WMH load. Second, we assess the effects of adjusting for WMH load when comparing MD and FA in prodromal AD subjects (n = 83) to cognitively healthy elderly (n = 132) in the abovementioned white matter tracts. Results showed the WMH in cognitively healthy elderly to have a generally large effect on DTI estimates (Cohen’s d = 0.63 to 1.27 for significant differences in MD and −1.06 to −0.69 for FA). These effect sizes were comparable to those of various neurological and psychiatric diseases (Cohen’s d = 0.57 to 2.20 for differences in MD and −1.76 to −0.61 for FA). Adjusting for WMH when comparing DTI estimates in prodromal AD subjects to cognitively healthy elderly improved the explanatory power as well as the outcome of the analysis, indicating that some of the differences in MD and FA were largely driven by unequal WMH load between the groups rather than alterations in normal-appearing white matter (NAWM). Thus, our findings suggest that if the purpose of a study is to compare alterations in NAWM between two groups using DTI it may be necessary to adjust the statistical analysis for WMH.
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Affiliation(s)
- Daniel Svärd
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
- * E-mail:
| | - Markus Nilsson
- Lund University Bioimaging Center, Lund University, Lund, Sweden
| | - Björn Lampinen
- Medical Radiation Physics, Lund University, Lund, Sweden
| | - Jimmy Lätt
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Pia C. Sundgren
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
| | - Erik Stomrud
- Clinical Memory Research, Lund University, Malmoö, Sweden
| | | | - Oskar Hansson
- Clinical Memory Research, Lund University, Malmoö, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Lund University, Lund, Sweden
- Medical Imaging and Physiology, Skåne University Hospital, Lund, Sweden
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139
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Tabei KI, Kida H, Hosoya T, Satoh M, Tomimoto H. Prediction of Cognitive Decline from White Matter Hyperintensity and Single-Photon Emission Computed Tomography in Alzheimer's Disease. Front Neurol 2017; 8:408. [PMID: 28928704 PMCID: PMC5591322 DOI: 10.3389/fneur.2017.00408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/28/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND While several studies support an association of white matter hyperintensity (WMH) volume and regional cerebral blood flow (rCBF) with cognitive decline in Alzheimer's disease (AD), no reports have simultaneously considered the effects of both factors on cognitive decline. OBJECTIVE The purpose of the present study was to compare WMH volume and rCBF in relation to cognitive function by developing a new software program to fuse magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) data. METHOD We used MRI, SPECT, and neuropsychological data from 182 serial outpatients treated at the memory clinic of our hospital. RESULTS Twenty-nine AD patients fulfilled the inclusion criteria (18 females, mean age: 73.1 ± 7.9 years, mean Mini-Mental State Examination: 23.1 ± 3.0). Analysis of variance revealed that posterior deep WMH (DWMH) volume was significantly larger than both anterior periventricular hyperintensity (PVH) and DWMH, and posterior PVH volumes. Multivariate regression analysis showed that increased volumes of the anterior PVH and the posterior DWMH and decreased rCBF of the parietal cortex negatively affected cognitive function. The other areas had no significant negative effects on cognitive function. CONCLUSION Our findings show that the volume of the posterior WMH was significantly larger than that of other areas, and the increased posterior WMH volume and decreased rCBF of the parietal cortex negatively affected cognitive function. Therefore, the posterior WMH volume and the parietal rCBF are key parameters of cognitive decline in AD patients.
