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Bednorz A, Religa D. Utility of the Comprehensive Trail Making Test in the Assessment of Mild Cognitive Impairment in Older Patients. Geriatrics (Basel) 2023; 8:108. [PMID: 37987468 PMCID: PMC10660718 DOI: 10.3390/geriatrics8060108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/18/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The purpose of this study is to determine the usefulness of the CTMT (Comprehensive Trail Making Test) in diagnosing mild cognitive impairment in older patients. The test is used to assess executive functions, of which impairment is already observed in the early stages of the neurodegenerative process. MATERIALS AND METHODS The study includes 98 patients of a geriatric ward assigned to 2 groups of 49 patients each: patients diagnosed with a mild cognitive impairment and patients without a cognitive impairment, constituting the control group (group K). A set of screening tests was used in the initial study: the MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment), and CDT (Clock Drawing Test), GDS (Geriatric Depression Scale). The second study included the performance of the CTMT; the performance indicator was the time of performance. RESULTS Statistically significant differences are obtained between patients with mild cognitive impairments and those in cognitive normality in the performance of the CTMT test (p < 0.01). Patients with MCIs took longer to complete all trails of the test. To identify cognitive impairment, cutoff points were proposed for the CTMT total score and the other test trails. The CTMT overall score and CTMT 5 scored the highest AUCs (CTMT overall score = 0.77, CTMT Trail 5 = 0.80). CONCLUSIONS The Comprehensive Trail Making Test may be useful in diagnosing mild cognitive impairment as a complementary screening tool.
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Affiliation(s)
- Adam Bednorz
- John Paul II Geriatric Hospital, 40-353 Katowice, Poland;
- Institute of Psychology, Humanitas Academy, 41-200 Sosnowiec, Poland
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 86 Huddinge, Sweden
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202
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Amos JG, Zheng L, Eramudugolla R, Parekh D, Huque MH, Delbaere K, Lautenschlager N, Anstey KJ. MyCOACH (COnnected Advice for Cognitive Health): a digitally delivered multidomain intervention for cognitive decline and risk of dementia in adults with mild cognitive impairment or subjective cognitive decline-study protocol for a randomised controlled trial. BMJ Open 2023; 13:e075015. [PMID: 37903606 PMCID: PMC10619101 DOI: 10.1136/bmjopen-2023-075015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/26/2023] [Indexed: 11/01/2023] Open
Abstract
INTRODUCTION Digital health interventions are cost-effective and easily accessible, but there is currently a lack of effective online options for dementia prevention especially for people at risk due to mild cognitive impairment (MCI) or subjective cognitive decline (SCD). METHODS AND ANALYSIS MyCOACH (COnnected Advice for Cognitive Health) is a tailored online dementia risk reduction programme for adults aged ≥65 living with MCI or SCD. The MyCOACH trial aims to evaluate the programme's effectiveness in reducing dementia risk compared with an active control over a 64-week period (N=326). Eligible participants are randomly allocated to one of two intervention arms for 12 weeks: (1) the MyCOACH intervention programme or (2) email bulletins with general healthy ageing information (active control). The MyCOACH intervention programme provides participants with information about memory impairments and dementia, memory strategies and different lifestyle factors associated with brain ageing as well as practical support including goal setting, motivational interviewing, brain training, dietary and exercise consultations, and a 26-week post-intervention booster session. Follow-up assessments are conducted for all participants at 13, 39 and 65 weeks from baseline, with the primary outcome being exposure to dementia risk factors measured using the Australian National University-Alzheimer's Disease Risk Index. Secondary measures include cognitive function, quality of life, functional impairment, motivation to change behaviour, self-efficacy, morale and dementia literacy. ETHICS AND DISSEMINATION Ethical approval was obtained from the University of New South Wales Human Research Ethics Committee (HC210012, 19 February 2021). The results of the study will be disseminated in peer-reviewed journals and research conferences. TRIAL REGISTRATION NUMBER ACTRN12621000977875.
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Affiliation(s)
- Jessica G Amos
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Lidan Zheng
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Ranmalee Eramudugolla
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Dinaz Parekh
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Md Hamidul Huque
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicola Lautenschlager
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
- Academic Unit of Psychiatry of Old Age, University of Melbourne, Kew, Victoria, Australia
- NorthWestern Mental Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia
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203
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Jauregi-Zinkunegi A, Langhough R, Johnson SC, Mueller KD, Bruno D. Comparison of the 10-, 14- and 20-Item CES-D Scores as Predictors of Cognitive Decline. Brain Sci 2023; 13:1530. [PMID: 38002491 PMCID: PMC10669678 DOI: 10.3390/brainsci13111530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/18/2023] [Accepted: 10/27/2023] [Indexed: 11/26/2023] Open
Abstract
The association between depressive symptomatology and cognitive decline has been examined using the Centre for Epidemiologic Studies-Depression Scale (CES-D); however, concerns have been raised about this self-report measure. Here, we examined how the CES-D total score from the 14- and 10-item versions compared to the 20-item version in predicting progression to cognitive decline from a cognitively unimpaired baseline. Data from 1054 participants were analysed using ordinal logistic regression, alongside moderator and receiver-operating characteristics curve analyses. All baseline total scores significantly predicted progression to cognitive decline. The 14-item version was better than the 20-item version in predicting consensus diagnosis, as shown by their AICs, while also showing the highest accuracy when discriminating between participants by diagnosis at last visit. We did not find sex to moderate the relationship between CES-D score and cognitive decline. Current findings suggest the 10- and 14-item versions of the CES-D are comparable to the 20-item version, and that the 14-item version may be better at predicting longitudinal consensus diagnosis compared to the 20-item version.
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Affiliation(s)
| | - Rebecca Langhough
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI 53705, USA
- Geriatric Research Education and Clinical Center, William S. Middleton Veterans Hospital, Madison, WI 53225, USA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA; (R.L.)
- Wisconsin Alzheimer’s Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI 53705, USA
| | - Davide Bruno
- School of Psychology, Liverpool John Moores University, Liverpool L3 3AF, UK;
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204
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Huang CS, Yan YJ, Luo YT, Lin R, Li H. Effects of dance therapy on cognitive and mental health in adults aged 55 years and older with mild cognitive impairment: a systematic review and meta-analysis. BMC Geriatr 2023; 23:695. [PMID: 37880590 PMCID: PMC10601250 DOI: 10.1186/s12877-023-04406-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Individuals with mild cognitive impairment are at high risk of developing dementia. Dance therapy has promising applications in delaying cognitive decline. However, the effectiveness of dance therapy for older adults with mild cognitive impairment is unclear. The objective of this review was to evaluate the effectiveness of dance therapy on global cognitive function, specific cognitive subdomains, quality of life, and mental health in older adults with mild cognitive impairment to enrich health management strategies for dementia. METHODS Electronic databases and grey literature were searched from inception up to September 23, 2023. The language was limited to English and Chinese. Relevant studies were screened and assessed for risk of bias. A meta-analysis and subgroup analyses stratified by measurement instrument, dance type, intervention duration, and frequency were conducted using the STATA 16.0 software. This review was conducted in accordance with the PRISMA guidelines. RESULTS Ten studies involving 984 participants aged 55 years and over who met the eligibility criteria were included. Dance therapy significantly improved global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). However, the effects of dance therapy on processing speed, visuospatial ability, and quality of life in older adults with mild cognitive impairment remain inconclusive. Moreover, dance interventions of longer duration (> 3 months) improved global cognition more than shorter interventions. CONCLUSION This review reported that dance therapy was effective in improving global cognitive function, memory, executive function, attention, language, and mental health (i.e., depression and neuropsychiatric symptoms). Hence, it may be an effective non-pharmacological complementary treatment for older adults with mild cognitive impairment.
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Affiliation(s)
- Chen-Shan Huang
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, 350122, Fujian Province, China
| | - Yuan-Jiao Yan
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, 350122, Fujian Province, China
- Department of Nursing, Fujian Provincial Hospital & Shengli Clinical Medical College, No. 134 Dongjie Street, Gulou District, Fuzhou City, 350001, Fujian Province, China
| | - Yu-Ting Luo
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, 350122, Fujian Province, China
| | - Rong Lin
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, 350122, Fujian Province, China
| | - Hong Li
- School of Nursing, Fujian Medical University, No. 1 Xueyuan Road, Shangjie Town, Fuzhou City, 350122, Fujian Province, China.
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205
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Dieckelmann M, González-González AI, Banzer W, Berghold A, Jeitler K, Pantel J, Pregartner G, Schall A, Tesky VA, Siebenhofer A. Effectiveness of exercise interventions to improve long-term outcomes in people living with mild cognitive impairment: a systematic review and meta-analysis. Sci Rep 2023; 13:18074. [PMID: 37872230 PMCID: PMC10593841 DOI: 10.1038/s41598-023-44771-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/12/2023] [Indexed: 10/25/2023] Open
Abstract
Although exercise guidelines now recommend exercise for patients with MCI, the long-term effects of exercise in patients with MCI has not been reviewed systematically. The aim was to assess (1) the effectiveness of exercise and physical activity (EXPA) interventions in improving long-term patient-relevant cognitive and non-cognitive outcomes in people with mild cognitive impairment, (2) how well the included trials reported details of the intervention, and (3) the extent to which reported endpoints were in line with patient preferences that were assessed in patient workshops. Following PRISMA guidelines, we performed a systematic review and meta-analysis including randomized controlled trials. A total of ten studies were included after searching in six electronic sources from 1995 onwards. There is a trend that 6 + -month EXPA interventions improve global cognition 12 months after initiation. Evidence on long-term effects of EXPA interventions on non-cognitive health outcomes could not be meaningfully pooled and the individual studies reported mixed results. Workshop participants considered freedom from pain and stress, mood, motivation and self-efficacy to be important, but these outcomes were rarely addressed. Too little information is available on intervention details for EXPA programs to be replicated and confidently recommended for patients with MCI. PROSPERO registration in December, 2021 (CRD42021287166).
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Affiliation(s)
- Mirjam Dieckelmann
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.
| | - Ana I González-González
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Winfried Banzer
- Institute for Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt, Germany
| | - Andrea Berghold
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Klaus Jeitler
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
| | - Johannes Pantel
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Gudrun Pregartner
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Arthur Schall
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Valentina A Tesky
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Andrea Siebenhofer
- Institute of General Practice, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
- Institute of General Practice and Evidence-Based Health Services Research, Medical University of Graz, Graz, Austria
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206
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Skourti E, Simos P, Zampetakis A, Koutentaki E, Zaganas I, Alexopoulou C, Vgontzas A, Basta M. Long-term associations between objective sleep quality and quantity and verbal memory performance in normal cognition and mild cognitive impairment. Front Neurosci 2023; 17:1265016. [PMID: 37928739 PMCID: PMC10620682 DOI: 10.3389/fnins.2023.1265016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/29/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Although the link between sleep and memory function is well established, associations between sleep macrostructure and memory function in normal cognition and Mild Cognitive Impairment remain unclear. We aimed to investigate the longitudinal associations of baseline objectively assessed sleep quality and duration, as well as time in bed, with verbal memory capacity over a 7-9 year period. Participants are a well-characterized subsample of 148 persons (mean age at baseline: 72.8 ± 6.7 years) from the Cretan Aging Cohort. Based on comprehensive neuropsychiatric and neuropsychological evaluation at baseline, participants were diagnosed with Mild Cognitive Impairment (MCI; n = 79) or found to be cognitively unimpaired (CNI; n = 69). Sleep quality/quantity was estimated from a 3-day consecutive actigraphy recording, whereas verbal memory capacity was examined using the Rey Auditory Verbal Learning Test (RAVLT) and the Greek Passage Memory Test at baseline and follow-up. Panel models were applied to the data using AMOS including several sociodemographic and clinical covariates. Results Sleep efficiency at baseline directly predicted subsequent memory performance in the total group (immediate passage recall: β = 0.266, p = 0.001; immediate word list recall: β = 0.172, p = 0.01; delayed passage retrieval: β = 0.214, p = 0.002) with the effects in Passage Memory reaching significance in both clinical groups. Wake after sleep onset time directly predicted follow-up immediate passage recall in the total sample (β = -0.211, p = 0.001) and in the MCI group (β = -0.235, p = 0.02). In the total sample, longer 24-h sleep duration was associated with reduced memory performance indirectly through increased sleep duration at follow-up (immediate passage recall: β = -0.045, p = 0.01; passage retention index: β = -0.051, p = 0.01; RAVLT-delayed recall: β = -0.048, p = 0.009; RAVLT-retention index:β = -0.066, p = 0.004). Similar indirect effects were found for baseline 24-h time in bed. Indirect effects of sleep duration/time in bed were found predominantly in the MCI group. Discussion Findings corroborate and expand previous work suggesting that poor sleep quality and long sleep duration predict worse memory function in elderly. Timely interventions to improve sleep could help prevent or delay age-related memory decline among non-demented elderly.
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Affiliation(s)
- Eleni Skourti
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
| | - Panagiotis Simos
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, Greece
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Alexandros Zampetakis
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
| | - Eirini Koutentaki
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
| | - Ioannis Zaganas
- Division of Neurology and Sensory Organs, School of Medicine, University of Crete, Heraklion, Greece
| | | | - Alexandros Vgontzas
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, College of Medicine, Pennsylvania State University, Hershey, PA, United States
| | - Maria Basta
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, Heraklion, Greece
- Department of Psychiatry, University Hospital of Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry and Behavioral Health, Penn State Health Milton S. Hershey Medical Center, College of Medicine, Pennsylvania State University, Hershey, PA, United States
- Day Care Center for Alzheimer’s Disease “Nefeli”, University Hospital of Heraklion, Crete, Greece
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Brito DVC, Esteves F, Rajado AT, Silva N, Araújo I, Bragança J, Castelo-Branco P, Nóbrega C. Assessing cognitive decline in the aging brain: lessons from rodent and human studies. NPJ AGING 2023; 9:23. [PMID: 37857723 PMCID: PMC10587123 DOI: 10.1038/s41514-023-00120-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/31/2023] [Indexed: 10/21/2023]
Abstract
As life expectancy continues to increase worldwide, age-related dysfunction will largely impact our societies in the future. Aging is well established to promote the deterioration of cognitive function and is the primary risk factor for the development of prevalent neurological disorders. Even in the absence of dementia, age-related cognitive decline impacts specific types of memories and brain structures in humans and animal models. Despite this, preclinical and clinical studies that investigate age-related changes in brain physiology often use largely different methods, which hinders the translational potential of findings. This review seeks to integrate what is known about age-related changes in the brain with analogue cognitive tests used in humans and rodent studies, ranging from "pen and paper" tests to virtual-reality-based paradigms. Finally, we draw parallels between the behavior paradigms used in research compared to the enrollment into clinical trials that aim to study age-related cognitive decline.
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Affiliation(s)
- D V C Brito
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
| | - F Esteves
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
| | - A T Rajado
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
| | - N Silva
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
| | - I Araújo
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld.2, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - J Bragança
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld.2, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - P Castelo-Branco
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld.2, Faro, Portugal
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal
| | - C Nóbrega
- Algarve Biomedical Center-Research Institute (ABC-RI), Campus Gambelas, Bld.2, Faro, Portugal.
- Algarve Biomedical Center- (ABC), Campus Gambelas, Bld.2, Faro, Portugal.
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Gambelas Campus, Bld.2, Faro, Portugal.
- Champalimaud Research Program, Champalimaud Centre for the Unknown, Lisbon, Portugal.
