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Beer SA, Möhle R, Tabatabai G, Merle DA, Ernemann U, Richter V, Lengerke C. Clinical relevance of brain MRI changes in primary central nervous system lymphoma after high-dose-chemotherapy and autologous stem cell transplantation. Bone Marrow Transplant 2024:10.1038/s41409-024-02382-4. [PMID: 39122834 DOI: 10.1038/s41409-024-02382-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 07/19/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024]
Abstract
Primary central nervous system lymphoma (PCNSL) is a potentially curable disease, but affected patients often struggle in everyday life due to disease- and therapy-associated sequelae. High-dose chemotherapy followed by autologous stem cell transplantation (HDC/ASCT) is the standard consolidation therapy, replacing whole brain radiation therapy (WBRT) amongst others due to less long-term cognitive decline. Nevertheless, white matter lesions (WML) are common findings in brain MRI after HDC/ASCT, but their clinical significance remains underexplored. Here, we correlate WML and brain atrophy with neuropsychological and quality-of-life evaluations collected post-treatment. We found that a significant part of PNCSL long-term survivors develop a high WML burden after HDC/ASCT, but we fail to associate them with specific patient or therapy characteristics. Intriguingly, even a high WML burden does not seem to affect QoL, basic neurocognition testing or performance status negatively. These results contrast findings in previous neuroimaging studies on healthy and cancer patients.
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Affiliation(s)
- Sina A Beer
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany.
| | - Robert Möhle
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
| | - Ghazaleh Tabatabai
- Department of Neurology and Interdisciplinary Neuro-Oncology, University Hospital Tübingen, Hertie Institute for Clinical Brain Research, Tübingen, Germany
- Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany
| | - David A Merle
- Department of Ophthalmology, University Hospital Tübingen, Tübingen, Germany
| | - Ulrike Ernemann
- Department of Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Vivien Richter
- Department of Neuroradiology, University Hospital Tübingen, Tübingen, Germany
| | - Claudia Lengerke
- Department of Internal Medicine II, Hematology, Oncology, Clinical Immunology and Rheumatology, University Hospital Tübingen, Tübingen, Germany
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Chintapalli SS, Wang R, Yang Z, Tassopoulou V, Yu F, Bashyam V, Erus G, Chaudhari P, Shou H, Davatzikos C. NeuroSynth: MRI-Derived Neuroanatomical Generative Models and Associated Dataset of 18,000 Samples. ARXIV 2024:arXiv:2407.12897v1. [PMID: 39070036 PMCID: PMC11275685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Availability of large and diverse medical datasets is often challenged by privacy and data sharing restrictions. For successful application of machine learning techniques for disease diagnosis, prognosis, and precision medicine, large amounts of data are necessary for model building and optimization. To help overcome such limitations in the context of brain MRI, we present NeuroSynth: a collection of generative models of normative regional volumetric features derived from structural brain imaging. NeuroSynth models are trained on real brain imaging regional volumetric measures from the iSTAGING consortium, which encompasses over 40,000 MRI scans across 13 studies, incorporating covariates such as age, sex, and race. Leveraging NeuroSynth, we produce and offer 18,000 synthetic samples spanning the adult lifespan (ages 22-90 years), alongside the model's capability to generate unlimited data. Experimental results indicate that samples generated from NeuroSynth agree with the distributions obtained from real data. Most importantly, the generated normative data significantly enhance the accuracy of downstream machine learning models on tasks such as disease classification. Data and models are available at: https://huggingface.co/spaces/rongguangw/neuro-synth.
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Affiliation(s)
- Sai Spandana Chintapalli
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rongguang Wang
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zhijian Yang
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Vasiliki Tassopoulou
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Fanyang Yu
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Vishnu Bashyam
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Guray Erus
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Pratik Chaudhari
- Department of Electrical and Systems Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Haochang Shou
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Christos Davatzikos
- Center for AI and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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3
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Hernandez H, Baez S, Medel V, Moguilner S, Cuadros J, Santamaria-Garcia H, Tagliazucchi E, Valdes-Sosa PA, Lopera F, OchoaGómez JF, González-Hernández A, Bonilla-Santos J, Gonzalez-Montealegre RA, Aktürk T, Yıldırım E, Anghinah R, Legaz A, Fittipaldi S, Yener GG, Escudero J, Babiloni C, Lopez S, Whelan R, Lucas AAF, García AM, Huepe D, Caterina GD, Soto-Añari M, Birba A, Sainz-Ballesteros A, Coronel C, Herrera E, Abasolo D, Kilborn K, Rubido N, Clark R, Herzog R, Yerlikaya D, Güntekin B, Parra MA, Prado P, Ibanez A. Brain health in diverse settings: How age, demographics and cognition shape brain function. Neuroimage 2024; 295:120636. [PMID: 38777219 DOI: 10.1016/j.neuroimage.2024.120636] [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: 02/08/2024] [Revised: 04/17/2024] [Accepted: 05/04/2024] [Indexed: 05/25/2024] Open
Abstract
Diversity in brain health is influenced by individual differences in demographics and cognition. However, most studies on brain health and diseases have typically controlled for these factors rather than explored their potential to predict brain signals. Here, we assessed the role of individual differences in demographics (age, sex, and education; n = 1298) and cognition (n = 725) as predictors of different metrics usually used in case-control studies. These included power spectrum and aperiodic (1/f slope, knee, offset) metrics, as well as complexity (fractal dimension estimation, permutation entropy, Wiener entropy, spectral structure variability) and connectivity (graph-theoretic mutual information, conditional mutual information, organizational information) from the source space resting-state EEG activity in a diverse sample from the global south and north populations. Brain-phenotype models were computed using EEG metrics reflecting local activity (power spectrum and aperiodic components) and brain dynamics and interactions (complexity and graph-theoretic measures). Electrophysiological brain dynamics were modulated by individual differences despite the varied methods of data acquisition and assessments across multiple centers, indicating that results were unlikely to be accounted for by methodological discrepancies. Variations in brain signals were mainly influenced by age and cognition, while education and sex exhibited less importance. Power spectrum activity and graph-theoretic measures were the most sensitive in capturing individual differences. Older age, poorer cognition, and being male were associated with reduced alpha power, whereas older age and less education were associated with reduced network integration and segregation. Findings suggest that basic individual differences impact core metrics of brain function that are used in standard case-control studies. Considering individual variability and diversity in global settings would contribute to a more tailored understanding of brain function.