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Affiliation(s)
- Ken-Ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | | | - Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan
| | - Hidekazu Tomimoto
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Mie, Japan.,Department of Neurology, Graduate School of Medicine, Mie University, Mie, Japan
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140
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McAleese KE, Walker L, Graham S, Moya ELJ, Johnson M, Erskine D, Colloby SJ, Dey M, Martin-Ruiz C, Taylor JP, Thomas AJ, McKeith IG, De Carli C, Attems J. Parietal white matter lesions in Alzheimer's disease are associated with cortical neurodegenerative pathology, but not with small vessel disease. Acta Neuropathol 2017. [PMID: 28638989 PMCID: PMC5563333 DOI: 10.1007/s00401-017-1738-2] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cerebral white matter lesions (WML) encompass axonal loss and demyelination, and the pathogenesis is assumed to be small vessel disease (SVD)-related ischemia. However, WML may also result from the activation of Wallerian degeneration as a consequence of cortical Alzheimer's disease (AD) pathology, i.e. hyperphosphorylated tau (HPτ) and amyloid-beta (Aβ) deposition. WML seen in AD have a posterior predominance compared to non-demented individuals but it is unclear whether the pathological and molecular signatures of WML differ between these two groups. We investigated differences in the composition and aetiology of parietal WML from AD and non-demented controls. Parietal WML tissue from 55 human post-mortem brains (AD, n = 27; non-demented controls, n = 28) were quantitatively assessed for axonal loss and demyelination, as well as for cortical HPτ and Aβ burden and SVD. Biochemical assessment included Wallerian degeneration protease calpain and the myelin-associated glycoprotein (MAG) to proteolipid protein (PLP) ratio (MAG:PLP) as a measure of hypoperfusion. WML severity was associated with both axonal loss and demyelination in AD, but only with demyelination in controls. Calpain was significantly increased in WML tissue in AD, whereas MAG:PLP was significantly reduced in controls. Calpain levels were associated with increasing amounts of cortical AD-pathology but not SVD. We conclude that parietal WML seen in AD differ in their pathological composition and aetiology compared to WML seen in aged controls: WML seen in AD may be associated with Wallerian degeneration that is triggered by cortical AD-pathology, whereas WML in aged controls are due to ischaemia. Hence, parietal WML as seen on MRI should not invariably be interpreted as a surrogate biomarker for SVD as they may be indicative of cortical AD-pathology, and therefore, AD should also be considered as the main underlying cause for cognitive impairment in cases with parietal WML.
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141
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Robinson-Papp J, Navis A, Dhamoon MS, Clark US, Gutierrez-Contreras J, Morgello S. The Use of Visual Rating Scales to Quantify Brain MRI Lesions in Patients with HIV Infection. J Neuroimaging 2017; 28:217-224. [PMID: 28833868 DOI: 10.1111/jon.12466] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/25/2017] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Human immunodeficiency virus (HIV)-infected patients commonly have abnormalities in cerebral white matter that are visible on magnetic resonance imaging (MRI) as hyperintensities (WMHs). Visual rating scales (VRSs) have been used to quantify WMH in other diseases such as cerebral small vessel disease (CSVD), but not in HIV. Such scales are advantageous because they are applicable to routinely acquired MRIs and so are suitable for large-scale studies and clinical care. We sought to establish the utility of three VRSs (the Fazekas, Scheltens, and van Sweiten scales) in HIV. METHODS The Manhattan HIV Brain Bank (MHBB) is a longitudinal cohort study that performs serial neurologic examinations and neuropsychological testing. All brain MRIs (n = 73) performed for clinical purposes on MHBB participants were scored using the three VRSs. We assessed reliability, validity, and correlation of the VRS with clinical factors relevant to HIV and CSVD. RESULTS The VRSs all showed acceptable internal consistency and interrater reliability and were highly correlated with one another (r = 0.836-0.916, P < .001). The Fazekas and Scheltens scales demonstrated more WMH in periventricular regions, and the Scheltens scale also suggested a frontal to occipital gradient, with greater WMH frontally. All three VRSs correlated significantly with cognitive impairment (global T score). Age and hepatitis C virus antibody serostatus were the strongest clinical/demographic correlates of WMH, followed by African-American race. CONCLUSIONS VRSs reliably quantify WMH in HIV-infected individuals and correlate with cognitive impairment. Future studies may find routinely acquired brain MRI quantified by VRS to be an accessible and meaningful neurologic outcome measure in HIV.