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Blanco K, Salcidua S, Orellana P, Sauma-Pérez T, León T, Steinmetz LCL, Ibañez A, Duran-Aniotz C, de la Cruz R. Systematic review: fluid biomarkers and machine learning methods to improve the diagnosis from mild cognitive impairment to Alzheimer's disease. Alzheimers Res Ther 2023; 15:176. [PMID: 37838690 PMCID: PMC10576366 DOI: 10.1186/s13195-023-01304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/15/2023] [Indexed: 10/16/2023]
Abstract
Mild cognitive impairment (MCI) is often considered an early stage of dementia, with estimated rates of progression to dementia up to 80-90% after approximately 6 years from the initial diagnosis. Diagnosis of cognitive impairment in dementia is typically based on clinical evaluation, neuropsychological assessments, cerebrospinal fluid (CSF) biomarkers, and neuroimaging. The main goal of diagnosing MCI is to determine its cause, particularly whether it is due to Alzheimer's disease (AD). However, only a limited percentage of the population has access to etiological confirmation, which has led to the emergence of peripheral fluid biomarkers as a diagnostic tool for dementias, including MCI due to AD. Recent advances in biofluid assays have enabled the use of sophisticated statistical models and multimodal machine learning (ML) algorithms for the diagnosis of MCI based on fluid biomarkers from CSF, peripheral blood, and saliva, among others. This approach has shown promise for identifying specific causes of MCI, including AD. After a PRISMA analysis, 29 articles revealed a trend towards using multimodal algorithms that incorporate additional biomarkers such as neuroimaging, neuropsychological tests, and genetic information. Particularly, neuroimaging is commonly used in conjunction with fluid biomarkers for both cross-sectional and longitudinal studies. Our systematic review suggests that cost-effective longitudinal multimodal monitoring data, representative of diverse cultural populations and utilizing white-box ML algorithms, could be a valuable contribution to the development of diagnostic models for AD due to MCI. Clinical assessment and biomarkers, together with ML techniques, could prove pivotal in improving diagnostic tools for MCI due to AD.
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Affiliation(s)
- Kevin Blanco
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile
| | - Stefanny Salcidua
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Faculty of Engineering and Sciences, Universidad Adolfo Ibáñez, Diagonal Las Torres 2700, Building D, Peñalolén, Santiago, Chile
| | - Paulina Orellana
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tania Sauma-Pérez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tomás León
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- Memory and Neuropsychiatric Center (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lorena Cecilia López Steinmetz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Technische Universität Berlin, Berlin, Deutschland
- Instituto de Investigaciones Psicológicas (IIPsi), Universidad Nacional de Córdoba (UNC) y Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Agustín Ibañez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- Global Brain Health Institute, University of California San Francisco (UCSF), San Francisco, CA, USA
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile.
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
| | - Rolando de la Cruz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
- Faculty of Engineering and Sciences, Universidad Adolfo Ibáñez, Diagonal Las Torres 2700, Building D, Peñalolén, Santiago, Chile.
- Data Observatory Foundation, ANID Technology Center No. DO210001, Santiago, Chile.
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Abbatantuono C, Alfeo F, Clemente L, Lancioni G, De Caro MF, Livrea P, Taurisano P. Current Challenges in the Diagnosis of Progressive Neurocognitive Disorders: A Critical Review of the Literature and Recommendations for Primary and Secondary Care. Brain Sci 2023; 13:1443. [PMID: 37891810 PMCID: PMC10605551 DOI: 10.3390/brainsci13101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 10/29/2023] Open
Abstract
Screening for early symptoms of cognitive impairment enables timely interventions for patients and their families. Despite the advances in dementia diagnosis, the current nosography of neurocognitive disorders (NCDs) seems to overlook some clinical manifestations and predictors that could contribute to understanding the conversion from an asymptomatic stage to a very mild one, eventually leading to obvious disease. The present review examines different diagnostic approaches in view of neurophysiological and neuropsychological evidence of NCD progression, which may be subdivided into: (1) preclinical stage; (2) transitional stage; (3) prodromal or mild stage; (4) major NCD. The absence of univocal criteria and the adoption of ambiguous or narrow labels might complicate the diagnostic process. In particular, it should be noted that: (1) only neuropathological hallmarks characterize preclinical NCD; (2) transitional NCD must be assessed through proactive neuropsychological protocols; (3) prodromal/mild NCDs are based on cognitive functional indicators; (4) major NCD requires well-established tools to evaluate its severity stage; (5) insight should be accounted for by both patient and informants. Therefore, the examination of evolving epidemiological and clinical features occurring at each NCD stage may orient primary and secondary care, allowing for more targeted prevention, diagnosis, and/or treatment of both cognitive and functional impairment.
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Affiliation(s)
- Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | - Federica Alfeo
- Department of Education, Communication and Psychology (For.Psi.Com), University of Bari “Aldo Moro”, 70121 Bari, Italy;
| | - Livio Clemente
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | - Giulio Lancioni
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
- Lega F D’Oro Research Center, 60027 Osimo, Italy
| | - Maria Fara De Caro
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
| | | | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience (DiBrain), University of Bari “Aldo Moro”, 70121 Bari, Italy; (C.A.); (L.C.); (G.L.); (M.F.D.C.)
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210
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Flores-Sandoval AA, Davila-Pérez P, Buss SS, Donohoe K, O'Connor M, Shafi MM, Pascual-Leone A, Benwell CSY, Fried PJ. Spectral power ratio as a measure of EEG changes in mild cognitive impairment due to Alzheimer's disease: a case-control study. Neurobiol Aging 2023; 130:50-60. [PMID: 37459658 PMCID: PMC10614059 DOI: 10.1016/j.neurobiolaging.2023.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 08/13/2023]
Abstract
Adopting preventive strategies in individuals with subclinical Alzheimer's disease (AD) has the potential to delay dementia onset and reduce healthcare costs. Thus, it is extremely important to identify inexpensive, scalable, sensitive, and specific markers to track disease progression. The electroencephalography spectral power ratio (SPR: the fast to slow spectral power ratio), a measure of the shift in power distribution from higher to lower frequencies, holds potential for aiding clinical practice. The SPR is altered in patients with AD, correlates with cognitive functions, and can be easily implemented in clinical settings. However, whether the SPR is sensitive to pathophysiological changes in the prodromal stage of AD is unclear. We explored the SPR of individuals diagnosed with amyloid-positive amnestic mild cognitive impairment (Aβ+aMCI) and its association with both cognitive function and amyloid load. The SPR was lower in Aβ+aMCI than in the cognitively unimpaired individuals and correlated with executive function scores but not with amyloid load. Hypothesis-generating analyses suggested that aMCI participants with a lower SPR had an increased probability of a positive amyloid positron emission tomography. Future research may explore the potential of this measure to classify aMCI individuals according to their AD biomarker status.
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Affiliation(s)
- Aimee A Flores-Sandoval
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Charité - Universitätsmedizin Berlin, Einstein Center for Neurosciences Berlin, 10117 Berlin, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Paula Davila-Pérez
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Clinical Neurophysiology, Hospital Universitario Rey Juan Carlos, Móstoles, Spain; Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Stephanie S Buss
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Kevin Donohoe
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Margaret O'Connor
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Mouhsin M Shafi
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School, Boston, MA, USA; Hinda and Arthur Marcus Institute for Aging Research, and Deanna and Sidney Wolk Center for Memory Health, Hebrew Senior Life, Boston, MA, USA
| | - Christopher S Y Benwell
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.
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211
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Krell-Roesch J, Rakusa M, Syrjanen JA, van Harten AC, Lowe VJ, Jack CR, Kremers WK, Knopman DS, Stokin GB, Petersen RC, Vassilaki M, Geda YE. Association between CSF biomarkers of Alzheimer's disease and neuropsychiatric symptoms: Mayo Clinic Study of Aging. Alzheimers Dement 2023; 19:4498-4506. [PMID: 35142047 PMCID: PMC10433790 DOI: 10.1002/alz.12557] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/17/2021] [Accepted: 11/02/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION We examined the association between cerebrospinal fluid (CSF)-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms (NPS) in older non-demented adults. METHODS We included 784 persons (699 cognitively unimpaired, 85 with mild cognitive impairment) aged ≥ 50 years who underwent CSF amyloid beta (Aβ42), hyperphosphorylated tau 181 (p-tau), and total tau (t-tau) as well as NPS assessment using Beck Depression and Anxiety Inventories (BDI-II, BAI), and Neuropsychiatric Inventory Questionnaire (NPI-Q). RESULTS Lower CSF Aβ42, and higher t-tau/Aβ42 and p-tau/Aβ42 ratios were associated with BDI-II and BAI total scores, clinical depression (BDI-II ≥ 13), and clinical anxiety (BAI ≥ 10), as well as NPI-Q-assessed anxiety, apathy, and nighttime behavior. DISCUSSION CSF Aβ42, t-tau/Aβ42, and p-tau/Aβ42 ratios were associated with NPS in community-dwelling individuals free of dementia. If confirmed by a longitudinal cohort study, the findings have clinical relevance of taking into account the NPS status of individuals with abnormal CSF biomarkers.
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Affiliation(s)
- Janina Krell-Roesch
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Martin Rakusa
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, University Medical Centre Maribor, Maribor, Slovenia
| | - Jeremy A. Syrjanen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Argonde C. van Harten
- Alzheimer Center, Department of Neurology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Walter K. Kremers
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | | | - Gorazd B. Stokin
- International Clinical Research Center, St. Anne’s Hospital, Brno, Czech Republic
| | - Ronald C. Petersen
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
| | - Yonas E. Geda
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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212
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Xu W, Sun X, Jiang H, Wang X, Wang B, Niu Q, Meng H, Du J, Yang G, Liu B, Zhang H, Tan Y. Diffusion Kurtosis Imaging in Evaluating the Mild Cognitive Impairment of Occupational Aluminum Workers. Acad Radiol 2023; 30:2225-2233. [PMID: 36690563 DOI: 10.1016/j.acra.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 12/02/2022] [Accepted: 12/02/2022] [Indexed: 01/23/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate whether diffusion kurtosis imaging (DKI) can distinguish mild cognitive impairment (MCI) from normal controls (NC) in aluminum (Al)-exposed workers, and to explore the association of DKI with cognitive performance and plasma Al concentration. MATERIALS AND METHODS 28 patients with MCI and 25 NC at Al factory were enrolled in this study. All subjects underwent conventional MRI and DKI scans. The mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), mean diffusivity (MD) and fractional anisotropy (FA) parameters of the hippocampus, substantia nigra, red nucleus, thalamus, anterior cingulate gyrus, genu and crus of the corpus callosum, frontal, parietal and temporal lobe were measured. To compare the parameters between the two groups, the Mann-Whitney rank sum test was used. The correlation of parameter values with cognitive performance and plasma Al concentration was analyzed using Spearman correlation analysis. The receiver operating characteristic (ROC) curve and the Z-scores were used to evaluate the diagnostic efficacy of each parameter. RESULTS Compared with the NC group, the MK, Ka, Kr, and FA values in the MCI group were significantly decreased, and the MD values were significantly increased (p<0.05). For the diagnosis of MCI, MK in the right hippocampus showed the largest AUC (0.924). The MK, Kr, MD and FA values were correlated with the Montreal Cognitive Assessment (MoCA) scores, and MK values in the right hippocampus showed the greatest correlation with MoCA scores (r=0.744, p <0.001). Plasma Al in the MCI group was higher than that in the NC group, although there was no significant difference in plasma Al between the two groups (p=0.057). There was no correlation between DKI parameters and plasma Al. CONCLUSION The DKI method might be a sensitive imaging biomarker to discriminate MCI from NC, and could preliminarily assess the severity of cognitive impairment in Al-exposed workers. MK in the right hippocampus appeared to be the best independent predictor. The mechanism of cognitive decline is an important content of aluminum exposure research. This study indicates that the DKI technique could provide valuable information for the diagnosis of MCI.
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Affiliation(s)
- Wenji Xu
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xiangru Sun
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Haoru Jiang
- College of Medical Imaging, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Xiaochun Wang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Bin Wang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Qiao Niu
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Huaxing Meng
- School of Public Health, Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Jiangfeng Du
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Guoqiang Yang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Bo Liu
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Hui Zhang
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China
| | - Yan Tan
- Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Shanxi Key Laboratory of Intelligent Imaging and Nanomedicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China.; Intelligent Imaging Big Data and Functional Nano-imaging Engineering Research Center of Shanxi Province, First Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China..
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213
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Dean LT, Chung SE, Gross AL, Clay OJ, Willis SL, Crowe M, McDonough IM, Thomas KR, Marsiske M, Aysola J, Thorpe RJ, Felix C, Berkowitz M, Coe NB. Does Consumer Credit Precede or Follow Changes in Cognitive Impairment Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial. J Aging Health 2023; 35:84S-94S. [PMID: 37994853 DOI: 10.1177/08982643221113715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVES We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI). METHODS Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, linked to TransUnion consumer credit data. RESULTS Each 50-point increase in credit score was associated with up to 8% lower odds of MCI in the next 3 years. In contrast, new unpaid collections over doubled the odds of having MCI in the next 3 years. MCI was associated with subsequent credit score declines and a 47%-71% greater risk of having a new unpaid collection in the next 4 years. DISCUSSION Credit declines may signal risk for future MCI. MCI may lead to financial challenges that warrant credit monitoring interventions for older adults.
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Affiliation(s)
- Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shang-En Chung
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- University of Alabama at Birmingham Alzheimer's Disease Research Center, Birmingham, AL, USA
| | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ian M McDonough
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Kelsey R Thomas
- VA San Diego Healthcare System and Department of Psychiatry, San Diego School of Medicine, University of California, San Diego, CA, USA
| | | | - Jaya Aysola
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Cynthia Felix
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melissa Berkowitz
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Norma B Coe
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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214
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Deng LH, Geng JX, Xue Q, Jiang J, Chen LX, Wang JT. Correlation between nocturnal intermittent hypoxemia and mild cognitive impairment in the older adult and the role of BDNF Val66Met polymorphism: a hospital-based cross-sectional study. Sleep Breath 2023; 27:1945-1952. [PMID: 36567420 DOI: 10.1007/s11325-022-02772-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 11/14/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE To explore the prevalence of nocturnal intermittent hypoxemia (NIH) in a tertiary hospital geriatric department and the relationship between NIH and mild cognitive impairment (MCI) in older adults, and to examine the role of brain-derived neurotrophic factor (BDNF) Val66Met polymorphism. METHODS Older adults aged ≥ 60 were enrolled. NIH and cognitive assessments were conducted. BDNF concentrations and BDNF Val66Met polymorphism were detected for a preliminary exploration of the possible mechanism of the process. RESULTS Of 325 older adults enrolled, 157 (48%) had NIH and were further divided into mild, moderate, and severe NIH groups according to their oxygen desaturation of ≥ 4% per hour of sleep (ODI4). MCI detection rate in the four groups gradually increased, and the differences were statistically significant (chi-square = 4.457, P = 0.035). ODI4 was negatively correlated with MoCA score in all participants (r = - 0.115, P = 0.039) and patients with NIH (r = - 0.199, P = 0.012). After adjusting for sex, age, and cardiovascular risk factors, NIH and MCI remained independently associated (OR = 3.13, 95% CI 1.03-9.53, P = 0.045). BDNF levels were positively correlated with MoCA score (r = 0.169, P = 0.028) and negatively correlated with nocturnal average oxygen saturation in patients with NIH (r = - 0.288, P = 0.008). Older adults with different BDNF Val66Met genotypes did not show significant differences in MCI rate and BDNF levels (P > 0.05). CONCLUSION The older adults with NIH have a higher MCI detection rate. BDNF levels may be a potential biomarker for cognitive dysfunction in patients with NIH.
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Affiliation(s)
- L H Deng
- Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, People's Republic of China
| | - J X Geng
- Peking University Health Science Center, Beijing, China
| | - Q Xue
- Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, People's Republic of China
| | - J Jiang
- Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, People's Republic of China
| | - L X Chen
- Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, People's Republic of China
| | - J T Wang
- Department of Geriatrics, Peking University People's Hospital, No. 11 Xizhimen South Street, Xicheng District, 100044, Beijing, People's Republic of China.