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Affiliation(s)
- Hernan Hernandez
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Sandra Baez
- Universidad de los Andes, Bogota, Colombia; Global Brain Health Institute (GBHI), University of California, San Francisco, US Trinity College Dublin, Dublin, Ireland
| | - Vicente Medel
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Sebastian Moguilner
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Harvard Medical School, Boston, MA, USA
| | - Jhosmary Cuadros
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Advanced Center for Electrical and Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2390123, Chile; Grupo de Bioingeniería, Decanato de Investigación, Universidad Nacional Experimental del Táchira, San Cristóbal 5001, Venezuela
| | - Hernando Santamaria-Garcia
- Pontificia Universidad Javeriana (PhD Program in Neuroscience) Bogotá, San Ignacio, Colombia; Center of Memory and Cognition Intellectus, Hospital Universitario San Ignacio Bogotá, San Ignacio, Colombia
| | - Enzo Tagliazucchi
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; University of Buenos Aires, Argentina
| | - Pedro A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Sciences, University of Electronic Sciences Technology of China, Chengdu, China; Cuban Neuroscience Center, La Habana, Cuba
| | - Francisco Lopera
- Grupo de Neurociencias de Antioquia, University of Antioquia, Medellín, Colombia
| | | | | | | | | | - Tuba Aktürk
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Ebru Yıldırım
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Renato Anghinah
- Reference Center of Behavioural Disturbances and Dementia, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil; Traumatic Brain Injury Cognitive Rehabilitation Out-Patient Center, University of Sao Paulo, Sao Paulo, Brazil
| | - Agustina Legaz
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Cognitive Neuroscience Center, Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Sol Fittipaldi
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Global Brain Health Institute (GBHI), University of California, San Francisco, US Trinity College Dublin, Dublin, Ireland; School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Görsev G Yener
- Faculty of Medicine, Izmir University of Economics, 35330, Izmir, Turkey; Brain Dynamics Multidisciplinary Research Center, Dokuz Eylul University, Izmir, Turkey; Izmir Biomedicine and Genome Center, Izmir, Turkey
| | - Javier Escudero
- School of Engineering, Institute for Imaging, Data and Communications, University of Edinburgh, Scotland, UK
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, (FR), Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology "V. Erspamer", Sapienza University of Rome, Rome, Italy
| | - Robert Whelan
- Global Brain Health Institute (GBHI), University of California, San Francisco, US Trinity College Dublin, Dublin, Ireland; Department of Legal Medicine, Psychiatry and Pathology at the Complutense University of Madrid, Madrid, Spain
| | - Alberto A Fernández Lucas
- Department of Legal Medicine, Psychiatry and Pathology at the Complutense University of Madrid, Madrid, Spain
| | - Adolfo M García
- Global Brain Health Institute (GBHI), University of California, San Francisco, US Trinity College Dublin, Dublin, Ireland; Cognitive Neuroscience Center, Universidad de San Andréss, Buenos Aires, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - David Huepe
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez
| | - Gaetano Di Caterina
- Department of Electronic and Electrical Engineering, University of Strathclyde, Glasgow, UK
| | | | - Agustina Birba
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | | | - Carlos Coronel
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Global Brain Health Institute (GBHI), University of California, San Francisco, US Trinity College Dublin, Dublin, Ireland; Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
| | - Eduar Herrera
- Departamento de Estudios Psicológicos, Universidad ICESI, Cali, Colombia
| | - Daniel Abasolo
- Centre for Biomedical Engineering, School of Mechanical Engineering Sciences, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Kerry Kilborn
- School of Psychology, University of Glasgow, Glasgow, Scotland, UK
| | - Nicolás Rubido
- Institute for Complex Systems and Mathematical Biology, University of Aberdeen, Aberdeen, AB24 3UE, UK
| | - Ruaridh Clark
- Centre for Signal and Image Processing, Department of Electronic and Electrical Engineering, University of Strathclyde, UK
| | - Ruben Herzog
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Sorbonne Université, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Paris 75013, France
| | - Deniz Yerlikaya
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylül University, Izmir, Turkey
| | - Bahar Güntekin
- Health Sciences and Technology Research Institute (SABITA), Istanbul Medipol University, Istanbul, Turkey; Department of Biophysics, School of Medicine, Istanbul Medipol University, Turkey
| | - Mario A Parra
- Department of Psychological Sciences and Health, University of Strathclyde, United Kingdom and Associate Researcher of the Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Pavel Prado
- Escuela de Fonoaudiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile
| | - Agustin Ibanez
- Latin American Brain Health Institute, Universidad Adolfo Ibañez, Santiago de Chile, Chile; Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA; Cognitive Neuroscience Center, Universidad de San Andrés and Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina; Trinity College Dublin, The University of Dublin, Dublin, Ireland.