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Affiliation(s)
| | - Allison Navis
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Mandip S Dhamoon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Uraina S Clark
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Susan Morgello
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY
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142
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Keith J, Gao FQ, Noor R, Kiss A, Balasubramaniam G, Au K, Rogaeva E, Masellis M, Black SE. Collagenosis of the Deep Medullary Veins: An Underrecognized Pathologic Correlate of White Matter Hyperintensities and Periventricular Infarction? J Neuropathol Exp Neurol 2017; 76:299-312. [PMID: 28431180 DOI: 10.1093/jnen/nlx009] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
White matter hyperintensities (WMH) are prevalent. Although arteriolar disease has been implicated in their pathogenesis, venous pathology warrants consideration. We investigated relationships of WMH with histologic venous, arteriolar and white matter abnormalities and correlated findings with premortem neuroimaging. Three regions of periventricular white matter were sampled from archived autopsy brains of 24 pathologically confirmed Alzheimer disease (AD) and 18 age-matched nonAD patients. Using trichrome staining, venous collagenosis (VC) of periventricular veins (<150 µm in diameter) was scored for severity of wall thickening and occlusion; percent stenosis by collagenosis of large caliber (>200 µm) veins (laVS) was measured. Correlations were made between WMH in premortem neuroimaging and vascular and white matter pathology. We found greater VC (U(114) = 2092.5, p = 0.005 and U(114) = 2121.5, p = 0.002 for small and medium caliber veins, respectively) and greater laVS (t(110) = 3.46, p = 0.001) in patients with higher WMH scores; WMH scores correlated with VC (rs(114) = 0.27, p = 0.004) and laVS (rs(110) = 0.38, p < 0.001). By multiple linear regression analysis, the strongest predictor of WMH score was laVS (β = 0.338, p < 0.0001). VC was frequent in patients with periventricular infarcts identified on imaging. We conclude that periventricular VC is associated with WMH in both AD and nonAD patients and the potential roles of VC in WMH pathogenesis merit further study.
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Affiliation(s)
- Julia Keith
- Department of Anatomic Pathology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Fu-Qiang Gao
- L.C. Campbell Cognitive Neurology Unit, Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Health Science Center, University of Toronto, Toronto, Canada
| | - Raza Noor
- Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alex Kiss
- Evaluative Clinical Sciences, Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Gayathiri Balasubramaniam
- Department of Anatomic Pathology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Kelvin Au
- Department of Anatomic Pathology, Sunnybrook Health Sciences Center, University of Toronto, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- L.C. Campbell Cognitive Neurology Unit, Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Health Science Center, University of Toronto, Toronto, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Unit, Heart and Stroke Foundation Center for Stroke Recovery, Sunnybrook Health Science Center, University of Toronto, Toronto, Canada.,Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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143
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Birdsill AC, Oleson S, Kaur S, Pasha E, Ireton A, Tanaka H, Haley A. Abdominal obesity and white matter microstructure in midlife. Hum Brain Mapp 2017; 38:3337-3344. [PMID: 28390146 DOI: 10.1002/hbm.23576] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 12/12/2022] Open
Abstract
The aging U.S. population and the recent rise in the prevalence of obesity are two phenomena of great importance to public health. In addition, research suggests that midlife body mass index (BMI) is a risk factor for dementia, a particularly costly disease, in later life. BMI could influence brain health by adversely impacting cerebral white matter. Recently, greater BMI has been associated with lower white matter fractional anisotropy (FA), an index of tissue microstructure, as measured by diffusion-tensor imaging in midlife. The aim of this study was to investigate the role of abdominal obesity, the most metabolically active adipose tissue compartment, and white matter microstructure in midlife. Community dwelling participants (N = 168) between the ages of 40-62 underwent MRI scanning at 3T and a general health assessment. Inferences were made on whole brain white matter tracts using full-tensor, high-dimension normalization, and tract-based spatial statistics. Higher waist circumference was associated with higher FA, indicating more directional diffusion in several white matter tracts controlling for age, sex, triglycerides, systolic blood pressure, fasting glucose, and HDL-cholesterol. Post hoc analysis revealed that greater waist circumference was associated with lower axial diffusivity, indicating lower parallel diffusion; lower radial diffusivity, indicating lower perpendicular diffusion; and lower mean diffusivity, indicating restricted diffusion. This is the first study to report a positive relationship between obesity and FA, indicating a more complicated view of this relationship in the aging brain. Hum Brain Mapp 38:3337-3344, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Alex Cole Birdsill