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Fiamingo G, Capittini C, De Silvestri A, Rebuffi C, Cerami C, Arnaldi D, Terzaghi M. Neuropsychological evaluation of phenoconversion risk in REM sleep behaviour disorder: A scoping review. J Sleep Res 2023; 32:e13873. [PMID: 36958793 DOI: 10.1111/jsr.13873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/25/2023] [Accepted: 02/27/2023] [Indexed: 03/25/2023]
Abstract
The objective of this study was to assess the role of cognitive evaluation in the prediction of phenoconversion in polysomnography-confirmed idiopathic or isolated rapid eye movement sleep behaviour disorder, through a scoping review focussing on a longitudinal comprehensive neuropsychological assessment of patients with idiopathic REM sleep behaviour disorder. A literature search (2006-2022) yielded 1034 records, and 20 were selected for analysis. The sample included 899 patients from eight different cohorts and five countries. We extracted data on clinical evolution, mild cognitive impairment diagnosis, neuropsychological tests used, and classification of cognitive domains. Tests, cognitive domains, and mild cognitive impairment definitions were heterogeneous across the studies, precluding a meta-analysis. Ten studies (50%) evaluated the presence of mild cognitive impairment; 14 studies (70%) grouped neuropsychological tests into between three (6 studies, 21.4%) and seven (1 study, 7.1%) cognitive domains. The most frequently used tests were semantic fluency, Stroop colour word test, trail making test A and B, digit span, Rey auditory verbal learning test, and Rey-Osterrieth figure. All except digit span showed a role in predicting phenoconversion. The authors did not consistently assign tests to specific cognitive domains. In conclusion, we discuss methodological differences between the studies and highlight the need for a standardised framework for neuropsychological data acquisition and presentation, based on a multilevel approach covering test selection, domain assignment, and mild cognitive impairment diagnostic criteria.
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Affiliation(s)
- Giuseppe Fiamingo
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Capittini
- Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | - Annalisa De Silvestri
- Clinical Epidemiology and Biometric Unit, Scientific Direction, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
| | | | - Chiara Cerami
- Scuola Universitaria di Studi Superiori IUSS, Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Dario Arnaldi
- Clinical Neurology, DINOGMI, University of Genoa, Genoa, Italy
- IRCSS Ospedale Policlinico San Martino, Genoa, Italy
| | - Michele Terzaghi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Unit of Sleep Medicine and Epilepsy, IRCSS Mondino Foundation, Pavia, Italy
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216
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Elhalag RH, Motawea KR, Talat NE, Rouzan SS, Mahmoud N, Hammad EM, Reyad SM, Mohamed MS, Shah J. Herpes simplex virus infection and the risk of dementia: a systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:5060-5074. [PMID: 37811098 PMCID: PMC10552998 DOI: 10.1097/ms9.0000000000000951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 06/02/2023] [Indexed: 10/10/2023] Open
Abstract
Aim The authors aimed to perform a meta-analysis to evaluate the association between herpes simplex virus (HSV) infection and the risk of developing dementia. Methods The authors searched the following databases: PubMed, Scopus, Cochrane Library, and Web of Science. The authors included any randomized control trials and controlled observational studies that investigated the prevalence of dementia in HSV-infected patients and HSV-free control group. Also, if the studies measured the levels of HSV antibodies and incidence of these antibodies in patients with dementia compared with a healthy control group. Results After a comprehensive literature search, 19 studies were included in the meta-analysis with 342 535 patients included in the analysis. The pooled analysis showed a statistically significant association between Alzheimer's disease (AD), mild cognitive impairment (MCI), and increased levels of IgG titer group [mean difference (MD) = 0.99, 95% confidence interval (CI) = 0.36-1.63, P-value = 0.002], (MD = 0.80, 95% CI = 0.26-1.35, P-value = 0.004), respectively. Additionally, the generic inverse variance showed a statistically significant association between the HSV group and increased incidence of dementia compared with the no HSV control group [risk ratio (RR) = 2.23, 95% CI = 1.18-2.29, P-value <0.00001]. Moreover, this analysis showed no statistically significant difference between the AD group and the control group in anti-HSV IgM titer n (%) outcome (RR = 1.35, 95% CI = 0.91-2.01, P-value = 0.14), respectively. Conclusion This study revealed that AD and MCI patients have increased levels of IgG antibodies titer against HSV infection. The study showed a significant association between HSV infection and increased incidence of dementia. Thus, regular follow-up of HSV patients' IgG titer levels could be useful in the prevention of dementia in these patients.
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Affiliation(s)
| | | | | | - Samah S. Rouzan
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Nada Mahmoud
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Sarraa M. Reyad
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mai S. Mohamed
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Frölich L, von Arnim C, Bohlken J, Pantel J, Peters O, Förstl H. [Mild cognitive impairment in geriatric practice: patient orientation, diagnostics, treatment and ethics]. Z Gerontol Geriatr 2023; 56:492-497. [PMID: 36006476 DOI: 10.1007/s00391-022-02098-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 10/15/2022]
Abstract
Mild cognitive impairment (MCI) is a common problem in old people, which can be distressing for patients and their families. The main feature of MCI is a decrease in cognitive performance with activities of daily living still unimpaired. The identification of treatable risk factors, recognition of early cognitive changes and a timely differential diagnosis, comprehensive information and counselling are important tasks in geriatric medicine. The aim of this article is to present practical recommendations to support physicians working with geriatric patients in recognizing cognitive deficits at an early stage, provide high-quality care focusing on counselling, treatment, and comorbidity management and to maximize the potential of the available treatment options.
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Affiliation(s)
- Lutz Frölich
- Abteilung Gerontopsychiatrie, Zentralinstitut für Seelische Gesundheit, 68163, Mannheim, Deutschland.
| | | | - Jens Bohlken
- Institut für Arbeitsmedizin, Sozialmedizin und Public Health, Universitätklinikum Leipzig, Leipzig, Deutschland
| | - Johannes Pantel
- Bereich Altersmedizin, Institut für Allgemeinmedizin, Universität Frankfurt, Frankfurt, Deutschland
| | - Oliver Peters
- Zentrum für Demenzprävention, Klinik für Psychiatrie und Psychotherapie CBF, Charité, Berlin, Deutschland
| | - Hans Förstl
- Klinik für Psychiatrie und Psychotherapie, TU München, München, Deutschland
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Kang EY, Kim DY, Kim HK, Shin WS, Park YS, Kim TH, Kim W, Cao L, Lee SG, Gang G, Shin M, Kim JM, Go GW. Modified Korean MIND Diet: A Nutritional Intervention for Improved Cognitive Function in Elderly Women through Mitochondrial Respiration, Inflammation Suppression, and Amino Acid Metabolism Regulation. Mol Nutr Food Res 2023; 67:e2300329. [PMID: 37650267 DOI: 10.1002/mnfr.202300329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 07/19/2023] [Indexed: 09/01/2023]
Abstract
SCOPE Mild cognitive impairment is associated with a high prevalence of dementia. The study examines the benefits of a modified Korean MIND (K-MIND) diet and explores biomarkers using multi-omics analysis. METHODS AND RESULTS The K-MIND diet, tailored to the elderly Korean population, includes perilla oil, milk, or fermented milk, and avoids alcohol consumption. As a result, the K-MIND diet significantly improves subjects "orientation to place" in the Korean version of the Mini-Mental State Examination, 2nd edition test. According to multi-omics analysis, the K-MIND diet upregulates genes associated with mitochondrial respiration, including ubiquinone oxidoreductase, cytochrome C oxidase, and ATP synthase, and immune system processes, and downregulates genes related to nuclear factor kappa B activity and inflammatory responses. In addition, K-MIND affects the metabolic pathways of glycine, serine, threonine, tryptophan, and sphingolipids, which are closely linked to cognitive function through synthesis of neurotransmitters and structures of brain cell membranes. CONCLUSION The findings imply that the K-MIND diet improves cognitive function by upregulating key genes involved in oxidative phosphorylation and downregulating pro-inflammatory cytokines.
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Affiliation(s)
- Eun Young Kang
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
| | - Do-Young Kim
- Department of Animal Science and Technology, Chung-Ang University, Gyeonggi-do, 17546, Republic of Korea
| | - Hyun Kyung Kim
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
| | - Weon-Sun Shin
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
| | - Young-Sook Park
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
| | - Tae Hoon Kim
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
| | - Wooki Kim
- Department of Food Science and Biotechnology, Kyung Hee University, Gyeonggi-do, 17104, Republic of Korea
| | - Lei Cao
- Department of Food Science and Biotechnology, Gachon University, Seongnam, 13120, Republic of Korea
| | - Sang-Gil Lee
- Department of Food Science and Nutrition, Pukyong National University, Busan, 48513, Republic of Korea
- Department of Smart Green Technology Engineering, Pukyong National University, Busan, 48513, Republic of Korea
| | - Gyoungok Gang
- Department of Food Science and Nutrition, Pukyong National University, Busan, 48513, Republic of Korea
| | - Minhye Shin
- Department of Microbiology, Inha University, Incheon, 22212, Republic of Korea
| | - Jun-Mo Kim
- Department of Animal Science and Technology, Chung-Ang University, Gyeonggi-do, 17546, Republic of Korea
| | - Gwang-Woong Go
- Department of Food and Nutrition, Hanyang University, Seoul, 04763, Republic of Korea
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219
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Andruchow D, Cunningham D, Sharma MJ, Ismail Z, Callahan BL. Characterizing mild cognitive impairment to predict incident dementia in adults with bipolar disorder: What should the benchmark be? Clin Neuropsychol 2023; 37:1455-1478. [PMID: 36308307 PMCID: PMC11128134 DOI: 10.1080/13854046.2022.2135605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 10/07/2022] [Indexed: 11/03/2022]
Abstract
Objective: Although mild cognitive impairment (MCI) is generally considered a risk state for dementia, its prevalence and association with dementia are impacted by the number of tests and cut-points used to assess cognition and define "impairment," and sources of norms. Here, we investigate how these methodological variations impact estimates of incident dementia in adults with bipolar disorder (BD), a vulnerable population with pre-existing cognitive deficits and increased dementia risk. Method: Neuropsychological data from 148 adults with BD and 13,610 healthy controls (HC) were drawn from the National Alzheimer's Coordinating Center. BD participants' scores were standardized against published norms and again using regression-based norms generated from HC within the same catchment area as individual BD patients ("site-specific norms"), varying the number of within-domain tests (one vs. two) and the cut-points (-1 vs. -1.5 SD) used to operationalize MCI. Results: Site-specific norms were more sensitive to incident dementia (88.6%-94.3%) than published norms (74.3%-88.6%), but only when using a "single test" definition of impairment. Specificity (22.1%-74.3%), accuracy (37.8%-68.9%), and positive predictive values (26.1%-38.3%) were overall poor. Applying a "single test" definition of impairment resulted in better negative predictive values using site-specific (92.3%-93.3%) than published norms (83.6%-86.2%), and a substantial increase in relative risk of incident dementia relative to published norms. Conclusions: Neuropsychologists should define "impairment" as scores below -1.0 or -1.5 SD on at least two within-domain measures when using published norms to interpret cognitive performance in adults with BD.
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Affiliation(s)
- Daniel Andruchow
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Daniel Cunningham
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Manu J. Sharma
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
| | - Zahinoor Ismail
- Hotchkiss Brain Institute, Calgary, AB, Canada
- Departments of Psychiatry, Clinical Neurosciences, and Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Brandy L. Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, Calgary, AB, Canada
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220
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Rotblatt LJ, Aiken-Morgan AT, Marsiske M, Horgas AL, Thomas KR. Do Associations Between Vascular Risk and Mild Cognitive Impairment Vary by Race? J Aging Health 2023; 35:74S-83S. [PMID: 33497299 PMCID: PMC8310897 DOI: 10.1177/0898264320984357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: Given prevalence differences of mild cognitive impairment (MCI) among Black and white older adults, this study aimed to examine whether overall vascular risk factor (VRF) burden and individual VRF associations with amnestic (aMCI) and nonamnestic (naMCI) MCI status varied by Black/white race. Methods: Participants included 2755 older adults without dementia from the ACTIVE study. Comprehensive neuropsychological criteria were used to classify cognitively normal, aMCI, and naMCI. VRFs were primarily defined using subjective report and medication data. Multinomial logistic regression was run predicting MCI subtype. Results: Greater overall VRF burden, high cholesterol, and obesity evinced greater odds of naMCI in Black participants than whites. Across participants, diabetes and hypertension were associated with increased odds of aMCI and naMCI, respectively. Discussion: Results may reflect known systemic inequities on dimensions of social determinants of health for Black older adults. Continued efforts toward examining underlying mechanisms contributing to these findings are critical.
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Affiliation(s)
- Lindsay J. Rotblatt
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | | | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
| | - Ann L. Horgas
- Department of Biobehavioral Nursing Science, University of Florida, Gainesville, FL
| | - Kelsey R. Thomas
- Veterans Affairs San Diego Healthcare System, San Diego, CA
- Department of Psychiatry, University of California San Diego, La Jolla, CA
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221
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Teipel SJ, Dyrba M, Levin F, Altenstein S, Berger M, Beyle A, Brosseron F, Buerger K, Burow L, Dobisch L, Ewers M, Fliessbach K, Frommann I, Glanz W, Goerss D, Gref D, Hansen N, Heneka MT, Incesoy EI, Janowitz D, Keles D, Kilimann I, Laske C, Lohse A, Munk MH, Perneczky R, Peters O, Preis L, Priller J, Rostamzadeh A, Roy N, Schmid M, Schneider A, Spottke A, Spruth EJ, Wiltfang J, Düzel E, Jessen F, Kleineidam L, Wagner M. Cognitive Trajectories in Preclinical and Prodromal Alzheimer's Disease Related to Amyloid Status and Brain Atrophy: A Bayesian Approach. J Alzheimers Dis Rep 2023; 7:1055-1076. [PMID: 37849637 PMCID: PMC10578328 DOI: 10.3233/adr-230027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/22/2023] [Indexed: 10/19/2023] Open
Abstract
Background Cognitive decline is a key outcome of clinical studies in Alzheimer's disease (AD). Objective To determine effects of global amyloid load as well as hippocampus and basal forebrain volumes on longitudinal rates and practice effects from repeated testing of domain specific cognitive change in the AD spectrum, considering non-linear effects and heterogeneity across cohorts. Methods We included 1,514 cases from three cohorts, ADNI, AIBL, and DELCODE, spanning the range from cognitively normal people to people with subjective cognitive decline and mild cognitive impairment (MCI). We used generalized Bayesian mixed effects analysis of linear and polynomial models of amyloid and volume effects in time. Robustness of effects across cohorts was determined using Bayesian random effects meta-analysis. Results We found a consistent effect of amyloid and hippocampus volume, but not of basal forebrain volume, on rates of memory change across the three cohorts in the meta-analysis. Effects for amyloid and volumetric markers on executive function were more heterogeneous. We found practice effects in memory and executive performance in amyloid negative cognitively normal controls and MCI cases, but only to a smaller degree in amyloid positive controls and not at all in amyloid positive MCI cases. Conclusions We found heterogeneity between cohorts, particularly in effects on executive functions. Initial increases in cognitive performance in amyloid negative, but not in amyloid positive MCI cases and controls may reflect practice effects from repeated testing that are lost with higher levels of cerebral amyloid.