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4
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Putri AF, Utomo DH, Tunjung WAS, Putri WA. Analysis of the anti-Alzheimer potential of bioactive compounds from Citrus hystrix DC. peel, leaf, and essential oil by network pharmacology. Heliyon 2024; 10:e33496. [PMID: 39050443 PMCID: PMC11267028 DOI: 10.1016/j.heliyon.2024.e33496] [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: 02/21/2024] [Revised: 05/30/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024] Open
Abstract
Alzheimer's disease (AD) is the most known neurodegenerative disease, and its prevalence is predicted to increase significantly. Discovering novel drugs and treatments for AD is urgently needed. Drugs from natural products have been preferred lately due to their high potential and low toxicity. Citrus hystrix DC. (kaffir lime; KL) is one such herbal plant that is found abundantly in Southeast Asia with many biological activities. In this study, the potential of bioactive compounds from KL peel, leaf, and essential oil as anti-AD agents was explored using network pharmacology. First, the compounds were identified with KNApSAcK database and related literature. Subsequently, the targets of each corresponding compound were determined with SEA Search Server and Swiss Target Prediction, while the proteins associated with AD were identified using OMIM, GenCLiP3, and DisGeNET. Furthermore, a protein-protein interaction network and a compound-target interaction network were constructed to identify the most crucial proteins and compounds in the network by employing Cytoscape v3.9.1. The study continued with pathway enrichment analysis using STRING v1.7.1, molecular docking with PyRx and SwissDock, and molecular dynamics simulation with YASARA for further confirmation. Our results showed that almost all the secondary metabolites of KL targeted AD-associated genes, with oxypeucedanin and citrusoside A showing the highest anti-AD potential and targeting essential genes, EGFR and MAPK14, respectively. These targets were associated with inflammatory and oxidative stress pathways, indicating the potential mechanism of KL in attenuating AD clinical manifestation.
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Affiliation(s)
- Adhisa Fathirisari Putri
- Faculty of Biology, Universitas Gadjah Mada, Jl. Teknika Selatan, Sekip Utara, Yogyakarta, 55281, Indonesia
- Bioinformatics Research Center, INBIO-Indonesia, Malang, 65162, Indonesia
| | - Didik Huswo Utomo
- Bioinformatics Research Center, INBIO-Indonesia, Malang, 65162, Indonesia
- Biosystem Education Center, Brawijaya University, Malang, 65145, Indonesia
| | - Woro Anindito Sri Tunjung
- Faculty of Biology, Universitas Gadjah Mada, Jl. Teknika Selatan, Sekip Utara, Yogyakarta, 55281, Indonesia
| | - Wahyu Aristyaning Putri
- Faculty of Biology, Universitas Gadjah Mada, Jl. Teknika Selatan, Sekip Utara, Yogyakarta, 55281, Indonesia
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Beheshti I, Potvin O, Dadar M, Duchesne S. Cerebrovascular lesion loads and accelerated brain aging: insights into the cognitive spectrum. FRONTIERS IN DEMENTIA 2024; 3:1380015. [PMID: 39081605 PMCID: PMC11285662 DOI: 10.3389/frdem.2024.1380015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/03/2024] [Indexed: 08/02/2024]
Abstract
Introduction White matter hyperintensities (WMHs) and cerebral microbleeds are widespread among aging population and linked with cognitive deficits in mild cognitive impairment (MCI), vascular MCI (V-MCI), and Alzheimer's disease without (AD) or with a vascular component (V-AD). In this study, we aimed to investigate the association between brain age, which reflects global brain health, and cerebrovascular lesion load in the context of pathological aging in diverse forms of clinically-defined neurodegenerative conditions. Methods We computed brain-predicted age difference (brain-PAD: predicted brain age minus chronological age) in the Comprehensive Assessment of Neurodegeneration and Dementia cohort of the Canadian Consortium on Neurodegeneration in Aging including 70 cognitively intact elderly (CIE), 173 MCI, 88 V-MCI, 50 AD, and 47 V-AD using T1-weighted magnetic resonance imaging (MRI) scans. We used a well-established automated methodology that leveraged fluid attenuated inversion recovery MRIs for precise quantification of WMH burden. Additionally, cerebral microbleeds were detected utilizing a validated segmentation tool based on the ResNet50 network, utilizing routine T1-weighted, T2-weighted, and T2* MRI scans. Results The mean brain-PAD in the CIE cohort was around zero, whereas the four categories showed a significantly higher mean brain-PAD compared to CIE, except MCI group. A notable association trend between brain-PAD and WMH loads was observed in aging and across the spectrum of cognitive impairment due to AD, but not between brain-PAD and microbleed loads. Discussion WMHs were associated with faster brain aging and should be considered as a risk factor which imperils brain health in aging and exacerbate brain abnormalities in the context of neurodegeneration of presumed AD origin. Our findings underscore the significance of novel research endeavors aimed at elucidating the etiology, prevention, and treatment of WMH in the area of brain aging.
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Affiliation(s)
- Iman Beheshti
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Olivier Potvin
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche de l'Institut universitaire de cardiologie et pneumologie de Québec, Québec, QC, Canada
| | - Mahsa Dadar
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Simon Duchesne
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche de l'Institut universitaire de cardiologie et pneumologie de Québec, Québec, QC, Canada
- Département de Radiologie et de Médecine Nucléaire, Faculté de Médecine, Université Laval, Québec, QC, Canada
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6
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Aghaei A, Ebrahimi Moghaddam M. Brain age gap estimation using attention-based ResNet method for Alzheimer's disease detection. Brain Inform 2024; 11:16. [PMID: 38833039 DOI: 10.1186/s40708-024-00230-1] [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: 11/03/2023] [Accepted: 05/27/2024] [Indexed: 06/06/2024] Open
Abstract
This study investigates the correlation between brain age and chronological age in healthy individuals using brain MRI images, aiming to identify potential biomarkers for neurodegenerative diseases like Alzheimer's. To achieve this, a novel attention-based ResNet method, 3D-Attention-Resent-SVR, is proposed to accurately estimate brain age and distinguish between Cognitively Normal (CN) and Alzheimer's disease (AD) individuals by computing the brain age gap (BAG). Unlike conventional methods, which often rely on single datasets, our approach addresses potential biases by employing four datasets for training and testing. The results, based on a combined dataset from four public sources comprising 3844 data points, demonstrate the model's efficacy with a mean absolute error (MAE) of 2.05 for brain age gap estimation. Moreover, the model's generalizability is showcased by training on three datasets and testing on a separate one, yielding a remarkable MAE of 2.4. Furthermore, leveraging BAG as the sole biomarker, our method achieves an accuracy of 92% and an AUC of 0.87 in Alzheimer's disease detection on the ADNI dataset. These findings underscore the potential of our approach in assisting with early detection and disease monitoring, emphasizing the strong correlation between BAG and AD.