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Stephanie Oleson
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Sonya Kaur
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Evan Pasha
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, Texas
| | - Adele Ireton
- Department of Psychology, The University of Texas at Austin, Austin, Texas
| | - Hirofumi Tanaka
- Department of Kinesiology & Health Education, The University of Texas at Austin, Austin, Texas
| | - Andreana Haley
- Department of Psychology, The University of Texas at Austin, Austin, Texas
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144
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Amin N, Jovanova O, Adams HHH, Dehghan A, Kavousi M, Vernooij MW, Peeters RP, de Vrij FMS, van der Lee SJ, van Rooij JGJ, van Leeuwen EM, Chaker L, Demirkan A, Hofman A, Brouwer RWW, Kraaij R, Willems van Dijk K, Hankemeier T, van Ijcken WFJ, Uitterlinden AG, Niessen WJ, Franco OH, Kushner SA, Ikram MA, Tiemeier H, van Duijn CM. Exome-sequencing in a large population-based study reveals a rare Asn396Ser variant in the LIPG gene associated with depressive symptoms. Mol Psychiatry 2017; 22:537-543. [PMID: 27431295 DOI: 10.1038/mp.2016.101] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 04/19/2016] [Accepted: 04/20/2016] [Indexed: 11/09/2022]
Abstract
Despite a substantial genetic component, efforts to identify common genetic variation underlying depression have largely been unsuccessful. In the current study we aimed to identify rare genetic variants that might have large effects on depression in the general population. Using high-coverage exome-sequencing, we studied the exonic variants in 1265 individuals from the Rotterdam study (RS), who were assessed for depressive symptoms. We identified a missense Asn396Ser mutation (rs77960347) in the endothelial lipase (LIPG) gene, occurring with an allele frequency of 1% in the general population, which was significantly associated with depressive symptoms (P-value=5.2 × 10-08, β=7.2). Replication in three independent data sets (N=3612) confirmed the association of Asn396Ser (P-value=7.1 × 10-03, β=2.55) with depressive symptoms. LIPG is predicted to have enzymatic function in steroid biosynthesis, cholesterol biosynthesis and thyroid hormone metabolic processes. The Asn396Ser variant is predicted to have a damaging effect on the function of LIPG. Within the discovery population, carriers also showed an increased burden of white matter lesions (P-value=3.3 × 10-02) and a higher risk of Alzheimer's disease (odds ratio=2.01; P-value=2.8 × 10-02) compared with the non-carriers. Together, these findings implicate the Asn396Ser variant of LIPG in the pathogenesis of depressive symptoms in the general population.
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Affiliation(s)
- N Amin
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - O Jovanova
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - H H H Adams
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - A Dehghan
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - M Kavousi
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - M W Vernooij
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - R P Peeters
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Rotterdam Thyroid Center, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - F M S de Vrij
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - S J van der Lee
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - J G J van Rooij
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - E M van Leeuwen
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - L Chaker
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Rotterdam Thyroid Center, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - A Demirkan
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, RC Leiden, The Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - R W W Brouwer
- Center for Biomics, Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - R Kraaij
- Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - K Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, RC Leiden, The Netherlands.,Division of Endocrinology, Department of Medicine, Leiden University Medical Center, RC Leiden, The Netherlands
| | - T Hankemeier
- Leiden Academic Center for Drug Research, Division of Analytical Biosciences, Leiden University, Leiden, The Netherlands.,The Netherlands Metabolomics Centre, Leiden University, Leiden, The Netherlands
| | - W F J van Ijcken