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Affiliation(s)
- Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Martin Dyrba
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Fedor Levin
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Moritz Berger
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Aline Beyle
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Frederic Brosseron
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Lena Burow
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE), Munich, Munich, Germany
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Ingo Frommann
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Daria Gref
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Niels Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Michael T. Heneka
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Enise I. Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
- Department for Psychiatry and Psychotherapy, University Clinic Magdeburg, Magdeburg, Germany pGerman Center for Neurodegenerative Diseases (DZNE), T¨ubingen, Germany
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Deniz Keles
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
- Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), T¨ubingen, Germany
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of T¨ubingen, T¨ubingen, Germany
| | - Andrea Lohse
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Matthias H. Munk
- German Center for Neurodegenerative Diseases (DZNE), T¨ubingen, Germany
- Department of Psychiatry and Psychotherapy, University of T¨ubingen, T¨ubingen, Germany
| | - Robert Perneczky
- German Center for Neurodegenerative Diseases (DZNE), Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Berlin, Germany
| | - Lukas Preis
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
- School of Medicine, Technical University of Munich; Department of Psychiatry and Psychotherapy, Munich, Germany
- University of Edinburgh and UK DRI, Edinburgh, UK
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Matthias Schmid
- Institute for Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
| | - Anja Schneider
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany
- Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Frank Jessen
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Luca Kleineidam
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Michael Wagner
- Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Belvaux, Luxembourg
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
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Marzi C, Scheda R, Salvadori E, Giorgio A, De Stefano N, Poggesi A, Inzitari D, Pantoni L, Mascalchi M, Diciotti S. Fractal dimension of the cortical gray matter outweighs other brain MRI features as a predictor of transition to dementia in patients with mild cognitive impairment and leukoaraiosis. Front Hum Neurosci 2023; 17:1231513. [PMID: 37822707 PMCID: PMC10562576 DOI: 10.3389/fnhum.2023.1231513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/31/2023] [Indexed: 10/13/2023] Open
Abstract
Background The relative contribution of changes in the cerebral white matter (WM) and cortical gray matter (GM) to the transition to dementia in patients with mild cognitive impairment (MCI) is not yet established. In this longitudinal study, we aimed to analyze MRI features that may predict the transition to dementia in patients with MCI and T2 hyperintensities in the cerebral WM, also known as leukoaraiosis. Methods Sixty-four participants with MCI and moderate to severe leukoaraiosis underwent baseline MRI examinations and annual neuropsychological testing over a 2 year period. The diagnosis of dementia was based on established criteria. We evaluated demographic, neuropsychological, and several MRI features at baseline as predictors of the clinical transition. The MRI features included visually assessed MRI features, such as the number of lacunes, microbleeds, and dilated perivascular spaces, and quantitative MRI features, such as volumes of the cortical GM, hippocampus, T2 hyperintensities, and diffusion indices of the cerebral WM. Additionally, we examined advanced quantitative features such as the fractal dimension (FD) of cortical GM and WM, which represents an index of tissue structural complexity derived from 3D-T1 weighted images. To assess the prediction of transition to dementia, we employed an XGBoost-based machine learning system using SHapley Additive exPlanations (SHAP) values to provide explainability to the machine learning model. Results After 2 years, 18 (28.1%) participants had transitioned from MCI to dementia. The area under the receiving operator characteristic curve was 0.69 (0.53, 0.85) [mean (90% confidence interval)]. The cortical GM-FD emerged as the top-ranking predictive feature of transition. Furthermore, aggregated quantitative neuroimaging features outperformed visually assessed MRI features in predicting conversion to dementia. Discussion Our findings confirm the complementary roles of cortical GM and WM changes as underlying factors in the development of dementia in subjects with MCI and leukoaraiosis. FD appears to be a biomarker potentially more sensitive than other brain features.
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Affiliation(s)
- Chiara Marzi
- Department of Statistics, Computer Science, Applications “Giuseppe Parenti, ” University of Florence, Florence, Italy
| | - Riccardo Scheda
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi, ” University of Bologna, Cesena, Italy
| | - Emilia Salvadori
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Antonio Giorgio
- Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery, and Neuroscience, University of Siena, Siena, Italy
| | - Anna Poggesi
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Domenico Inzitari
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Leonardo Pantoni
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - Mario Mascalchi
- Department of Experimental and Clinical Biomedical Sciences “Mario Serio, ” University of Florence, Florence, Italy
- Division of Epidemiology and Clinical Governance, Institute for Study, Prevention and Network in Oncology (ISPRO), Florence, Italy
| | - Stefano Diciotti
- Department of Electrical, Electronic, and Information Engineering “Guglielmo Marconi, ” University of Bologna, Cesena, Italy
- Alma Mater Research Institute for Human-Centered Artificial Intelligence, University of Bologna, Bologna, Italy
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Demirayak P, Kıyı İ, İşbitiren YÖ, Yener G. Cognitive load associates prolonged P300 latency during target stimulus processing in individuals with mild cognitive impairment. Sci Rep 2023; 13:15956. [PMID: 37743392 PMCID: PMC10518304 DOI: 10.1038/s41598-023-43132-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/20/2023] [Indexed: 09/26/2023] Open
Abstract
Alterations in P300 amplitude and latency, as well as neuropsychological tests, are informative to detect early signs of the affected high cognitive processing in Mild Cognitive Impairment (MCI). In the present study, we examined P300 latency and amplitude elicited by visual oddball paradigm in 20 participants with MCI and age, education, and sex-matched healthy controls from frontal, central, and parietal midline electrodes. We performed a mixed-design ANOVA to compare P300 amplitude and latency between groups during target and non-target stimulus presentation. We also assessed the correlation between our electrophysiology findings and neuropsychological tests. Our results indicated that in healthy individuals P300 is elicited earlier in target stimulus processing compared to non-target stimulus processing. On the contrary, in the MCI group, P300 latency was increased during target processing compared to non-target stimulus processing. Moreover, P300 latency in target processing is prolonged in the MCI group compared to controls. Also, our correlation results showed a significant correlation between P300 peak latency and amplitude, and attention required cognitive tasks. In conclusion, our results provide evidence that high-order cognitive processes that are involved in stimulus processing slows down in individuals with MCI due to the high working memory demand for neural processing.
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Affiliation(s)
- Pinar Demirayak
- Civitan International Research Center, University of Alabama at Birmingham, 1719 6th Ave S Suite:252B, Birmingham, AL, 35233, USA.
- Department of Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - İlayda Kıyı
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Yağmur Özbek İşbitiren
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Görsev Yener
- Brain Dynamics Multidisciplinary Research Center, Dokuz Eylül University, İzmir, Turkey
- Faculty of Medicine, İzmir University of Economics, İzmir, Turkey
- İzmir International Biomedicine and Genome Institute, Dokuz Eylül University, Izmir, Turkey
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224
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Bampa G, Tsolaki M, Moraitou D, Metallidou P, Masoura E, Mintziviri M, Paparis K, Tsourou D, Papantoniou G, Sofologi M, Papaliagkas V, Kougioumtzis G, Papatzikis E. Metacognitive Differences in Amnestic Mild Cognitive Impairment and Healthy Cognition: A Cross-Sectional Study Employing Online Measures. J Intell 2023; 11:184. [PMID: 37754914 PMCID: PMC10532837 DOI: 10.3390/jintelligence11090184] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/28/2023] Open
Abstract
This study aimed to examine metacognitive abilities in individuals diagnosed with amnestic mild cognitive impairment (aMCI) by using online metacognitive measures during cognitive tasks. A total of 100 participants were enrolled, all aged 50 or older (mean age = 61.98; SD = 6.27), and with a minimum of six years of education (mean = 14.95; SD = 2.94). The sample included 50 individuals with aMCI (34 females) and 50 healthy controls (HC) (33 females). Both groups underwent metacognitive versions of memory tasks (Doors and People) and executive functions tasks (Wisconsin Card Sorting Test). Metacognition was assessed through confidence ratings given after each answer (referred to as metacognitive monitoring) and the accuracy of the participants' decisions to include or exclude answers from their final scores (known as metacognitive control). The results showed that although individuals with aMCI were aware of their cognitive limitations-evidenced by their lower confidence ratings across all tasks-they still exhibited overconfidence relative to their actual performance. Moreover, they included a greater number of incorrect answers in their final scores compared to the healthy control group. These findings suggest that while individuals with aMCI retain some level of awareness, their self-evaluations appear to lack precision. This observation was consistent across both types of cognitive tasks. The results underscore the need for additional research to better understand metacognition in MCI as well as the interplay between metacognitive monitoring and control.
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Affiliation(s)
- Grigoria Bampa
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Magdalini Tsolaki
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
- Greek Association of Alzheimer’s Disease and Related Disorders (GAADRD), 54643 Thessaloniki, Greece
| | - Despina Moraitou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
- Laboratory of Neurodegenerative Diseases, Center of Interdisciplinary Research and Innovation (CIRI–AUTH), Balcan Center, Buildings A & B, 10th km Thessaloniki-Thermi, 54124 Thessaloniki, Greece;
| | - Panagiota Metallidou
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Elvira Masoura
- Laboratory of Psychology, Department of Cognition, Brain and Behavior, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (D.M.); (P.M.); (E.M.)
| | - Maria Mintziviri
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Konstantinos Paparis
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Dorothea Tsourou
- School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Georgia Papantoniou
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Maria Sofologi
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 45110 Ioannina, Greece; (G.P.); (M.S.)
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (URCI), 45110 Ioannina, Greece
| | - Vasileios Papaliagkas
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | - Georgios Kougioumtzis
- Department of Turkish and Modern Asian Studies, National and Kapodistrian University of Athens, 15772 Athens, Greece;
- Department of Psychology, Neapolis University Pafos, Pafos 8042, Cyprus
| | - Efthymios Papatzikis
- Department of Early Childhood Education and Care, Oslo Metropolitan University, 0167 Oslo, Norway
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi 127788, United Arab Emirates
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Li S, Chen X, Gao M, Zhang X, Han P, Cao L, Gao J, Tao Q, Zhai J, Liang D, Guo Q. The neutrophil-to-lymphocyte ratio is associated with mild cognitive impairment in community-dwelling older women aged over 70 years: a population-based cross-sectional study. Front Aging Neurosci 2023; 15:1261026. [PMID: 37781103 PMCID: PMC10539551 DOI: 10.3389/fnagi.2023.1261026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/01/2023] [Indexed: 10/03/2023] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) is a marker of inflammation that can be obtained quickly, conveniently, and cheaply from blood samples. However, there is no research to explore the effects of sex and age on the relationship between the NLR and mild cognitive impairment (MCI) in community-dwelling older adults. Methods A total of 3,126 individuals aged over 60 years in Shanghai were recruited for face-to-face interviews, and blood samples were collected. MCI was assessed by the Mini-Mental State Examination (MMSE) and the Instrumental Activities of Daily Living (IADL) scale, and neutrophil count and lymphocyte counts were measured in fasting blood samples. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Results In females, the NLR in the MCI group was significantly higher than that in the cognitively normal group (2.13 ± 0.94 vs. 1.85 ± 0.83, p < 0.001) but not in men. Logistic regression showed that a higher NLR was an independent risk factor for MCI in women [odds ratio (OR) = 1.33; 95% confidence interval (CI) = 1.14-1.55]. In addition, the elevated NLR quartile was associated with an increased risk of MCI, especially in women older than 70 years (p value for trend = 0.012). Conclusion Compared with males, female MCI patients had a significantly higher NLR than cognitively normal controls. In addition, elevated NLR was found to be significantly associated with MCI risk in women older than 70 years. Therefore, elderly Chinese women with a higher NLR value may be the target population for effective prevention of MCI.
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Affiliation(s)
- Shengjie Li
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- School of Sports and Health, Tianjin University of Sport, Tianjin, China
| | - Xiaoyu Chen
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Mengze Gao
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- School of Sports and Health, Tianjin University of Sport, Tianjin, China
| | - Xingyu Zhang
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- School of Sports and Health, Tianjin University of Sport, Tianjin, China
| | - Peipei Han
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Liou Cao
- Department of Nephrology, Molecular Cell Lab for Kidney Disease, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Gao
- General Practice Clinic, Pujiang Community Health Service Center in Minhang District, Shanghai, China
| | - Qiongying Tao
- Jiading Subdistrict Community Health Center, Shanghai, China
| | - Jiayi Zhai
- Jiading Subdistrict Community Health Center, Shanghai, China
| | - Dongyu Liang
- Clinical Research Center, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Qi Guo
- Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
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Balakrishnan R, Kim YS, Kim GW, Kim WJ, Hong SM, Kim CG, Choi DK. Standardized extract of Glehnia Littoralis abrogates memory impairment and neuroinflammation by regulation of CREB/BDNF and NF-κB/MAPK signaling in scopolamine-induced amnesic mice model. Biomed Pharmacother 2023; 165:115106. [PMID: 37421783 DOI: 10.1016/j.biopha.2023.115106] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/10/2023] Open
Abstract
Mild cognitive impairment is a typical symptom of early Alzheimer's disease (AD). Glehnia littoralis (G. littoralis), a medicinal halophyte plant commonly used to treat strokes, has been shown to possess some therapeutic qualities. In this study, we investigated the neuroprotective and anti-neuroinflammatory effects of a 50% ethanol extract of G. littoralis (GLE) on lipopolysccharide (LPS)-stimulated BV-2 cells and scopolamine-induced amnesic mice. In the in vitro study, GLE treatment (100, 200, and 400 µg/mL) markedly attenuated the translocation of NF-κB to the nucleus concomitantly with the significant mitigation of the LPS-induced production of inflammatory mediators, including NO, iNOS, COX-2, IL-6, and TNF-α. In addition, the GLE treatment suppressed the phosphorylation of MAPK signaling in the LPS-stimulated BV-2 cells. In the in vivo study, mice were orally administered with the GLE (50, 100, and 200 mg/kg) for 14 days, and cognitive loss was induced via the intraperitoneal injection of scopolamine (1 mg/kg) from 8 to 14 days. We found that GLE treatment ameliorated memory impairment and simultaneously improved memory function in the scopolamine-induced amnesic mice. Correspondingly, GLE treatment significantly decreased the AChE level and upregulated the protein expression of neuroprotective markers, such as BDNF and CREB, as well as Nrf2/HO-1 and decreased the levels of iNOS and COX-2 in the hippocampus and cortex. Furthermore, GLE treatment attenuated the increased phosphorylation of NF-κB/MAPK signaling in the hippocampus and cortex. These results suggest that GLE has a potential neuroprotective activity that may ameliorate learning and memory impairment by regulating AChE activity, promoting CREB/BDNF signaling, and inhibiting NF-κB/MAPK signaling and neuroinflammation.
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Affiliation(s)
- Rengasamy Balakrishnan
- BK21 FOUR GLOCAL Education Program of Nutraceuticals Development, Konkuk University, Chungju 27478, Republic of Korea; Department of Biotechnology, College of Biomedical and Health Science, Research Institute of Inflammatory Disease (RID), Konkuk University, Chungju 27478, Republic of Korea
| | - Yon-Suk Kim
- Department of Biotechnology, College of Biomedical and Health Science, Research Institute of Inflammatory Disease (RID), Konkuk University, Chungju 27478, Republic of Korea
| | - Ga-Won Kim
- Department of Applied Life Sciences, Graduate School, Konkuk University, Chungju 27478, Republic of Korea
| | - Woo-Jung Kim
- Biocenter, Gyeonggido Business and Science Accelerator, Gwanggyo-ro 147, Yeongtong-gu, Suwon 16229, Republic of Korea
| | - Sun-Mee Hong
- Department of Technology Development, Marine Industry Research Institute for East Sea Rim, Uljin-gun, Gyeongsangbuk-do 36315, Republic of Korea
| | - Choong-Gon Kim
- Marine Ecosystem Research Center, Korea Institute of Ocean Science and Technology, 385 Haeyang-ro, Yeongdo-gu, Busan 49111, Republic of Korea
| | - Dong-Kug Choi
- BK21 FOUR GLOCAL Education Program of Nutraceuticals Development, Konkuk University, Chungju 27478, Republic of Korea; Department of Biotechnology, College of Biomedical and Health Science, Research Institute of Inflammatory Disease (RID), Konkuk University, Chungju 27478, Republic of Korea; Department of Applied Life Sciences, Graduate School, Konkuk University, Chungju 27478, Republic of Korea.
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Quaranta D, Caraglia N, L'Abbate F, Giuffrè GM, Guglielmi V, Iacobucci GM, Rossini PM, Calabresi P, Marra C. Neuropsychological predictors of conversion from mild cognitive impairment to dementia at different timepoints. Brain Behav 2023; 13:e3098. [PMID: 37550896 PMCID: PMC10498086 DOI: 10.1002/brb3.3098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Impairment of episodic memory is largely considered the main cognitive marker of prodromic Alzheimer's disease (AD). Nevertheless, the neuropathological process in AD starts several years before and, apart from biomarkers well defined in the Amyloid (A), Tauopathy (T), Neurodegeneration (N) framework, early clinical and neuropsychological markers able to detect mild cognitive impairment (MCI) due to AD before the appearance of memory disorders are lacking in clinical practice. Investigations on semantic memory have shown promising results in providing an earlier marker of dementia in MCI patients. METHODS A total of 253 MCI subjects were followed up every 6 months for 6 years-186 converted to dementia and 67 remained stable at the sixth year of follow-up. Twenty-seven patients progressed in the first 2 years (fast converters), 107 in the third to fourth year (intermediate converters), and 51 after the fourth year of follow-up (slow converters). RESULTS Stable MCI subjects performed better than fast decliners in Mini-Mental State Examination (MMSE), several long-term memory scores, and category verbal fluency test (CFT); stable and intermediate converters differ only in MMSE and CFT tests; and stable and slow converters differ only in MMSE and phonological/semantic discrepancy score. CONCLUSION Early impairment of semantic memory could predict the evolution to AD before the onset of episodic memory disorders, and the discrepancy between phonological and semantic verbal fluency could be able to detect this impairment in advance in respect of simple CFT tests. The assessment of different aspects of semantic memory and its degradation could represent an early cognitive marker to intercept MCI due to AD in clinical practice.