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Affiliation(s)
- Atefe Aghaei
- Faculty of Computer Science and Engineering, Shahid Beheshti University, Tehran, Iran
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7
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Sorooshyari SK. Brain age monotonicity and functional connectivity differences of healthy subjects. PLoS One 2024; 19:e0300720. [PMID: 38814972 PMCID: PMC11139261 DOI: 10.1371/journal.pone.0300720] [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: 11/27/2023] [Accepted: 03/04/2024] [Indexed: 06/01/2024] Open
Abstract
Alterations in the brain's connectivity or the interactions among brain regions have been studied with the aid of resting state (rs)fMRI data attained from large numbers of healthy subjects of various demographics. This has been instrumental in providing insight into how a phenotype as fundamental as age affects the brain. Although machine learning (ML) techniques have already been deployed in such studies, novel questions are investigated in this work. We study whether young brains develop properties that progressively resemble those of aged brains, and if the aging dynamics of older brains provide information about the aging trajectory in young subjects. The degree of a prospective monotonic relationship will be quantified, and hypotheses of brain aging trajectories will be tested via ML. Furthermore, the degree of functional connectivity across the age spectrum of three datasets will be compared at a population level and across sexes. The findings scrutinize similarities and differences among the male and female subjects at greater detail than previously performed.
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Affiliation(s)
- Siamak K. Sorooshyari
- Department of Statistics, Stanford University, Stanford, CA, United States of America
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8
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Valdes-Hernandez PA, Johnson AJ, Montesino-Goicolea S, Nodarse CL, Bashyam V, Davatzikos C, Fillingim RB, Cruz-Almeida Y. Accelerated Brain Aging Mediates the Association Between Psychological Profiles and Clinical Pain in Knee Osteoarthritis. THE JOURNAL OF PAIN 2024; 25:104423. [PMID: 37952863 PMCID: PMC11144298 DOI: 10.1016/j.jpain.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 10/12/2023] [Accepted: 11/02/2023] [Indexed: 11/14/2023]
Abstract
Chronic pain is driven by factors across the biopsychosocial spectrum. Previously, we demonstrated that magnetic resonance images (MRI)-based brain-predicted age differences (brain-PAD: brain-predicted age minus chronological age) were significantly associated with pain severity in individuals with chronic knee pain. We also previously identified four distinct, replicable, multidimensional psychological profiles significantly associated with clinical pain. The brain aging-psychological characteristics interface in persons with chronic pain promises elucidating factors contributing to their poor health outcomes, yet this relationship is barely understood. That is why we examined the interplay between the psychological profiles in participants having chronic knee pain impacting function, brain-PAD, and clinical pain severity. Controlling for demographics and MRI scanner, we compared the brain-PAD among psychological profiles at baseline (n = 164) and over two years (n = 90). We also explored whether profile-related differences in pain severity were mediated by brain-PAD. Brain-PAD differed significantly between profiles (ANOVA's omnibus test, P = .039). Specifically, participants in the profile 3 group (high negative/low positive emotions) had an average brain-PAD ∼4 years higher than those in profile- (low somatic reactivity), with P = .047, Bonferroni-corrected, and than those in profile 2 (high coping), with P = .027, uncorrected. Repeated measures ANOVA revealed no significant change in profile-related brain-PAD differences over time, but there was a significant decrease in brain-PAD for profile 4 (high optimism/high positive affect), with P = .045. Moreover, profile-related differences in pain severity at baseline were partly explained by brain-PAD differences between profile 3 and 1, or 2; but brain-PAD did not significantly mediate the influence of variations in profiles on changes in pain severity over time. PERSPECTIVE: Accelerated brain aging could underlie the psychological-pain relationship, and psychological characteristics may predispose individuals with chronic knee pain to worse health outcomes via neuropsychological processes.