- Center for Biomics, Department of Cell Biology, Erasmus MC, Rotterdam, The Netherlands
| | - A G Uitterlinden
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - W J Niessen
- Departments of Radiology and Medical Informatics, Erasmus MC, Rotterdam, The Netherlands.,Department of Imaging Physics, Delft University of Technology, Delft, The Netherlands
| | - O H Franco
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - S A Kushner
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - M A Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.,Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - H Tiemeier
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - C M van Duijn
- Genetic Epidemiology Unit, Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
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145
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Ogama N, Sakurai T, Nakai T, Niida S, Saji N, Toba K, Umegaki H, Kuzuya M. Impact of frontal white matter hyperintensity on instrumental activities of daily living in elderly women with Alzheimer disease and amnestic mild cognitive impairment. PLoS One 2017; 12:e0172484. [PMID: 28253275 PMCID: PMC5333806 DOI: 10.1371/journal.pone.0172484] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 02/06/2017] [Indexed: 11/19/2022] Open
Abstract
Background Instrumental activities of daily living (IADL) start to decline during the progression of amnestic mild cognitive impairment (aMCI) to Alzheimer disease (AD). Cognitive and physical decline are involved in the loss of functional independence. However, little is known about AD-related neural change that leads to IADL impairment. The purpose of this study was to clarify the effects of regional white matter hyperintensity (WMH) on IADL impairment in persons with AD and aMCI. Methods The participants were 347 female subjects aged 65–85 years diagnosed with AD (n = 227), aMCI (n = 44) or normal cognition (n = 76). IADL was assessed by the Lawton Index. Cognition, mood and mobility function were evaluated by comprehensive geriatric assessment batteries. WMH and brain atrophy were analyzed with brain magnetic resonance imaging, using an automatic segmentation program. Regional WMH was measured in the frontal, temporal, occipital and parietal lobes. Results Ability to carry out IADL of shopping, food preparation, mode of transportation, responsibility for own medication, and ability to handle finances was obviously impaired in the early stage of AD. Frontal WMH was specifically associated with disability to do shopping and food preparation even after adjusting for several confounders including brain atrophy. Conclusions IADL subcategories were differentially impaired along with cognitive status in persons with AD and aMCI. Frontal WMH was an important predictor of impaired ability to do shopping and food preparation. A preventive strategy for WMH might lead to suppression of IADL disability and slow the progression of AD.
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Affiliation(s)
- Noriko Ogama
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
- * E-mail:
| | - Toshiharu Nakai
- NeuroImaging and Informatics, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shumpei Niida
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kenji Toba
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hiroyuki Umegaki
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masafumi Kuzuya
- Department of Community Healthcare and Geriatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
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146
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Sarro L, Tosakulwong N, Schwarz CG, Graff-Radford J, Przybelski SA, Lesnick TG, Zuk SM, Reid RI, Raman MR, Boeve BF, Ferman TJ, Knopman DS, Comi G, Filippi M, Murray ME, Parisi JE, Dickson DW, Petersen RC, Jack CR, Kantarci K. An investigation of cerebrovascular lesions in dementia with Lewy bodies compared to Alzheimer's disease. Alzheimers Dement 2017; 13:257-266. [PMID: 27521790 PMCID: PMC5303194 DOI: 10.1016/j.jalz.2016.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 07/08/2016] [Accepted: 07/11/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Cerebrovascular lesions on MRI are common in Alzheimer's disease (AD) dementia, but less is known about their frequency and impact on dementia with Lewy bodies (DLB). METHODS White-matter hyperintensities (WMHs) and infarcts on MRI were assessed in consecutive DLB (n = 81) and AD dementia (n = 240) patients and compared to age-matched and sex-matched cognitively normal subjects (CN) from a population-based cohort. RESULTS DLB had higher WMH volume compared to CN, and WMH volume was higher in the occipital and posterior periventricular regions in DLB compared to AD. Higher WMH volume was associated with history of cardiovascular disease and diabetes but not with clinical disease severity in DLB. Frequency of infarcts in DLB was not different from CN and AD dementia. DISCUSSION In DLB, WMH volume is higher than AD and CN and appears to be primarily associated with history of vascular disease.