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Affiliation(s)
- Davide Quaranta
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | - Naike Caraglia
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | - Federica L'Abbate
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | | | - Valeria Guglielmi
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
| | | | - Paolo Maria Rossini
- Brain Connectivity Laboratory, Department of Neuroscience and NeurorehabilitationIRCCS San Raffaele RomaRomeItaly
| | - Paolo Calabresi
- Neurology UnitFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
| | - Camillo Marra
- Department of NeuroscienceCatholic University of Sacred HeartRomeItaly
- Memory ClinicFoundation Policlinico Agostino Gemelli IRCCSRomeItaly
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228
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Komagamine Y, Kanazawa M, Miyayasu A, Uehara Y, Watanabe M, Sahaprom N, Huyen TBN, Iwaki M, Sato D, Minakuchi S. The effect of single-implant overdentures on cognitive function in older adults: A 3-year follow-up report. J Dent 2023; 136:104632. [PMID: 37506810 DOI: 10.1016/j.jdent.2023.104632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 07/01/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE To investigate the occurrence of mild cognitive impairment in edentulous patients up to 3 years after they received single-implant overdentures (1-IODs). METHODS This was a follow-up study for a crossover randomized controlled trial comparing 1-IODs and conventional complete dentures, with patient satisfaction as the primary outcome. In the present study, the cognitive function of the patients, measured with the Japanese version of the Montreal cognitive assessment (MoCA-J), was evaluated as the secondary outcome at baseline and 2 months, 1 year, 2 years, and 3 years after 1-IOD placement. The total and domain (memory, executive function, visuospatial skills, language, attention, and orientation) MoCA-J scores of the patients at each timepoint were analyzed and compared. RESULTS Twenty-two patients with edentulous mandibles received 1-IODs. Within-group comparisons revealed that the total MoCA-J scores at 1 year and 3 years after 1-IOD placement were significantly increased compared with baseline scores. Additionally, the memory domain scores at all timepoint were significantly increased compared with the baseline scores, and the executive function domain scores at the 2-month, 2-year and 3-year timepoint were significantly increased compared with the baseline scores. CONCLUSION Patients with edentulous mandibles who underwent 1-IOD placement showed significantly improved total scores of MoCA-J after 1 year and 3 years of wearing 1-IODs. In addition, they showed significantly improved memory domain scores at 2 months, 1 year, 2 years, and 3 years after 1-IOD placement and executive function domain scores at 2 months, 2 years, and 3 years after 1-IOD placement. CLINICAL SIGNIFICANCE The results of this study suggest that 1-IOD treatment for older adults, especially those with edentulous mandibles, may prevent cognitive decline regardless of the condition of the maxilla.
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Affiliation(s)
- Yuriko Komagamine
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Manabu Kanazawa
- Digital Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, TMDU, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan.
| | - Anna Miyayasu
- Advanced Biomaterials, University Hospital of Dentistry, Tokyo Medical and Dental University, TMDU, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Yoko Uehara
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Masataka Watanabe
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Namano Sahaprom
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Trang Bui Ngoc Huyen
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Maiko Iwaki
- Digital Dentistry, University Hospital of Dentistry, Tokyo Medical and Dental University, TMDU, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
| | - Daisuke Sato
- Department of Implant Dentistry, School of Dentistry, Showa University, 1-5-8 Hatanodai Shinagawa-ku Tokyo 142-8555, Japan
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo, Tokyo 113-8549, Japan
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Ma JH, Huang NH, Huang T, Mu DL. 25-hydroxyvitamin D concentrations and risk of incident dementia, mild cognitive impairment, and delirium in 443,427 UK Biobank participants. Psychiatry Res 2023; 327:115369. [PMID: 37523888 DOI: 10.1016/j.psychres.2023.115369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 05/20/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
This study aimed to investigate the association between serum 25-hydroxyvitamin D (25(OH)D) levels and dementia, mild cognitive impairment (MCI), and delirium. Participants from the United Kingdom (UK) Biobank with complete information on serum 25(OH)D concentrations were enrolled. Dementia, MCI and delirium were defined using the UK Biobank algorithm. 443,427 participants with a mean (standard deviation) age of 56.8 (8.0) years were included in this study. Based on Cox regression models, serum 25(OH)D concentrations were inversely associated with the risk of dementia, MCI, and delirium in a dose-dependent manner after adjusting for demographics (P-trend <0.001). In comparison with 25(OH)D levels less than 32.4 nmol/L, participants with the highest 25(OH)D levels (i.e., >64.4 nmol/L) had the lowest risk of dementia (hazards ratio [HR]: 0.58, 95% confidence interval [CI] 0.49-0.69, P<0.001), MCI (HR: 0.55, 95% CI 0.37-0.84, P=0.005), and delirium (HR: 0.63, 95% CI 0.51-0.79, P<0.001). These results were consistent with the sensitivity analysis, in which participants with events occurring within the first two years of follow-up were excluded. This study found that a lower serum 25(OH)D concentration was significantly associated with a higher risk of dementia (including Alzheimer's disease and vascular dementia), MCI, and delirium.
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Affiliation(s)
- Jia-Hui Ma
- Department of Anesthesiology, Peking University First Hospital, Address: No. 8 Xishiku Street, Beijing 100034, PR China
| | - Ning-Hao Huang
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Address: No, 38 Xueyuanlu, Haidian district, Beijing 100191, PR China
| | - Tao Huang
- Department of Epidemiology and Biostatics, School of Public Health, Peking University, Address: No, 38 Xueyuanlu, Haidian district, Beijing 100191, PR China; State Key Laboratory of Remote Sensing Science, Faculty of Geographical Science, Beijing Normal University, Beijing, PR China; Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, PR China.
| | - Dong-Liang Mu
- Department of Anesthesiology, Peking University First Hospital, Address: No. 8 Xishiku Street, Beijing 100034, PR China.
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Gao F, Dai L, Wang Q, Liu C, Deng K, Cheng Z, Lv X, Wu Y, Zhang Z, Tao Q, Yuan J, Li S, Wang Y, Su Y, Cheng X, Ni J, Wu Z, Zhang S, Shi J, Shen Y. Blood-based biomarkers for Alzheimer's disease: a multicenter-based cross-sectional and longitudinal study in China. Sci Bull (Beijing) 2023; 68:1800-1808. [PMID: 37500404 DOI: 10.1016/j.scib.2023.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/03/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023]
Abstract
Discrepancies in diagnostic biomarkers for Alzheimer's Disease (AD) may arise from racial disparities, risk factors, or lifestyle differences. Moreover, there has been a lack of systematic and multicenter studies to evaluate baselines of the AD biomarkers in Chinese populations. Thus, there is an urgent need for research to investigate the effectiveness of blood biomarkers for AD, specifically in the Chinese Han population, using a multicenter approach. In the present multicenter-based cross-sectional and longitudinal study, we evaluated 817 blood samples from 6 different clinical centers. We measured plasma amyloid beta (Aβ)-40, Aβ42, phosphorylated tau 181 (pTau), total tau (tTau), serum neurofilament light (NFL), and glial fibrillary acidic protein (GFAP). Additionally, 18F-florbetapir positron electron tomography and magnetic resonance imaging were also performed. A combination of the APOE genotype with plasma pTau and serum GFAP demonstrated exceptional performance in distinguishing Aβ status. Furthermore, baseline GFAP levels exhibited a strong association with cognitive decline over time and brain atrophy, with higher GFAP levels predicting a faster rate of neurodegeneration. In summary, these results validate the practicality of blood biomarkers in the Chinese Han population, encompassing various regions within China. Additionally, they emphasize the potential of pTau and GFAP as non-invasive methods for detecting and screening AD at an early stage.
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Affiliation(s)
- Feng Gao
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Linbin Dai
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Qiong Wang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Chang Liu
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Kexue Deng
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Zhaozhao Cheng
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Xinyi Lv
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Yan Wu
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China
| | - Ziyi Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Qingqing Tao
- Department of Neurology and Research Center of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jing Yuan
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China
| | - Shiping Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Yue Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Ya Su
- Department of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Xin Cheng
- Department of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai 200040, China.
| | - Jun Ni
- Department of Neurology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China.
| | - Zhiying Wu
- Department of Neurology and Research Center of Neurology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Shuting Zhang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China.
| | - Jiong Shi
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China.
| | - Yong Shen
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China; Neurodegenerative Disorder Research Center, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China; Anhui Province Key Laboratory of Biomedical Aging Research, University of Science and Technology of China, Hefei 230001, China.
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231
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Zhen Y, Gao L, Chen J, Gu L, Shu H, Wang Z, Liu D, Zhang Z. EEG Reveals Alterations in Motor Imagery in People With Amnestic Mild Cognitive Impairment. J Gerontol B Psychol Sci Soc Sci 2023; 78:1474-1483. [PMID: 37216647 DOI: 10.1093/geronb/gbad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Indexed: 05/24/2023] Open
Abstract
OBJECTIVES Motor imagery has been used to investigate the cognitive mechanism of motor control. Although behavioral and electrophysiological changes in motor imagery in people with amnestic mild cognitive impairment (aMCI) have been reported, deficits in different types of imagery remain unclear. To explore this question, we used electroencephalography (EEG) to study neural correlates of visual imagery (VI) and kinesthetic imagery (KI) and their relationship to cognitive function in people with aMCI. METHODS A hand laterality judgment task was used to induce implicit motor imagery in 29 people with aMCI and 40 healthy controls during EEG recording. Mass univariate and multivariate EEG analysis was applied to explore group differences in a data-driven manner. RESULTS Modulation of stimuli orientation to event-related potential (ERP) amplitudes differed significantly between groups at 2 clusters located in the posterior-parietal and frontal areas. Multivariate decoding revealed sufficient representation of VI-related orientation features in both groups. Relative to healthy controls, the aMCI group lacked accurate representation of KI-related biomechanical features, suggesting deficits in automatic activation of KI strategy. Electrophysiological correlates were associated with episodic memory, visuospatial function, and executive function. Higher decoding accuracy of biomechanical features predicted better executive function via longer response time in the imagery task in the aMCI group. DISCUSSION These findings reveal electrophysiological correlates related to motor imagery deficits in aMCI, including local ERP amplitudes and large-scale activity patterns. Alterations in EEG activity are related to cognitive function in multiple domains, including episodic memory, suggesting the potential of these EEG indices as biomarkers of cognitive impairment.
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Affiliation(s)
- Yanfen Zhen
- Shenzhen Key Laboratory of Precision Diagnosis and Treatment of Depression, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Lijuan Gao
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Jiu Chen
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Lihua Gu
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Hao Shu
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Zan Wang
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Duan Liu
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
| | - Zhijun Zhang
- Shenzhen Key Laboratory of Precision Diagnosis and Treatment of Depression, Shenzhen-Hong Kong Institute of Brain Science, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Department of Neurology, Affiliated Zhongda Hospital, Research Institution of Neuropsychiatry, School of Medicine, Southeast University, Nanjing, Jiangsu, China
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de la Monte SM, Tong M, Hapel AJ. Concordant and Discordant Cerebrospinal Fluid and Plasma Cytokine and Chemokine Responses in Mild Cognitive Impairment and Early-Stage Alzheimer's Disease. Biomedicines 2023; 11:2394. [PMID: 37760836 PMCID: PMC10525668 DOI: 10.3390/biomedicines11092394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/18/2023] [Accepted: 08/22/2023] [Indexed: 09/29/2023] Open
Abstract
Neuroinflammation may be a pathogenic mediator and biomarker of neurodegeneration at the boundary between mild cognitive impairment (MCI) and early-stage Alzheimer's disease (AD). Whether neuroinflammatory processes are endogenous to the central nervous system (CNS) or originate from systemic (peripheral blood) sources could impact strategies for therapeutic intervention. To address this issue, we measured cytokine and chemokine immunoreactivities in simultaneously obtained lumbar puncture cerebrospinal fluid (CSF) and serum samples from 39 patients including 18 with MCI or early AD and 21 normal controls using a 27-plex XMAP bead-based enzyme-linked immunosorbent assay (ELISA). The MCI/AD combined group had significant (p < 0.05 or better) or statistically trend-wise (0.05 ≤ p ≤ 0.10) concordant increases in CSF and serum IL-4, IL-5, IL-9, IL-13, and TNF-α and reductions in GM-CSF, b-FGF, IL-6, IP-10, and MCP-1; CSF-only increases in IFN-y and IL-7 and reductions in VEGF and IL-12p70; serum-only increases in IL-1β, MIP-1α, and eotaxin and reductions in G-CSF, IL-2, IL-8 and IL-15; and discordant CSF-serum responses with reduced CSF and increased serum PDGF-bb, IL-17a, and RANTES. The results demonstrate simultaneously parallel mixed but modestly greater pro-inflammatory compared to anti-inflammatory or neuroprotective responses in CSF and serum. In addition, the findings show evidence that several cytokines and chemokines are selectively altered in MCI/AD CSF, likely corresponding to distinct neuroinflammatory responses unrelated to systemic pathologies. The aggregate results suggest that early management of MCI/AD neuroinflammation should include both anti-inflammatory and pro-neuroprotective strategies to help prevent disease progression.
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Affiliation(s)
- Suzanne M. de la Monte
- Departments of Pathology (Neuropathology), Neurology, and Neurosurgery, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI 02903, USA
- Department of Medicine, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI 02903, USA;
| | - Ming Tong
- Department of Medicine, Rhode Island Hospital, The Alpert Medical School of Brown University, Providence, RI 02903, USA;
| | - Andrew J. Hapel
- Department of Genome Biology, John Curtin School of Medical Research, Australian National University, Canberra 2601, Australia;
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Kau YL, Lin IH, Juang CL, Chang CK, Ho WH, Wen HC. Metabolite Variations in the Hippocampus and Corpus Callosum of Patients with Mild Cognitive Impairment Using Magnetic Resonance Spectroscopy with Three-Dimensional Chemical Shift Images. Brain Sci 2023; 13:1244. [PMID: 37759845 PMCID: PMC10526271 DOI: 10.3390/brainsci13091244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 07/30/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
This study compared the metabolites in the brain regions of hippocampus and corpus callosum between patients with mild cognitive impairment (MCI) and healthy controls using no-radiation and high-sensitivity magnetic resonance spectroscopy (MRS) with three-dimensional chemical shift images (3D-CSI). Twenty volunteers (seven patients with MCI and 13 healthy controls) aged 50-71 years were recruited for this prospective study. MRS with 3D-CSI images of a variety of metabolites was collected from the hippocampus and corpus callosum. Sex and weight showed no significant differences between the two groups. The metabolite levels in the hippocampus and corpus callosum of the MCI group were generally lower than in those of the healthy group, especially for creatine (p < 0.001 in the hippocampus and p = 0.020 in the corpus callosum) and N-acetyl aspartate/creatine (p < 0.001 in the hippocampus and p = 0.020 in the corpus callosum); however, choline/creatine showed a significant difference (p < 0.001) only in the hippocampus, and myo-inositol/creatine showed a significant difference (p < 0.001) only in the corpus callosum. Our study demonstrated that MRS with 3D-CSI can be used to measure these metabolite levels to determine the differences between patients with MCI and healthy individuals. This would aid early diagnosis of MCI in clinical practice, and patients could receive prompt intervention to improve their quality of life.
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Affiliation(s)
- Yen-Lon Kau
- Department of Medical Imaging, Camillian St. Mary’s Hospital, Luodong, Yilan 265502, Taiwan; (Y.-L.K.); (W.-H.H.)