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Affiliation(s)
- Pedro A. Valdes-Hernandez
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, USA
| | - Alisa J. Johnson
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
| | - Soamy Montesino-Goicolea
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, USA
| | - Chavier Laffitte Nodarse
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, USA
| | - Vishnu Bashyam
- Center for Biomedical Image Computing & Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, USA
- Artificial Intelligence in Biomedical Imaging Lab (AIBIL), Department of Radiology, Perelman School of Medicine, University of Pennsylvania, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing & Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, USA
| | - Roger B. Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
| | - Yenisel Cruz-Almeida
- Department of Community Dentistry and Behavioral Science, University of Florida, USA
- Pain Research and Intervention Center of Excellence, University of Florida, USA
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, USA
- Department of Neuroscience, College of Medicine, University of Florida, USA
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Skampardoni I, Nasrallah IM, Abdulkadir A, Wen J, Melhem R, Mamourian E, Erus G, Doshi J, Singh A, Yang Z, Cui Y, Hwang G, Ren Z, Pomponio R, Srinivasan D, Govindarajan ST, Parmpi P, Wittfeld K, Grabe HJ, Bülow R, Frenzel S, Tosun D, Bilgel M, An Y, Marcus DS, LaMontagne P, Heckbert SR, Austin TR, Launer LJ, Sotiras A, Espeland MA, Masters CL, Maruff P, Fripp J, Johnson SC, Morris JC, Albert MS, Bryan RN, Yaffe K, Völzke H, Ferrucci L, Benzinger TL, Ezzati A, Shinohara RT, Fan Y, Resnick SM, Habes M, Wolk D, Shou H, Nikita K, Davatzikos C. Genetic and Clinical Correlates of AI-Based Brain Aging Patterns in Cognitively Unimpaired Individuals. JAMA Psychiatry 2024; 81:456-467. [PMID: 38353984 PMCID: PMC10867779 DOI: 10.1001/jamapsychiatry.2023.5599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 11/29/2023] [Indexed: 02/17/2024]
Abstract
Importance Brain aging elicits complex neuroanatomical changes influenced by multiple age-related pathologies. Understanding the heterogeneity of structural brain changes in aging may provide insights into preclinical stages of neurodegenerative diseases. Objective To derive subgroups with common patterns of variation in participants without diagnosed cognitive impairment (WODCI) in a data-driven manner and relate them to genetics, biomedical measures, and cognitive decline trajectories. Design, Setting, and Participants Data acquisition for this cohort study was performed from 1999 to 2020. Data consolidation and harmonization were conducted from July 2017 to July 2021. Age-specific subgroups of structural brain measures were modeled in 4 decade-long intervals spanning ages 45 to 85 years using a deep learning, semisupervised clustering method leveraging generative adversarial networks. Data were analyzed from July 2021 to February 2023 and were drawn from the Imaging-Based Coordinate System for Aging and Neurodegenerative Diseases (iSTAGING) international consortium. Individuals WODCI at baseline spanning ages 45 to 85 years were included, with greater than 50 000 data time points. Exposures Individuals WODCI at baseline scan. Main Outcomes and Measures Three subgroups, consistent across decades, were identified within the WODCI population. Associations with genetics, cardiovascular risk factors (CVRFs), amyloid β (Aβ), and future cognitive decline were assessed. Results In a sample of 27 402 individuals (mean [SD] age, 63.0 [8.3] years; 15 146 female [55%]) WODCI, 3 subgroups were identified in contrast with the reference group: a typical aging subgroup, A1, with a specific pattern of modest atrophy and white matter hyperintensity (WMH) load, and 2 accelerated aging subgroups, A2 and A3, with characteristics that were more distinct at age 65 years and older. A2 was associated with hypertension, WMH, and vascular disease-related genetic variants and was enriched for Aβ positivity (ages ≥65 years) and apolipoprotein E (APOE) ε4 carriers. A3 showed severe, widespread atrophy, moderate presence of CVRFs, and greater cognitive decline. Genetic variants associated with A1 were protective for WMH (rs7209235: mean [SD] B = -0.07 [0.01]; P value = 2.31 × 10-9) and Alzheimer disease (rs72932727: mean [SD] B = 0.1 [0.02]; P value = 6.49 × 10-9), whereas the converse was observed for A2 (rs7209235: mean [SD] B = 0.1 [0.01]; P value = 1.73 × 10-15 and rs72932727: mean [SD] B = -0.09 [0.02]; P value = 4.05 × 10-7, respectively); variants in A3 were associated with regional atrophy (rs167684: mean [SD] B = 0.08 [0.01]; P value = 7.22 × 10-12) and white matter integrity measures (rs1636250: mean [SD] B = 0.06 [0.01]; P value = 4.90 × 10-7). Conclusions and Relevance The 3 subgroups showed distinct associations with CVRFs, genetics, and subsequent cognitive decline. These subgroups likely reflect multiple underlying neuropathologic processes and affect susceptibility to Alzheimer disease, paving pathways toward patient stratification at early asymptomatic stages and promoting precision medicine in clinical trials and health care.
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Affiliation(s)
- Ioanna Skampardoni
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Ilya M. Nasrallah
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Ahmed Abdulkadir
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Junhao Wen
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Laboratory of AI and Biomedical Science, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles
| | - Randa Melhem
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Elizabeth Mamourian
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Guray Erus
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Jimit Doshi
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Ashish Singh
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Zhijian Yang
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Yuhan Cui
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Gyujoon Hwang
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Zheng Ren
- Laboratory of AI and Biomedical Science, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles
| | - Raymond Pomponio
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Dhivya Srinivasan
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | | | - Paraskevi Parmpi
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
- German Centre for Neurodegenerative Diseases, Site Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
- German Centre for Neurodegenerative Diseases, Site Greifswald, Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Daniel S. Marcus
- Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Pamela LaMontagne
- Department of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Thomas R. Austin
- Cardiovascular Health Research Unit, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Lenore J. Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland
| | - Aristeidis Sotiras
- Department of Radiology and Institute of Informatics, Washington University in St Louis, St Louis, Missouri
| | - Mark A. Espeland
- Sticht Centre for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Colin L. Masters
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Paul Maruff
- Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian e-Health Research Centre CSIRO, Brisbane, Queensland, Australia
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison
| | - John C. Morris
- Knight Alzheimer Disease Research Centre, Washington University in St Louis, St Louis, Missouri
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - R. Nick Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia
| | - Kristine Yaffe
- Departments of Neurology, Psychiatry and Epidemiology and Biostatistics, University of California San Francisco, San Francisco
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Luigi Ferrucci
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Ali Ezzati
- Department of Neurology, University of California, Irvine
| | - Russell T. Shinohara
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia
| | - Yong Fan
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland
| | - Mohamad Habes
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Neuroimage Analytics Laboratory and the Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
| | - David Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia
| | - Haochang Shou
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, Greece
| | - Christos Davatzikos
- Centre for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
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Sorooshyari SK. Beyond network connectivity: A classification approach to brain age prediction with resting-state fMRI. Neuroimage 2024; 290:120570. [PMID: 38467344 DOI: 10.1016/j.neuroimage.2024.120570] [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: 11/20/2023] [Revised: 03/06/2024] [Accepted: 03/08/2024] [Indexed: 03/13/2024] Open
Abstract
The brain is a complex, dynamic organ that shows differences in the same subject at various periods. Understanding how brain activity changes across age as a function of the brain networks has been greatly abetted by fMRI. Canonical analysis consists of determining how alterations in connectivity patterns (CPs) of certain regions are affected. An alternative approach is taken here by not considering connectivity but rather features computed from recordings at the regions of interest (ROIs). Using machine learning (ML) we assess how neural signals are altered by and prospectively predictive of age and sex via a methodology that is novel in drawing upon pairwise classification across six decades of subjects' chronological ages. ML is used to answer the equally important questions of what properties of the computed features are most predictive as well as which brain networks are most affected by aging. It was found that there is decreased differentiation among the neural signals of older subjects that are separated in age by the same number of years as younger subjects. Furthermore, the burstiness of the signals change at different rates between males and females. The findings provide insight into brain aging via an ROI-based analysis, the consideration of several feature groups, and a novel classification-based ML pipeline. There is also a contribution to understanding the effects of data aggregated from different recording centers on the conclusions of fMRI studies.