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Affiliation(s)
- Lidia Sarro
- Department of Radiology, Mayo Clinic, Rochester, MN, USA; Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | | | | | - Timothy G Lesnick
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Samantha M Zuk
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Robert I Reid
- Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Mekala R Raman
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Tanis J Ferman
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Giancarlo Comi
- Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy; Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | | | - Ronald C Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Kejal Kantarci
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
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147
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Oppedal K, Engan K, Eftestøl T, Beyer M, Aarsland D. Classifying Alzheimer's disease, Lewy body dementia, and normal controls using 3D texture analysis in magnetic resonance images. Biomed Signal Process Control 2017. [DOI: 10.1016/j.bspc.2016.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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148
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Lindemer ER, Greve DN, Fischl BR, Augustinack JC, Salat DH. Regional staging of white matter signal abnormalities in aging and Alzheimer's disease. Neuroimage Clin 2017; 14:156-165. [PMID: 28180074 PMCID: PMC5279704 DOI: 10.1016/j.nicl.2017.01.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 01/02/2017] [Accepted: 01/20/2017] [Indexed: 11/07/2022]
Abstract
White matter lesions, quantified as 'white matter signal abnormalities' (WMSA) on neuroimaging, are common incidental findings on brain images of older adults. This tissue damage is linked to cerebrovascular dysfunction and is associated with cognitive decline. The regional distribution of WMSA throughout the cerebral white matter has been described at a gross scale; however, to date no prior study has described regional patterns relative to cortical gyral landmarks which may be important for understanding functional impact. Additionally, no prior study has described how regional WMSA volume scales with total global WMSA. Such information could be used in the creation of a pathologic 'staging' of WMSA through a detailed regional characterization at the individual level. Magnetic resonance imaging data from 97 cognitively-healthy older individuals (OC) aged 52-90 from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study were processed using a novel WMSA labeling procedure described in our prior work. WMSA were quantified regionally using a procedure that segments the cerebral white matter into 35 bilateral units based on proximity to landmarks in the cerebral cortex. An initial staging was performed by quantifying the regional WMSA volume in four groups based on quartiles of total WMSA volume (quartiles I-IV). A consistent spatial pattern of WMSA accumulation was observed with increasing quartile. A clustering procedure was then used to distinguish regions based on patterns of scaling of regional WMSA to global WMSA. Three patterns were extracted that showed high, medium, and non-scaling with global WMSA. Regions in the high-scaling cluster included periventricular, caudal and rostral middle frontal, inferior and superior parietal, supramarginal, and precuneus white matter. A data-driven staging procedure was then created based on patterns of WMSA scaling and specific regional cut-off values from the quartile analyses. Individuals with Alzheimer's disease (AD) and mild cognitive impairment (MCI) were then additionally staged, and significant differences in the percent of each diagnostic group in Stages I and IV were observed, with more AD individuals residing in Stage IV and more OC and MCI individuals residing in Stage I. These data demonstrate a consistent regional scaling relationship between global and regional WMSA that can be used to classify individuals into one of four stages of white matter disease. White matter staging could play an important role in a better understanding and the treatment of cerebrovascular contributions to brain aging and dementia.
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Affiliation(s)
- Emily R. Lindemer
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Douglas N. Greve
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Bruce R. Fischl
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Computer Science and Artificial Intelligence Laboratory (CSAIL), Massachusetts Institute of Technology (MIT), Cambridge, MA, USA
| | - Jean C. Augustinack
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David H. Salat
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
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149
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Watson C, Busovaca E, Foley JM, Allen IE, Schwarz CG, Jahanshad N, Nir TM, Esmaeili-Firidouni P, Milanini B, Rosen H, Carmichael OT, Thompson PM, Valcour VG. White matter hyperintensities correlate to cognition and fiber tract integrity in older adults with HIV. J Neurovirol 2017; 23:422-429. [PMID: 28101804 DOI: 10.1007/s13365-016-0509-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/20/2016] [Accepted: 12/26/2016] [Indexed: 12/24/2022]
Abstract
Our aim was to examine the clinical relevance of white matter hyperintensities (WMH) in HIV. We used an automated approach to quantify WMH volume in HIV seropositive (HIV+; n = 65) and HIV seronegative (HIV-; n = 29) adults over age 60. We compared WMH volumes between HIV+ and HIV- groups in cross-sectional and multiple time-point analyses. We also assessed correlations between WMH volumes and cardiovascular, HIV severity, cognitive scores, and diffusion tensor imaging variables. Serostatus groups did not differ in WMH volume, but HIV+ participants had less cerebral white matter (mean: 470.95 [43.24] vs. 497.63 [49.42] mL, p = 0.010). The distribution of WMH volume was skewed in HIV+ with a high proportion (23%) falling above the 95th percentile of WMH volume defined by the HIV- group. Serostatus groups had similar amount of WMH volume growth over time. Total WMH volume directly correlated with measures of hypertension and inversely correlated with measures of global cognition, particularly in executive functioning, and psychomotor speed. Greater WMH volume was associated with poorer brain integrity measured from diffusion tensor imaging (DTI) in the corpus callosum and sagittal stratum. In this group of HIV+ individuals over 60, WMH burden was associated with cardiovascular risk and both worse diffusion MRI and cognition. The median total burden did not differ by serostatus; however, a subset of HIV+ individuals had high WMH burden.