- Department of Medical Imaging and Radiological Sciences, Yuanpei University, Hsinchu 30015, Taiwan;
| | - I-Hung Lin
- Nobel Eye Institute, Taipei 100008, Taiwan;
- Department of Ophthalmology, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Chi-Long Juang
- Department of Medical Imaging and Radiological Sciences, Yuanpei University, Hsinchu 30015, Taiwan;
| | - Chao-Kai Chang
- Nobel Eye Institute, Taipei 100008, Taiwan;
- Department of Optometry, Yuanpei University, Hsinchu 30015, Taiwan;
| | - Wen-Hsiang Ho
- Department of Medical Imaging, Camillian St. Mary’s Hospital, Luodong, Yilan 265502, Taiwan; (Y.-L.K.); (W.-H.H.)
| | - Hsiao-Chuan Wen
- Department of Pet Healthcare, Yuanpei University, Hsinchu 300, Taiwan
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234
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Cai H, Zhang K, Wang M, Li X, Ran F, Han Y. Effects of mind-body exercise on cognitive performance in middle-aged and older adults with mild cognitive impairment: A meta-analysis study. Medicine (Baltimore) 2023; 102:e34905. [PMID: 37653776 PMCID: PMC10470775 DOI: 10.1097/md.0000000000034905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND To systematically evaluate the clinical efficacy of physical and mental exercise on cognitive performance in middle-aged people with mild cognitive impairment (MCI). METHODS Computer searches of PubMed, Web of science, Embase, Cochrane Library, China Biomedical Literature Service, Wanfang database, China Knowledge Network, and VIP full-text database of Veep journals were conducted to obtain clinical randomized controlled trials on physical and mental exercise interventions in middle-aged and elderly people with MCI. The literature was screened according to inclusion and exclusion criteria, and the final included literature was subjected to data extraction and risk of bias assessment. Meta-analysis was performed using Review Manager 5.4.1 software, and publication bias test was performed using stata17.0 software. RESULTS A total of 27 publications with a total of 2565 cases of elderly people with MCI were included. The control group was conventional care, health education, or blank control, and the physical and mental exercise group was exercises including Tai Chi, dance, orthopraxia, and qigong for 30 to 90 minutes each time, 3 to 6 times per week, for a total duration of 8 to 36 weeks. Meta-analysis results showed that Montreal cognitive assessment scores (mean difference [MD] = 2.33, 95% CI [1.55, 3.10], P < .00001), the mini-mental state examination score (MD = 1.73, 95% CI [0.60, 2.86], P = .003), trail making test-A score (MD = -4.00, 95% CI [-6.75, -1.25], P = .004), trail making test-B score (MD = -18.46, 95% CI [-23.87, -13.06], P < .00001), global deterioration scale score (MD = -0.72, 95% CI [-1.09, -0.34], P = .0002), Wechsler Logical Memory Scale score (MD = 2.07, 95% CI [0.03, 4.10], P = .05), berg score (MD = -0.70, 95% CI [0.32, 1.07], P < .0003), cerebrospinal fluid Tau protein level (MD = -166.69, 95% CI [-196.93, -136.45], P < .00001), and cerebrospinal fluid levels of αβ1-42 protein (MD = 180.39, 95% CI [134.24, 226.55], P < .00001). CONCLUSION Mind-body exercise can improve cognitive performance, depressive status, and balance as well as increase αβ1-42 protein levels and decrease Tau protein levels in middle-aged and older adults with mild cognitive impairment.
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Affiliation(s)
- Hejia Cai
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Kainan Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Mengzhao Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Xiaomei Li
- Guangxi University of Traditional Chinese Medicine, Nanning, China
| | - Fei Ran
- College of Physical Education, Yunnan Normal University, Kunming, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
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Daniilidou M, Eroli F, Alanko V, Goikolea J, Latorre-Leal M, Rodriguez-Rodriguez P, Griffiths WJ, Wang Y, Pacciarini M, Brinkmalm A, Zetterberg H, Blennow K, Rosenberg A, Bogdanovic N, Winblad B, Kivipelto M, Ibghi D, Cedazo-Minguez A, Maioli S, Matton A. Alzheimer's disease biomarker profiling in a memory clinic cohort without common comorbidities. Brain Commun 2023; 5:fcad228. [PMID: 37680670 PMCID: PMC10481253 DOI: 10.1093/braincomms/fcad228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/17/2023] [Accepted: 08/24/2023] [Indexed: 09/09/2023] Open
Abstract
Alzheimer's disease is a multifactorial disorder with large heterogeneity. Comorbidities such as hypertension, hypercholesterolaemia and diabetes are known contributors to disease progression. However, less is known about their mechanistic contribution to Alzheimer's pathology and neurodegeneration. The aim of this study was to investigate the relationship of several biomarkers related to risk mechanisms in Alzheimer's disease with the well-established Alzheimer's disease markers in a memory clinic population without common comorbidities. We investigated 13 molecular markers representing key mechanisms underlying Alzheimer's disease pathogenesis in CSF from memory clinic patients without diagnosed hypertension, hypercholesterolaemia or diabetes nor other neurodegenerative disorders. An analysis of covariance was used to compare biomarker levels between clinical groups. Associations were analysed by linear regression. Two-step cluster analysis was used to determine patient clusters. Two key markers were analysed by immunofluorescence staining in the hippocampus of non-demented control and Alzheimer's disease individuals. CSF samples from a total of 90 participants were included in this study: 30 from patients with subjective cognitive decline (age 62.4 ± 4.38, female 60%), 30 with mild cognitive impairment (age 65.6 ± 7.48, female 50%) and 30 with Alzheimer's disease (age 68.2 ± 7.86, female 50%). Angiotensinogen, thioredoxin-1 and interleukin-15 had the most prominent associations with Alzheimer's disease pathology, synaptic and axonal damage markers. Synaptosomal-associated protein 25 kDa and neurofilament light chain were increased in mild cognitive impairment and Alzheimer's disease patients. Grouping biomarkers by biological function showed that inflammatory and survival components were associated with Alzheimer's disease pathology, synaptic dysfunction and axonal damage. Moreover, a vascular/metabolic component was associated with synaptic dysfunction. In the data-driven analysis, two patient clusters were identified: Cluster 1 had increased CSF markers of oxidative stress, vascular pathology and neuroinflammation and was characterized by elevated synaptic and axonal damage, compared with Cluster 2. Clinical groups were evenly distributed between the clusters. An analysis of post-mortem hippocampal tissue showed that compared with non-demented controls, angiotensinogen staining was higher in Alzheimer's disease and co-localized with phosphorylated-tau. The identification of biomarker-driven endophenotypes in cognitive disorder patients further highlights the biological heterogeneity of Alzheimer's disease and the importance of tailored prevention and treatment strategies.
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Affiliation(s)
- Makrina Daniilidou
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden
| | - Francesca Eroli
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
| | - Vilma Alanko
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden
| | - Julen Goikolea
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
| | - Maria Latorre-Leal
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
| | - Patricia Rodriguez-Rodriguez
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
| | | | - Yuqin Wang
- Swansea University Medical School, Swansea SA2 8PP, UK
| | | | - Ann Brinkmalm
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 90 Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 90 Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London WC1N3AR, UK
- UK Dementia Research Institute at UCL, London WC1N3AR, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, 413 90 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, 413 90 Mölndal, Sweden
| | - Anna Rosenberg
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, FI-70029 Kuopio, Finland
| | - Nenad Bogdanovic
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
| | - Bengt Winblad
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 83 Huddinge, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London SW7 2AZ, UK
| | - Delphine Ibghi
- Neurodegeneration Cluster, Rare and Neurologic Disease Research Sanofi R&D, F-91380 Chilly-Mazarin, France
| | - Angel Cedazo-Minguez
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Neurodegeneration Cluster, Rare and Neurologic Disease Research Sanofi R&D, F-91380 Chilly-Mazarin, France
| | - Silvia Maioli
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
| | - Anna Matton
- Division of Neurogeriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 64 Solna, Sweden
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Huddinge, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London SW7 2AZ, UK
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Vogrinc D, Gregorič Kramberger M, Emeršič A, Čučnik S, Goričar K, Dolžan V. The Association of Selected GWAS Reported AD Risk Loci with CSF Biomarker Levels and Cognitive Decline in Slovenian Patients. Int J Mol Sci 2023; 24:12966. [PMID: 37629144 PMCID: PMC10455613 DOI: 10.3390/ijms241612966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/07/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disease, with a complex genetic background. Apart from rare, familial cases, a combination of multiple risk loci contributes to the susceptibility of the disease. Genome-wide association studies (GWAS) have identified numerous AD risk loci. Changes in cerebrospinal fluid (CSF) biomarkers and imaging techniques can detect AD-related brain changes before the onset of clinical symptoms, even in the presence of preclinical mild cognitive impairment. In this study, we aimed to assess the associations between SNPs in well-established GWAS AD risk loci and CSF biomarker levels or cognitive test results in Slovenian patients with cognitive decline. The study included 82 AD patients, 28 MCI patients with pathological CSF biomarker levels and 35 MCI patients with normal CSF biomarker levels. Carriers of at least one polymorphic TOMM40 rs157581 C allele had lower Aβ42 (p = 0.033) and higher total tau (p = 0.032) and p-tau181 levels (p = 0.034). Carriers of at least one polymorphic T allele in SORCS1 rs1358030 had lower total tau (p = 0.019), while polymorphic SORCS1 rs1416406 allele was associated with lower total tau (p = 0.013) and p-tau181 (p = 0.036). In addition, carriers of at least one polymorphic T allele in BCHE rs1803274 had lower cognitive test scores (p = 0.029). The study findings may contribute to the identification of genetic markers associated with AD and MCI and provide insights into early disease diagnostics.
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Affiliation(s)
- David Vogrinc
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (D.V.); (K.G.)
| | - Milica Gregorič Kramberger
- Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.G.K.); (A.E.); (S.Č.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Andreja Emeršič
- Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.G.K.); (A.E.); (S.Č.)
| | - Saša Čučnik
- Department of Neurology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (M.G.K.); (A.E.); (S.Č.)
- Department of Rheumatology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Katja Goričar
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (D.V.); (K.G.)
| | - Vita Dolžan
- Pharmacogenetics Laboratory, Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia; (D.V.); (K.G.)
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237
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Yan Y, Li B, Li F, Zhou X, Li T, Li Y, Liu C, Wang S, Cong Y, Deng Y, Wang Z, Zhou J, Rong S. The relationship between mushroom consumption and cognitive performance among middle-aged and older adults: a cross-sectional study. Food Funct 2023; 14:7663-7671. [PMID: 37540100 DOI: 10.1039/d3fo01101a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Objectives: Bioactive compounds in mushrooms may protect the brain from neurodegeneration by inhibiting the production of amyloid-β and playing an antioxidant role. This study aimed at examining the associations of mushroom consumption with cognitive function and mild cognitive impairment (MCI) among middle-aged and older adults in China. Design: A cross-sectional study. Setting and participants: This study was conducted in seven cities in China and included 2203 middle-aged and older adults. Methods: Data on mushroom consumption were collected using a semi-quantitative food frequency questionnaire. Cognitive function was evaluated by the Auditory Verbal Learning Test (AVLT), Verbal Fluency Test (VFT), Digit Symbol Substitution Test (DSST), and Trail Making Test-B (TMT-B). The composite z score was used to reflect global cognition. MCI was determined according to the Petersen criteria. Multiple linear regression and logistic regression were used to examine the relationship between mushroom consumption and cognitive performance. Results: This study included 2203 participants aged 55 years and above (mean age = 63.43 years). After controlling demographic characteristics, lifestyle factors, other dietary factors, and history of chronic disease, higher mushroom consumption was associated with better global cognition. Compared to the lowest quartile (Q1, 0-4.00 g day-1), the βs (95% confidence intervals, 95% CIs) were 0.10 (0.03, 0.18) for Q2 (4.01-10.42 g day-1), 0.13 (0.06, 0.20) for Q3 (10.43-20.84 g day-1), and 0.13 (0.06, 0.20) for Q4 (>20.84 g day-1). The higher mushroom consumption was positively related to better performance in DSST and TMT-B (P-values < 0.05). A 10 g day-1 increment in mushroom consumption was related to 12% lower odds of MCI (odds ratio = 0.88, 95% CI: 0.80-0.97). Conclusions: Higher mushroom consumption was positively related to better cognitive function and associated with lower odds of MCI. Further studies are needed to replicate our findings in other populations and determine the underlying mechanisms.
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Affiliation(s)
- Yaqiong Yan
- Department of Non-communicable Chronic Disease Prevention and Control, Wuhan Center for Disease Control and Prevention, 288 Machang Road, Wuhan 430024, China
| | - Benchao Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Fengping Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, No.115 Donghu Road, Wuhan 430071, China
| | - Xiaoqi Zhou
- Department of Non-communicable Chronic Disease Prevention and Control, Wuhan Center for Disease Control and Prevention, 288 Machang Road, Wuhan 430024, China
| | - Tingting Li
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Yuanyuan Li
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, No.115 Donghu Road, Wuhan 430071, China
| | - Changshu Liu
- Standard Foods (China) Co., Ltd., Taicang Port Economic and Technological Development Zone New Zone, No. 88 Dalian West Road, Suzhou, China
| | - Sai Wang
- Standard Foods (China) Co., Ltd., Taicang Port Economic and Technological Development Zone New Zone, No. 88 Dalian West Road, Suzhou, China
| | - Yang Cong
- Standard Foods (China) Co., Ltd., Taicang Port Economic and Technological Development Zone New Zone, No. 88 Dalian West Road, Suzhou, China
| | - Yan Deng
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Ziping Wang
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Jin Zhou
- Chinese Nutrition Society (CNS) Academy of Nutrition and Health (Beijing Zhongyinghui Nutrition and Health Research Institute), China
| | - Shuang Rong
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
- Department of Nutrition, School of Public Health, Wuhan University, Research Center of Public Health, Renmin Hospital of Wuhan University, No.115 Donghu Road, Wuhan 430071, China
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238
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Bachmann D, Buchmann A, Studer S, Saake A, Rauen K, Zuber I, Gruber E, Nitsch RM, Hock C, Gietl A, Treyer V. Age-, sex-, and pathology-related variability in brain structure and cognition. Transl Psychiatry 2023; 13:278. [PMID: 37574523 PMCID: PMC10423720 DOI: 10.1038/s41398-023-02572-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/20/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023] Open
Abstract
This work aimed to investigate potential pathways linking age and imaging measures to early age- and pathology-related changes in cognition. We used [18F]-Flutemetamol (amyloid) and [18F]-Flortaucipir (tau) positron emission tomography (PET), structural MRI, and neuropsychological assessment from 232 elderly individuals aged 50-89 years (46.1% women, 23% APOE-ε4 carrier, 23.3% MCI). Tau-PET was available for a subsample of 93 individuals. Structural equation models were used to evaluate cross-sectional pathways between age, amyloid and tau burden, grey matter thickness and volumes, white matter hyperintensity volume, lateral ventricle volume, and cognition. Our results show that age is associated with worse outcomes in most of the measures examined and had similar negative effects on episodic memory and executive functions. While increased lateral ventricle volume was consistently associated with executive function dysfunction, participants with mild cognitive impairment drove associations between structural measures and episodic memory. Both age and amyloid-PET could be associated with medial temporal lobe tau, depending on whether we used a continuous or a dichotomous amyloid variable. Tau burden in entorhinal cortex was related to worse episodic memory in individuals with increased amyloid burden (Centiloid >12) independently of medial temporal lobe atrophy. Testing models for sex differences revealed that amyloid burden was more strongly associated with regional atrophy in women compared with men. These associations were likely mediated by higher tau burden in women. These results indicate that influences of pathological pathways on cognition and sex-specific vulnerabilities are dissociable already in early stages of neuropathology and cognitive impairment.
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Affiliation(s)
- Dario Bachmann
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland.
- Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Andreas Buchmann
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Sandro Studer
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Antje Saake
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Katrin Rauen
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Zurich, Switzerland
| | - Isabelle Zuber
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Esmeralda Gruber
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
| | - Roger M Nitsch
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
- Neurimmune AG, Schlieren, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
- Neurimmune AG, Schlieren, Switzerland
| | - Anton Gietl
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
- Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Valerie Treyer
- Institute for Regenerative Medicine, University of Zurich, Schlieren, Switzerland
- Department of Nuclear Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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d’Angremont E, Begemann MJH, van Laar T, Sommer IEC. Cholinesterase Inhibitors for Treatment of Psychotic Symptoms in Alzheimer Disease and Parkinson Disease: A Meta-analysis. JAMA Neurol 2023; 80:813-823. [PMID: 37358841 PMCID: PMC10294019 DOI: 10.1001/jamaneurol.2023.1835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 04/17/2023] [Indexed: 06/27/2023]
Abstract
Importance Psychotic symptoms greatly increase the burden of disease for people with neurodegenerative disorders and their caregivers. Cholinesterase inhibitors (ChEIs) may be effective treatment for psychotic symptoms in these disorders. Previous trials only evaluated neuropsychiatric symptoms as a secondary and an overall outcome, potentially blurring the outcomes noted with ChEI use specifically for psychotic symptoms. Objective To quantitatively assess the use of ChEIs for treatment of individual neuropsychiatric symptoms, specifically hallucinations and delusions, in patients with Alzheimer disease (AD), Parkinson disease (PD), and dementia with Lewy bodies (DLB). Data Sources A systematic search was performed in PubMed (MEDLINE), Embase, and PsychInfo, without year restrictions. Additional eligible studies were retrieved from reference lists. The final search cutoff date was April 21, 2022. Study Selection Studies were selected if they presented the results of placebo-controlled randomized clinical trials, including at least 1 donepezil, rivastigmine, or galantamine treatment arm in patients with AD, PD, or DLB; if they applied at least 1 neuropsychiatric measure including hallucinations and/or delusions; and if a full-text version of the study was available in the English language. Study selection was performed and checked by multiple reviewers. Data Extraction and Synthesis Original research data were requested on eligible studies. A 2-stage meta-analysis was then performed, using random-effects models. Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed for extracting data and assessing the data quality and validity. Data extraction was checked by a second reviewer. Main Outcomes and Measures Primary outcomes were hallucinations and delusions; secondary outcomes included all other individual neuropsychiatric subdomains as well as the total neuropsychiatric score. Results In total, 34 eligible randomized clinical trials were selected. Individual participant data on 6649 individuals (3830 [62.6%] women; mean [SD] age, 75.0 [8.2] years) were obtained from 17 trials (AD: n = 12; PD: n = 5; individual participant data were not available for DLB). An association with ChEI treatment was shown in the AD subgroup for delusions (-0.08; 95% CI, -0.14 to -0.03; P = .006) and hallucinations (-0.09; 95% CI, -0.14 to -0.04; P = .003) and in the PD subgroup for delusions (-0.14; 95% CI, -0.26 to -0.01; P = .04) and hallucinations (-0.08, 95% CI -0.13 to -0.03; P = .01). Conclusions and Relevance The results of this individual participant data meta-analysis suggest that ChEI treatment improves psychotic symptoms in patients with AD and PD with small effect sizes.
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Affiliation(s)
- Emile d’Angremont
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| | - Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, Groningen, the Netherlands
| | - Teus van Laar
- Department of Neurology, University Medical Center Groningen, Groningen, the Netherlands
| | - Iris E. C. Sommer
- Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
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Bossa M, Argento O, Piacentini C, Manocchio N, Scipioni L, Oddi S, Maccarrone M, Nocentini U. Effects of Long-Term Oral Administration of N-Palmitoylethanolamine in Subjects with Mild Cognitive Impairment: Study Protocol. Brain Sci 2023; 13:1138. [PMID: 37626494 PMCID: PMC10452679 DOI: 10.3390/brainsci13081138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
N-palmitoylethanolamine (PEA) plays a key role in preventing Aβ-mediated neuroinflammation and neurotoxicity in murine models. It has been demonstrated that PEA provides anti-neuroinflammatory, pain-relieving and neuroprotective actions even in humans. In this project, we aim to evaluate these anti-neuroinflammatory effects via the cognitive evaluation and biochemical analyses of a 12-month oral administration of PEA in subjects with mild cognitive impairment (MCI). Subjects with MCI will be randomized to placebo or PEA groups, and followed for another 6 months. Cognitive abilities and neurological inflammation will be examined at baseline and after treatment. The specific objectives of the project are to ascertain whether: (i) PEA influences the scores of the neuropsychological and behavioral evaluations after one-year treatment, comparing PEA-treated and placebo subjects in both MCI and control groups; (ii) PEA can change the inflammatory and neuronal damage markers of blood and urine in MCI subjects; and (iii) these changes correlate with the clinical scores of participating subjects.
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Affiliation(s)
- Michela Bossa
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Ornella Argento
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Chiara Piacentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
| | - Nicola Manocchio
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Lucia Scipioni
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio Snc, 67100 L’Aquila, Italy; (L.S.); (M.M.)
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
| | - Sergio Oddi
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
- Faculty of Veterinary Medicine, University of Teramo, Via R. Balzarini 1, 64100 Teramo, Italy
| | - Mauro Maccarrone
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, Via Vetoio Snc, 67100 L’Aquila, Italy; (L.S.); (M.M.)
- European Center for Brain Research/I.R.C.C.S. “Santa Lucia” Foundation, Via del Fosso di Fiorano 64, 00143 Rome, Italy;
| | - Ugo Nocentini
- Behavioral Neuropsychology Laboratory, I.R.C.C.S. “Santa Lucia” Foundation, 00179 Rome, Italy; (O.A.); (C.P.); (U.N.)
- Department of Clinical Sciences and Translational Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy;
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Dai Y, Xia R, Wang D, Li S, Yuan X, Li X, Liu J, Wang M, Kuang Y, Chen S. Effect of acupuncture on episodic memory for amnesia-type mild cognitive impairment: study protocol of a multicenter, randomized, controlled trial. BMC Complement Med Ther 2023; 23:268. [PMID: 37507779 PMCID: PMC10375685 DOI: 10.1186/s12906-023-04059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Amnesic mild cognitive impairment (aMCI) is the main subtype of mild cognitive impairment (MCI) and has the highest risk of conversion to Alzheimer's disease (AD) among all MCI subtypes. Episodic memory impairment is the early cognitive impairment of aMCI, which has become an important target for AD prevention. Previous clinical evidence has shown that acupuncture can improve the cognitive ability of MCI patients. This experiment aimed to observe the efficacy and neural mechanism of TiaoshenYizhi acupuncture on the episodic memory of patients with aMCI. METHODS In this multicenter, parallel-group, double-blind, randomized controlled trial, 360 aMCI participants will be recruited from six subcenters and randomly assigned to the acupuncture group, sham acupuncture group, and control group. The acupuncture group will receive TiaoshenYizhi (TSYZ) acupuncture, the sham acupuncture group will use streitberger sham acupuncture, and the control group will only receive free health education. Participants in the two acupuncture groups will receive real acupuncture treatment or placebo acupuncture three times per week, 24 sessions over 8 consecutive weeks. The primary outcome will be global cognitive ability. Secondary outcomes will be a specific cognitive domain, including episodic memory and execution ability, electroencephalogram, and functional magnetic resonance imaging data. Outcomes will be measured at baseline and the fourth and eighth weeks after randomization. Repeated measurement analysis of variance and a mixed linear model will be used to observe the intervention effect. DISCUSSION The protocol will give a detailed procedure to the multicenter clinical trial to further evaluate the efficacy and neural mechanism of TiaoshenYizhi acupuncture on episodic memory in patients with aMCI. From this research, we expect to provide clinical evidence for early aMCI management. TRIAL REGISTRATION http://www.chictr.org.cn/edit.aspx?pid=142612&htm=4 , identifier: ChiCTR2100054009.
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Affiliation(s)
- Yalan Dai
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rui Xia
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Dan Wang
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Shuqian Li
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xu Yuan
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Xingjie Li
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Jun Liu
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Mengyang Wang
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Yuxing Kuang
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China
| | - Shangjie Chen
- Department of Rehabilitation Medicine, The People's Hospital of Baoan Shenzhen, Shenzhen, China.
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Shenzhen University, Shenzhen, China.
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Qi X, Liu Y, Chi H, Yang Y, Xiong Q, Li M, Yao R, Sun H, Li Z, Zhang J. Complement proteins in serum astrocyte-derived exosomes are associated with mild cognitive impairment in type 1 diabetes mellitus patients. Neurosci Lett 2023; 810:137318. [PMID: 37271220 DOI: 10.1016/j.neulet.2023.137318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/06/2023]
Abstract
BACKGROUND The complement system plays a crucial role in cognitive impairment. The aim of this study is to investigate the correlation between the complement proteins levels in serum astrocyte-derived exosomes (ADEs) and mild cognitive impairment (MCI) in type 1 diabetes mellitus (T1DM) patients. METHODS In this cross-sectional study, the patients with immune-mediated T1DM were enrolled. Healthy subjects matched for age and sex with T1DM patients were selected as controls. The cognitive function was evaluated by a Beijing version of the Montreal Cognitive Assessment (MoCA) questionnaire. The complement proteins including C5b-9, C3b and Factor B in serum ADEs were measured by ELISA kits. RESULTS This study recruited 55 subjects immune-mediated T1DM patients without dementia, including 31 T1DM patients with MCI, 24 T1DM patients without MCI. 33 healthy subjects were enrolled as controls. The results showed higher complement proteins including C5b-9, C3b and Factor B levels in ADEs from T1DM patients with MCI than those in the controls (P < 0.001, P < 0.001, P = 0.006) and T1DM patients without MCI (P = 0.02, P = 0.02, P = 0.03). The C5b-9 levels in ADEs were independently associated with MCI in T1DM patients(OR: 1.20, 95% CI: 1.00-1.44, P = 0.04). The C5b-9 levels in ADEs were significantly correlated with global cognitive scores (β = -0.360, P<0.001) and visuo-executive (β = -0.132, P<0.001), language(β = -0.036, P = 0.026) and delayed recall score (β = -0.090,P = 0.007). There was no correlation between the C5b-9 levels in ADEs and the fasting glucose, HbA1c, fasting c-peptide and GAD65 antibody in T1DM patients. Furthermore, the C5b-9, C3b and Factor B levels in ADEs exhibited a fair combined diagnostic value for MCI, with an area under the curve of 0.76 (95% CI: 0.63-0.88, P = 0.001). CONCLUSION The elevated C5b-9 levels in ADEswere significantly associated with theMCI in T1DM patients. The C5b-9 in ADEs may be used as a marker of MCI in T1DM patients.
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Affiliation(s)
- Xiaoxiao Qi
- Department of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261053, China; Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yingxiao Liu
- Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Haiyan Chi
- Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yachao Yang
- Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Qiao Xiong
- Department of Clinical Medicine, Weifang Medical University, Weifang, Shandong 261053, China; Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Mengfan Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Ran Yao
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Hairong Sun
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Zhenguang Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China.
| | - Jinbiao Zhang
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China.
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Gerstenecker A, Kennedy R, Zhang Y, Martin RC, Mackin RS, Weiner MW, Howell T, Petersen RC, Roberson ED, Marson DC. Item Response Analysis of the Financial Capacity Instrument-Short Form. Arch Clin Neuropsychol 2023; 38:739-758. [PMID: 36644855 PMCID: PMC10369359 DOI: 10.1093/arclin/acac112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2022] [Indexed: 06/17/2023] Open
Abstract
OBJECTIVE The Financial Capacity Instrument-Short Form (FCI-SF) is a performance-based measure of everyday financial skills that takes 15 min to administer. Although the FCI-SF has demonstrated excellent psychometric properties, advanced psychometric methods such as item response theory (IRT) can provide important information on the performance of individual test items in measuring financial capacity and in distinguishing between healthy and cognitively impaired individuals. METHOD Participants were 272 older adults diagnosed with mild cognitive impairment (MCI) and 1,344 cognitively healthy controls recruited from the Mayo Clinic Study of Aging at the Mayo Clinic in Rochester, Minnesota and also from the Cognitive Observations in Seniors study at the University of Alabama at Birmingham. Participants in each study were administered the FCI-SF, which evaluates coin/currency calculation, financial conceptual knowledge, use of a checkbook/register, and use of a bank statement. RESULTS A unidimensional two-parameter logistic model best fit the 37 FCI-SF Test items, and most FCI-SF items fit the unidimensional two-parameter model well. The results indicated that all FCI-SF items robustly distinguished cognitively healthy controls from persons with MCI. CONCLUSIONS The study results showed that the FCI-SF performed well under IRT analysis, further highlighted the psychometric properties of the FCI-SF as a valid and reliable measure of financial capacity, and demonstrated the clinical utility of the FCI-SF in distinguishing between cognitively normal and cognitively impaired individuals.
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Affiliation(s)
- Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Richard Kennedy
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, San Francisco, CA, USA
- Interdisciplinary Center for Aging Research, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Yue Zhang
- Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Roy C Martin
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
| | - R Scott Mackin
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
- San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
| | - Michael W Weiner
- San Francisco Veteran's Administration Medical Center, San Francisco, CA, USA
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Taylor Howell
- Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | | | - Erik D Roberson
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
- Interdisciplinary Center for Aging Research, University of Alabama at Birmingham, San Francisco, CA, USA
| | - Daniel C Marson
- Department of Neurology, University of Alabama at Birmingham, San Francisco, CA, USA
- Alzheimer’s Disease Center, University of Alabama at Birmingham, San Francisco, CA, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, San Francisco, CA, USA
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Peretti DE, Ribaldi F, Scheffler M, Mu L, Treyer V, Gietl AF, Hock C, Frisoni GB, Garibotto V. ATN profile classification across two independent prospective cohorts. Front Med (Lausanne) 2023; 10:1168470. [PMID: 37559930 PMCID: PMC10407659 DOI: 10.3389/fmed.2023.1168470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/10/2023] [Indexed: 08/11/2023] Open
Abstract
Background The ATN model represents a research framework used to describe in subjects the presence or absence of Alzheimer's disease (AD) pathology through biomarkers. The aim of this study was to describe the prevalence of different ATN profiles using quantitative imaging biomarkers in two independent cohorts, and to evaluate the pertinence of ATN biomarkers to identify comparable populations across independent cohorts. Methods A total of 172 subjects from the Geneva Memory Clinic and 113 volunteers from a study on healthy aging at the University Hospital of Zurich underwent amyloid (A) and tau (T) PET, as well as T1-weigthed MRI scans using site-specific protocols. Subjects were classified by cognition (cognitively unimpaired, CU, or impaired, CI) based on clinical assessment by experts. Amyloid data converted into the standardized centiloid scale, tau PET data normalized to cerebellar uptake, and hippocampal volume expressed as a ratio over total intracranial volume ratio were considered as biomarkers for A, T, and neurodegeneration (N), respectively. Positivity for each biomarker was defined based on previously published thresholds. Subjects were then classified according to the ATN model. Differences among profiles were tested using Kruskal-Wallis ANOVA, and between cohorts using Wilcoxon tests. Results Twenty-nine percent of subjects from the Geneva cohorts were classified with a normal (A-T-N-) profile, while the Zurich cohort included 64% of subjects in the same category. Meanwhile, 63% of the Geneva and 16% of the Zurich cohort were classified within the AD continuum (being A+ regardless of other biomarkers' statuses). Within cohorts, ATN profiles were significantly different for age and mini-mental state examination scores, but not for years of education. Age was not significantly different between cohorts. In general, imaging A and T biomarkers were significantly different between cohorts, but they were no longer significantly different when stratifying the cohorts by ATN profile. N was not significantly different between cohorts. Conclusion Stratifying subjects into ATN profiles provides comparable groups of subjects even when individual recruitment followed different criteria.