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11
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Keller JA, Sigurdsson S, Schmitz Abecassis B, Kant IMJ, Van Buchem MA, Launer LJ, van Osch MJP, Gudnason V, de Bresser J. Identification of Distinct Brain MRI Phenotypes and Their Association With Long-Term Dementia Risk in Community-Dwelling Older Adults. Neurology 2024; 102:e209176. [PMID: 38471053 PMCID: PMC11033985 DOI: 10.1212/wnl.0000000000209176] [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: 07/11/2023] [Accepted: 12/13/2023] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Individual brain MRI markers only show at best a modest association with long-term occurrence of dementia. Therefore, it is challenging to accurately identify individuals at increased risk for dementia. We aimed to identify different brain MRI phenotypes by hierarchical clustering analysis based on combined neurovascular and neurodegenerative brain MRI markers and to determine the long-term dementia risk within the brain MRI phenotype subgroups. METHODS Hierarchical clustering analysis based on 32 combined neurovascular and neurodegenerative brain MRI markers in community-dwelling individuals of the Age-Gene/Environment Susceptibility Reykjavik Study was applied to identify brain MRI phenotypes. A Cox proportional hazards regression model was used to determine the long-term risk for dementia per subgroup. RESULTS We included 3,056 participants and identified 15 subgroups with distinct brain MRI phenotypes. The phenotypes ranged from limited burden, mostly irregular white matter hyperintensity (WMH) shape and cerebral atrophy, mostly irregularly WMHs and microbleeds, mostly cortical infarcts and atrophy, mostly irregularly shaped WMH and cerebral atrophy to multiburden subgroups. Each subgroup showed different long-term risks for dementia (min-max range hazard ratios [HRs] 1.01-6.18; mean time to follow-up 9.9 ± 2.6 years); especially the brain MRI phenotype with mainly WMHs and atrophy showed a large increased risk (HR 6.18, 95% CI 3.37-11.32). DISCUSSION Distinct brain MRI phenotypes can be identified in community-dwelling older adults. Our results indicate that distinct brain MRI phenotypes are related to varying long-term risks of developing dementia. Brain MRI phenotypes may in the future assist in an improved understanding of the structural correlates of dementia predisposition.
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Affiliation(s)
- Jasmin Annica Keller
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Sigurdur Sigurdsson
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Bárbara Schmitz Abecassis
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Ilse M J Kant
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Mark A Van Buchem
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Lenore J Launer
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Matthias J P van Osch
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Vilmundur Gudnason
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
| | - Jeroen de Bresser
- From the Department of Radiology (J.A.K., B.S.A., M.A.V.B., M.J.P.v.O., J.d.B.), Leiden University Medical Center, the Netherlands; Icelandic Heart Association (S.S., V.G.), Kópavogur, Iceland; Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab) and Department of Information Technology & Digital Innovation, Department of Digital Health (I.M.J.K.), University Medical Center Utrecht, the Netherlands; Laboratory of Epidemiology and Population Science (L.J.L.), National Institute on Aging, Bethesda, MD; and Faculty of Medicine (V.G.), University of Iceland, Reykjavik
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Momota Y, Bun S, Hirano J, Kamiya K, Ueda R, Iwabuchi Y, Takahata K, Yamamoto Y, Tezuka T, Kubota M, Seki M, Shikimoto R, Mimura Y, Kishimoto T, Tabuchi H, Jinzaki M, Ito D, Mimura M. Amyloid-β prediction machine learning model using source-based morphometry across neurocognitive disorders. Sci Rep 2024; 14:7633. [PMID: 38561395 PMCID: PMC10984960 DOI: 10.1038/s41598-024-58223-3] [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: 09/12/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
Previous studies have developed and explored magnetic resonance imaging (MRI)-based machine learning models for predicting Alzheimer's disease (AD). However, limited research has focused on models incorporating diverse patient populations. This study aimed to build a clinically useful prediction model for amyloid-beta (Aβ) deposition using source-based morphometry, using a data-driven algorithm based on independent component analyses. Additionally, we assessed how the predictive accuracies varied with the feature combinations. Data from 118 participants clinically diagnosed with various conditions such as AD, mild cognitive impairment, frontotemporal lobar degeneration, corticobasal syndrome, progressive supranuclear palsy, and psychiatric disorders, as well as healthy controls were used for the development of the model. We used structural MR images, cognitive test results, and apolipoprotein E status for feature selection. Three-dimensional T1-weighted images were preprocessed into voxel-based gray matter images and then subjected to source-based morphometry. We used a support vector machine as a classifier. We applied SHapley Additive exPlanations, a game-theoretical approach, to ensure model accountability. The final model that was based on MR-images, cognitive test results, and apolipoprotein E status yielded 89.8% accuracy and a receiver operating characteristic curve of 0.888. The model based on MR-images alone showed 84.7% accuracy. Aβ-positivity was correctly detected in non-AD patients. One of the seven independent components derived from source-based morphometry was considered to represent an AD-related gray matter volume pattern and showed the strongest impact on the model output. Aβ-positivity across neurological and psychiatric disorders was predicted with moderate-to-high accuracy and was associated with a probable AD-related gray matter volume pattern. An MRI-based data-driven machine learning approach can be beneficial as a diagnostic aid.