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Affiliation(s)
- Christa Watson
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
| | - Edgar Busovaca
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jessica M Foley
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - I Elaine Allen
- Department of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, CA, USA
| | - Christopher G Schwarz
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Center for Neuroscience, Department of Neurology, University of California, Davis, Davis, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Talia M Nir
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Pardis Esmaeili-Firidouni
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Howard Rosen
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Owen T Carmichael
- Biomedical Imaging Center, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Victor G Valcour
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
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150
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Fiford CM, Manning EN, Bartlett JW, Cash DM, Malone IB, Ridgway GR, Lehmann M, Leung KK, Sudre CH, Ourselin S, Biessels GJ, Carmichael OT, Fox NC, Cardoso MJ, Barnes J. White matter hyperintensities are associated with disproportionate progressive hippocampal atrophy. Hippocampus 2017; 27:249-262. [PMID: 27933676 PMCID: PMC5324634 DOI: 10.1002/hipo.22690] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 11/30/2016] [Indexed: 01/18/2023]
Abstract
This study investigates relationships between white matter hyperintensity (WMH) volume, cerebrospinal fluid (CSF) Alzheimer's disease (AD) pathology markers, and brain and hippocampal volume loss. Subjects included 198 controls, 345 mild cognitive impairment (MCI), and 154 AD subjects with serial volumetric 1.5‐T MRI. CSF Aβ42 and total tau were measured (n = 353). Brain and hippocampal loss were quantified from serial MRI using the boundary shift integral (BSI). Multiple linear regression models assessed the relationships between WMHs and hippocampal and brain atrophy rates. Models were refitted adjusting for (a) concurrent brain/hippocampal atrophy rates and (b) CSF Aβ42 and tau in subjects with CSF data. WMH burden was positively associated with hippocampal atrophy rate in controls (P = 0.002) and MCI subjects (P = 0.03), and with brain atrophy rate in controls (P = 0.03). The associations with hippocampal atrophy rate remained following adjustment for concurrent brain atrophy rate in controls and MCIs, and for CSF biomarkers in controls (P = 0.007). These novel results suggest that vascular damage alongside AD pathology is associated with disproportionately greater hippocampal atrophy in nondemented older adults. © 2016 The Authors Hippocampus Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Cassidy M Fiford
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Emily N Manning
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | | | - David M Cash
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Ian B Malone
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Gerard R Ridgway
- Nuffield Department of Clinical Neurosciences, FMRIB Centre, University of Oxford, United Kingdom.,Wellcome Trust Centre for Neuroimaging, London, United Kingdom
| | - Manja Lehmann
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Kelvin K Leung
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - Carole H Sudre
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Sebastien Ourselin
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Geert Jan Biessels
- Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus University Medical Center Utrecht, The Netherlands
| | | | - Nick C Fox
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
| | - M Jorge Cardoso
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom.,Translational Imaging Group, Centre for Medical Image Computing, University College London, London, United Kingdom
| | - Josephine Barnes
- Department of Neurodegenerative Disease, Dementia Research Centre, UCL Institute of Neurology, London, United Kingdom
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