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Affiliation(s)
- Débora E. Peretti
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, Geneva University Neurocenter, University of Geneva, Geneva, Switzerland
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
| | - Max Scheffler
- Division of Radiology, Geneva University Hospitals, Geneva, Switzerland
| | - Linjing Mu
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute of Pharmaceutical Sciences, Zurich, Switzerland
| | - Valerie Treyer
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Anton F. Gietl
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Christoph Hock
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Giovanni B. Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Valentina Garibotto
- Laboratory of Neuroimaging and Innovative Molecular Tracers (NIMTlab), Faculty of Medicine, Geneva University Neurocenter, University of Geneva, Geneva, Switzerland
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
- Center for Biomedical Imaging, University of Geneva, Geneva, Switzerland
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Bucci M, Bluma M, Savitcheva I, Ashton NJ, Chiotis K, Matton A, Kivipelto M, Di Molfetta G, Blennow K, Zetterberg H, Nordberg A. Profiling of plasma biomarkers in the context of memory assessment in a tertiary memory clinic. Transl Psychiatry 2023; 13:268. [PMID: 37491358 PMCID: PMC10368630 DOI: 10.1038/s41398-023-02558-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 06/24/2023] [Accepted: 07/03/2023] [Indexed: 07/27/2023] Open
Abstract
Plasma biomarkers have shown promising performance in research cohorts in discriminating between different stages of Alzheimer's disease (AD). Studies in clinical populations are necessary to provide insights on the clinical utility of plasma biomarkers before their implementation in real-world settings. Here we investigated plasma biomarkers (glial fibrillary acidic protein (GFAP), tau phosphorylated at 181 and 231 (pTau181, pTau231), amyloid β (Aβ) 42/40 ratio, neurofilament light) in 126 patients (age = 65 ± 8) who were admitted to the Clinic for Cognitive Disorders, at Karolinska University Hospital. After extensive clinical assessment (including CSF analysis), patients were classified as: mild cognitive impairment (MCI) (n = 75), AD (n = 25), non-AD dementia (n = 16), no dementia (n = 9). To refine the diagnosis, patients were examined with [18F]flutemetamol PET (Aβ-PET). Aβ-PET images were visually rated for positivity/negativity and quantified in Centiloid. Accordingly, 68 Aβ+ and 54 Aβ- patients were identified. Plasma biomarkers were measured using single molecule arrays (SIMOA). Receiver-operated curve (ROC) analyses were performed to detect Aβ-PET+ using the different biomarkers. In the whole cohort, the Aβ-PET centiloid values correlated positively with plasma GFAP, pTau231, pTau181, and negatively with Aβ42/40 ratio. While in the whole MCI group, only GFAP was associated with Aβ PET centiloid. In ROC analyses, among the standalone biomarkers, GFAP showed the highest area under the curve discriminating Aβ+ and Aβ- compared to other plasma biomarkers. The combination of plasma biomarkers via regression was the most predictive of Aβ-PET, especially in the MCI group (prior to PET, n = 75) (sensitivity = 100%, specificity = 82%, negative predictive value = 100%). In our cohort of memory clinic patients (mainly MCI), the combination of plasma biomarkers was sensitive in ruling out Aβ-PET negative individuals, thus suggesting a potential role as rule-out tool in clinical practice.
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Affiliation(s)
- Marco Bucci
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, SE-14186, Stockholm, Sweden
| | - Marina Bluma
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden
| | - Irina Savitcheva
- Medical Radiation Physics and Nuclear Medicine, Karolinska University, SE-14186, Stockholm, Sweden
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SE-43180, Mölndal, Sweden
| | - Konstantinos Chiotis
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden
- Department of Neurology, Karolinska University Hospital, SE-14186, Stockholm, Sweden
| | - Anna Matton
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden
| | - Miia Kivipelto
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, SE-14186, Stockholm, Sweden
| | - Guglielmo Di Molfetta
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SE-43180, Mölndal, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SE-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, SE-43180, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, SE-43180, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- UK Dementia Research Institute at UCL, London, WC1N 3BG, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Agneta Nordberg
- Department of Neurobiology, Care Sciences and Society, Centre for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, SE-14183, Stockholm, Sweden.
- Theme Inflammation and Aging, Karolinska University Hospital, SE-14186, Stockholm, Sweden.
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Liang Y, Liu W, Wang M. Characteristics of macroscopic sleep structure in patients with mild cognitive impairment: a systematic review. Front Psychiatry 2023; 14:1212514. [PMID: 37547222 PMCID: PMC10399242 DOI: 10.3389/fpsyt.2023.1212514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 06/27/2023] [Indexed: 08/08/2023] Open
Abstract
Objectives Conducting a systematic analysis of objective measurement tools to assess the characteristics of macroscopic sleep architecture in patients with mild cognitive impairment (MCI), amnestic MCI (aMCI), and non-amnestic MCI (naMCI) in order to provide sleep disorder guidance for MCI patients. Methods PubMed, EMbase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang Data, and VIP Data were examined to find literature relating to sleep in patients with MCI, aMCI, and naMCI, with a search time frame of build to April 2023. Following independent literature screening, data extraction, and quality evaluation by two researchers, statistical analysis was performed using RevMan 5.4 software. Results Twenty-five papers with 1,165 study subjects were included. Patients with MCI and aMCI were found to have altered total sleep time (TST), reduced sleep efficiency (SE), more wake-time after sleep onset (WASO), longer sleep latency (SL), a higher proportion of N1 stage and a lower proportion of N2 and N3 stage. naMCI was only found to have statistically significant differences in WASO. Conclusions The results of this study provide evidence for macroscopic sleep architecture abnormalities among MCI patients with sleep disorders. Maintaining a normal sleep time, improving SE, and reducing sleep fragmentation may have an association with a slowed development of cognitive impairment. Further exploration is required of the effects each component of macroscopic sleep structure after the intervention has on altered sleep disturbance and cognition in MCI, aMCI, and naMCI. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023401937, identifier: CRD42023401937.
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Affiliation(s)
- Yahui Liang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Weihua Liu
- School of Chemistry and Pharmaceutical Engineering, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Meizi Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
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Walker KA, Chen J, Shi L, Yang Y, Fornage M, Zhou L, Schlosser P, Surapaneni A, Grams ME, Duggan MR, Peng Z, Gomez GT, Tin A, Hoogeveen RC, Sullivan KJ, Ganz P, Lindbohm JV, Kivimaki M, Nevado-Holgado AJ, Buckley N, Gottesman RF, Mosley TH, Boerwinkle E, Ballantyne CM, Coresh J. Proteomics analysis of plasma from middle-aged adults identifies protein markers of dementia risk in later life. Sci Transl Med 2023; 15:eadf5681. [PMID: 37467317 PMCID: PMC10665113 DOI: 10.1126/scitranslmed.adf5681] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/28/2023] [Indexed: 07/21/2023]
Abstract
A diverse set of biological processes have been implicated in the pathophysiology of Alzheimer's disease (AD) and related dementias. However, there is limited understanding of the peripheral biological mechanisms relevant in the earliest phases of the disease. Here, we used a large-scale proteomics platform to examine the association of 4877 plasma proteins with 25-year dementia risk in 10,981 middle-aged adults. We found 32 dementia-associated plasma proteins that were involved in proteostasis, immunity, synaptic function, and extracellular matrix organization. We then replicated the association between 15 of these proteins and clinically relevant neurocognitive outcomes in two independent cohorts. We demonstrated that 12 of these 32 dementia-associated proteins were associated with cerebrospinal fluid (CSF) biomarkers of AD, neurodegeneration, or neuroinflammation. We found that eight of these candidate protein markers were abnormally expressed in human postmortem brain tissue from patients with AD, although some of the proteins that were most strongly associated with dementia risk, such as GDF15, were not detected in these brain tissue samples. Using network analyses, we found a protein signature for dementia risk that was characterized by dysregulation of specific immune and proteostasis/autophagy pathways in adults in midlife ~20 years before dementia onset, as well as abnormal coagulation and complement signaling ~10 years before dementia onset. Bidirectional two-sample Mendelian randomization genetically validated nine of our candidate proteins as markers of AD in midlife and inferred causality of SERPINA3 in AD pathogenesis. Last, we prioritized a set of candidate markers for AD and dementia risk prediction in midlife.
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Affiliation(s)
- Keenan A. Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD 21224, USA
| | - Jingsha Chen
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
| | - Liu Shi
- Novo Nordisk Research Centre Oxford (NNRCO), Oxford OX3 7FZ, UK
| | - Yunju Yang
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School and Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School and Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Linda Zhou
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
| | - Pascal Schlosser
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
| | - Aditya Surapaneni
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
| | - Morgan E. Grams
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21210, USA
| | - Michael R. Duggan
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD 21224, USA
| | - Zhongsheng Peng
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD 21224, USA
| | - Gabriela T. Gomez
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21210, USA
| | - Adrienne Tin
- MIND Center and Division of Nephrology, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Ron C. Hoogeveen
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kevin J. Sullivan
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Peter Ganz
- Department of Medicine, University of California-San Francisco, San Francisco, CA 94115, USA
| | - Joni V. Lindbohm
- Broad Institute of the Massachusetts Institute of Technology and Harvard University, Cambridge, MA 02142, USA
| | - Mika Kivimaki
- Department of Mental Health of Older People, Faculty of Brain Sciences, University College London, London WC1E 6BT, UK
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki 00100, Finland
| | | | - Noel Buckley
- Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK
| | - Rebecca F. Gottesman
- National Institute of Neurological Disorders and Stroke, Intramural Research Program, Bethesda, MD 20892, USA
| | - Thomas H. Mosley
- Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Eric Boerwinkle
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Christie M. Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21210, USA
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Zhang S, Wang A, Liu S, Liu H, Zhu W, Zhang Z. Glycemic variability correlates with medial temporal lobe atrophy and decreased cognitive performance in patients with memory deficits. Front Aging Neurosci 2023; 15:1156908. [PMID: 37533764 PMCID: PMC10390778 DOI: 10.3389/fnagi.2023.1156908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 06/28/2023] [Indexed: 08/04/2023] Open
Abstract
Background In the past, researchers have observed a significant link between glycemia and dementia. Medial temporal atrophy (MTA) is regarded as a common marker of dementia. The correlation between glycemic variability and MTA is unclear, and it has not been determined whether glycemic variability can be utilized as a biomarker of MTA and cognitive performance. Methods The patients in a memory clinic who underwent brain MRI scans and cognitive assessments within the first week of their hospital visit, were enrolled. All participants underwent three fasting blood glucose and one HBA1c assessments on three self-selected days within 1 week of their first visit. The variability independent of the mean (VIM) was employed. Validated visual scales were used to rate the MTA results. The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) scales were employed to assess the cognitive functions of the participants. Spearman's correlation and regression models were used to examine the relationship between the MMSE and MoCA scales, and also determine the link between the MRI characteristics and cognitive status, where vascular risk factors, educational status, age, gender, and mean glucose parameters served as covariates. Results Four hundred sixty-one subjects completed the MMSE scale, while 447 participants completed the MoCA scale. Data analysis revealed that 47.72% of the participants were men (220/461), and the median age of the patients was 69.87 ± 5.37 years. The findings of Spearman's correlation analysis exhibited a strong negative relationship between the VIM and MMSE score (r = -0.729, P < 0.01), and the MoCA score (r = -0.710, P < 0.01). The VIM was regarded as an independent risk factor for determining cognitive impairment in both the MMSE and MoCA assessments. The results were unaffected by sensitivity analysis. In addition, a non-linear relationship was observed between the VIM and MTA scores. Conclusion The variability in the blood glucose levels, which was presented as VIM, was related to the reduced cognitive function, which was reflected by MMSE and MoCA scales. The relationship between the VIM and the MTA score was non-linear. The VIM was positively related to the MTA score when the VIM was less than 2.42.
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Affiliation(s)
- Shuangmei Zhang
- Department of Pain Rehabilitation, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
- Institute of Cancer and Basic Medicine, Chinese Academy of Sciences, Hangzhou, China
| | - Anrong Wang
- The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
| | - Shen Liu
- The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, China
- Department of Neurology of Traditional Chinese Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Hongyu Liu
- Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University, Guangzhou, China
| | - Weifeng Zhu
- Affiliated Hospital of Traditional Chinese Medicine of Guangzhou Medical University, Guangzhou, China
| | - Zhaoxu Zhang
- Department of Neurology, Peking University People's Hospital, Beijing, China
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Park J, Lee HJ, Park JS, Kim CH, Jung WJ, Won S, Bae JB, Han JW, Kim KW. Development of a Gait Feature-Based Model for Classifying Cognitive Disorders Using a Single Wearable Inertial Sensor. Neurology 2023; 101:e12-e19. [PMID: 37188539 PMCID: PMC10351320 DOI: 10.1212/wnl.0000000000207372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/17/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Gait changes are potential markers of cognitive disorders (CDs). We developed a model for classifying older adults with CD from those with normal cognition using gait speed and variability captured from a wearable inertial sensor and compared its diagnostic performance for CD with that of the model using the Mini-Mental State Examination (MMSE). METHODS We enrolled community-dwelling older adults with normal gait from the Korean Longitudinal Study on Cognitive Aging and Dementia and measured their gait features using a wearable inertial sensor placed at the center of body mass while they walked on a 14-m long walkway thrice at comfortable paces. We randomly split our entire dataset into the development (80%) and validation (20%) datasets. We developed a model for classifying CD using logistic regression analysis from the development dataset and validated it in the validation dataset. In both datasets, we compared the diagnostic performance of the model with that using the MMSE. We estimated optimal cutoff score of our model using receiver operator characteristic analysis. RESULTS In total, 595 participants were enrolled, of which 101 of them experienced CD. Our model included both gait speed and temporal gait variability and exhibited good diagnostic performance for classifying CD from normal cognition in both the development (area under the receiver operator characteristic curve [AUC] = 0.788, 95% CI 0.748-0.823, p < 0.001) and validation datasets (AUC = 0.811, 95% CI 0.729-0.877, p < 0.001). Our model showed comparable diagnostic performance for CD with that of the model using the MMSE in both the development (difference in AUC = 0.026, standard error [SE] = 0.043, z statistic = 0.610, p = 0.542) and validation datasets (difference in AUC = 0.070, SE = 0.073, z statistic = 0.956, p = 0.330). The optimal cutoff score of the gait-based model was >-1.56. DISCUSSION Our gait-based model using a wearable inertial sensor may be a promising diagnostic marker of CD in older adults. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that gait analysis can accurately distinguish older adults with CDs from healthy controls.
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Affiliation(s)
- Jeongbin Park
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Hyang Jun Lee
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Ji Sun Park
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Chae Hyun Kim
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea.
| | - Woo Jin Jung
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Seunghyun Won
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Jong Bin Bae
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Ji Won Han
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea
| | - Ki Woong Kim
- From the PlanB4U Research Institute (J.P., C.H.K., W.J.J., K.W.K.), Seongnam; Department of Neuropsychiatry (H.J.L., J.B.B., J.W.H., K.W.K.), Seoul National University Bundang Hospital, Seongnam; Department of Brain and Cognitive Science (J.S.P., K.W.K.), Seoul National University College of Natural Sciences; Medical Research Collaborating Center (S.W.), Seoul National University Bundang Hospital, Seongnam; and Department of Psychiatry (K.W.K.), Seoul National University, College of Medicine, Korea.
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López-Pérez J, García-Herranz S, Díaz-Mardomingo MDC. Acquisition and consolidation of verbal learning and episodic memory as predictors of the conversion from mild cognitive impairment to probable Alzheimer's disease. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:638-653. [PMID: 35475773 DOI: 10.1080/13825585.2022.2069670] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Verbal episodic memory tests assess memory performance using total learning scores. The analysis of inter-trial indices such as gained (GA) and lost (LA) access can provide additional information on the acquisition and consolidation processes. The main objetive was to determine whether the GA and LA indices, derived from a word-list verbal episodic memory test are useful for predicting cognitive impairment in aging. 60 older people aged was divided into 3 groups: cognitively healthy, stable Mild Cognitive Impairment (MCI) and MCI converting to probable Alzheimer's disease (MCI-conv). The results showed that GA and LA measures are independent from the traditional measures -total score of correct answers-. Logistic regression showed that these values are predictive of the conversion over time and could be a cognitive marker of conversion from MCI to AD. This suggests that the GA index, which shows acquisition processes in word-list tests, may be a marker of cognitive impairment.
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Affiliation(s)
- Jorge López-Pérez
- Department of Basic Psychology I, Faculty of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Sara García-Herranz
- Department of Basic Psychology II, Faculty of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
- Instituto Mixto de Investigación-Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
| | - María Del Carmen Díaz-Mardomingo
- Department of Basic Psychology I, Faculty of Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain
- Instituto Mixto de Investigación-Escuela Nacional de Sanidad (IMIENS), Madrid, Spain
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