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Affiliation(s)
- Yuki Momota
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
- Department of Functional Brain Imaging Research, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-Ku, Chiba-Shi, Chiba, 263-8555, Japan
| | - Shogyoku Bun
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Jinichi Hirano
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan.
| | - Kei Kamiya
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Ryo Ueda
- Office of Radiation Technology, Keio University Hospital, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Yu Iwabuchi
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Keisuke Takahata
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
- Department of Functional Brain Imaging Research, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-Ku, Chiba-Shi, Chiba, 263-8555, Japan
| | - Yasuharu Yamamoto
- Department of Functional Brain Imaging Research, Institute for Quantum Medical Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-Ku, Chiba-Shi, Chiba, 263-8555, Japan
| | - Toshiki Tezuka
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Masahito Kubota
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Morinobu Seki
- Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Yu Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Taishiro Kishimoto
- Psychiatry Department, Donald and Barbara Zucker School of Medicine, Hempstead, NY, 11549, USA
- Hills Joint Research Laboratory for Future Preventive Medicine and Wellness, Keio University School of Medicine, Mori JP Tower F7, 1-3-1 Azabudai, Minato-ku, Tokyo, 106-0041, Japan
| | - Hajime Tabuchi
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Masahiro Jinzaki
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Daisuke Ito
- Department of Physiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
- Memory Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-Ku, Tokyo, 160-8582, Japan
| | - Masaru Mimura
- Center for Preventive Medicine, Keio University, Mori JP Tower 7th Floor, 1-3-1 Azabudai, Minato-ku, Tokyo, 106-0041, Japan
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Huang Y, Guo J, Chen WH, Lin HY, Tang H, Wang F, Xu H, Bian J. A scoping review of fair machine learning techniques when using real-world data. J Biomed Inform 2024; 151:104622. [PMID: 38452862 PMCID: PMC11146346 DOI: 10.1016/j.jbi.2024.104622] [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: 10/01/2023] [Revised: 01/19/2024] [Accepted: 03/03/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE The integration of artificial intelligence (AI) and machine learning (ML) in health care to aid clinical decisions is widespread. However, as AI and ML take important roles in health care, there are concerns about AI and ML associated fairness and bias. That is, an AI tool may have a disparate impact, with its benefits and drawbacks unevenly distributed across societal strata and subpopulations, potentially exacerbating existing health inequities. Thus, the objectives of this scoping review were to summarize existing literature and identify gaps in the topic of tackling algorithmic bias and optimizing fairness in AI/ML models using real-world data (RWD) in health care domains. METHODS We conducted a thorough review of techniques for assessing and optimizing AI/ML model fairness in health care when using RWD in health care domains. The focus lies on appraising different quantification metrics for accessing fairness, publicly accessible datasets for ML fairness research, and bias mitigation approaches. RESULTS We identified 11 papers that are focused on optimizing model fairness in health care applications. The current research on mitigating bias issues in RWD is limited, both in terms of disease variety and health care applications, as well as the accessibility of public datasets for ML fairness research. Existing studies often indicate positive outcomes when using pre-processing techniques to address algorithmic bias. There remain unresolved questions within the field that require further research, which includes pinpointing the root causes of bias in ML models, broadening fairness research in AI/ML with the use of RWD and exploring its implications in healthcare settings, and evaluating and addressing bias in multi-modal data. CONCLUSION This paper provides useful reference material and insights to researchers regarding AI/ML fairness in real-world health care data and reveals the gaps in the field. Fair AI/ML in health care is a burgeoning field that requires a heightened research focus to cover diverse applications and different types of RWD.
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Affiliation(s)
- Yu Huang
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA
| | - Jingchuan Guo
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA
| | - Wei-Han Chen
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA
| | - Hsin-Yueh Lin
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA
| | - Huilin Tang
- Pharmaceutical Outcomes & Policy, University of Florida, Gainesville, FL, USA
| | - Fei Wang
- Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA; Institute of Artificial Intelligence for Digital Health, Weill Cornell Medicine, New York, NY, USA
| | - Hua Xu
- Section of Biomedical Informatics and Data Science, School of Medicine, Yale University, New Haven, CT, USA
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA.
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Dougherty RJ, Wang H, Gross AL, Schrack JA, Agrawal Y, Davatzikos C, Cai Y, Simonsick EM, Ferrucci L, Resnick SM, Tian Q. Shared and Distinct Associations of Manual Dexterity and Gross Motor Function With Brain Atrophy. J Gerontol A Biol Sci Med Sci 2024; 79:glad245. [PMID: 37837441 PMCID: PMC10876075 DOI: 10.1093/gerona/glad245] [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: 02/09/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Poor motor function is associated with brain atrophy and cognitive impairment. Less is known about the relationship between motor domains and brain atrophy and whether associations are affected by cerebrovascular burden and/or physical activity. METHODS We analyzed data from 726 Baltimore Longitudinal Study of Aging participants (mean age 70.6 ± 10.1 years, 56% women, 27% Black), 525 of whom had repeat MRI scans over an average of 5.0 ± 2.1 years. Two motor domains, manual dexterity and gross motor, were operationalized as latent variables. Associations between the latent variables and cortical and subcortical brain volumes of interest were examined using latent growth curve modeling, adjusted for demographics, white matter hyperintensities, and physical activity. RESULTS Both higher manual dexterity and gross motor function were cross-sectionally associated with smaller ventricular volume and greater white matter volumes in the frontal, parietal, and temporal lobes (all p < .05). Manual dexterity was also cross-sectionally associated with parietal gray matter (B = 0.14; 95% CI: 0.05, 0.23), hippocampus (B = 0.10; 95% CI: 0.01, 0.20), postcentral gyrus (B = 0.11; 95% CI: 0.01, 0.20), and occipital white matter (B = 0.10; 95% CI: 0.01, 0.21) volumes, and gross motor function with temporal gray matter volume (B = 0.16; 95% CI: 0.05, 0.26). Longitudinally, both higher manual dexterity and gross motor function were associated with less temporal white matter and occipital gray matter atrophy (all p < .05). Manual dexterity was also associated with a slower rate of ventricular enlargement (B = -0.17; 95% CI: -0.29, -0.05) and less atrophy of occipital white matter (B = 0.39; 95% CI: 0.04, 0.71). CONCLUSIONS Among cognitively normal middle- and older-aged adults, manual dexterity and gross motor function exhibited shared as well as distinct associations with brain atrophy over time.
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Affiliation(s)
- Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Hang Wang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alden L Gross
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer A Schrack
- Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Yuri Agrawal
- Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Yurun Cai
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA
| | - Eleanor M Simonsick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Luigi Ferrucci
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Susan M Resnick
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
| | - Qu Tian
- Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA
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15
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Lock C, Tan NSM, Long IJ, Keong NC. Neuroimaging data repositories and AI-driven healthcare-Global aspirations vs. ethical considerations in machine learning models of neurological disease. Front Artif Intell 2024; 6:1286266. [PMID: 38440234 PMCID: PMC10910099 DOI: 10.3389/frai.2023.1286266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/27/2023] [Indexed: 03/06/2024] Open
Abstract
Neuroimaging data repositories are data-rich resources comprising brain imaging with clinical and biomarker data. The potential for such repositories to transform healthcare is tremendous, especially in their capacity to support machine learning (ML) and artificial intelligence (AI) tools. Current discussions about the generalizability of such tools in healthcare provoke concerns of risk of bias-ML models underperform in women and ethnic and racial minorities. The use of ML may exacerbate existing healthcare disparities or cause post-deployment harms. Do neuroimaging data repositories and their capacity to support ML/AI-driven clinical discoveries, have both the potential to accelerate innovative medicine and harden the gaps of social inequities in neuroscience-related healthcare? In this paper, we examined the ethical concerns of ML-driven modeling of global community neuroscience needs arising from the use of data amassed within neuroimaging data repositories. We explored this in two parts; firstly, in a theoretical experiment, we argued for a South East Asian-based repository to redress global imbalances. Within this context, we then considered the ethical framework toward the inclusion vs. exclusion of the migrant worker population, a group subject to healthcare inequities. Secondly, we created a model simulating the impact of global variations in the presentation of anosmia risks in COVID-19 toward altering brain structural findings; we then performed a mini AI ethics experiment. In this experiment, we interrogated an actual pilot dataset (n = 17; 8 non-anosmic (47%) vs. 9 anosmic (53%) using an ML clustering model. To create the COVID-19 simulation model, we bootstrapped to resample and amplify the dataset. This resulted in three hypothetical datasets: (i) matched (n = 68; 47% anosmic), (ii) predominant non-anosmic (n = 66; 73% disproportionate), and (iii) predominant anosmic (n = 66; 76% disproportionate). We found that the differing proportions of the same cohorts represented in each hypothetical dataset altered not only the relative importance of key features distinguishing between them but even the presence or absence of such features. The main objective of our mini experiment was to understand if ML/AI methodologies could be utilized toward modelling disproportionate datasets, in a manner we term "AI ethics." Further work is required to expand the approach proposed here into a reproducible strategy.
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Affiliation(s)
- Christine Lock
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Nicole Si Min Tan
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Ian James Long
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
| | - Nicole C. Keong
- Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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16
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Heckbert SR, Jensen PN, Erus G, Nasrallah IM, Rashid T, Habes M, Austin TR, Floyd JS, Schaich CL, Redline S, Bryan RN, Costa MD. Heart rate fragmentation and brain MRI markers of small vessel disease in MESA. Alzheimers Dement 2024; 20:1397-1405. [PMID: 38009395 PMCID: PMC10917025 DOI: 10.1002/alz.13554] [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: 06/11/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/28/2023]
Abstract
INTRODUCTION Heart rate (HR) fragmentation indices quantify breakdown of HR regulation and are associated with atrial fibrillation and cognitive impairment. Their association with brain magnetic resonance imaging (MRI) markers of small vessel disease is unexplored. METHODS In 606 stroke-free participants of the Multi-Ethnic Study of Atherosclerosis (mean age 67), HR fragmentation indices including percentage of inflection points (PIP) were derived from sleep study recordings. We examined PIP in relation to white matter hyperintensity (WMH) volume, total white matter fractional anisotropy (FA), and microbleeds from 3-Tesla brain MRI completed 7 years later. RESULTS In adjusted analyses, higher PIP was associated with greater WMH volume (14% per standard deviation [SD], 95% confidence interval [CI]: 2, 27%, P = 0.02) and lower WM FA (-0.09 SD per SD, 95% CI: -0.16, -0.01, P = 0.03). DISCUSSION HR fragmentation was associated with small vessel disease. HR fragmentation can be measured automatically from ambulatory electrocardiogram devices and may be useful as a biomarker of vascular brain injury.
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Affiliation(s)
- Susan R. Heckbert
- Cardiovascular Health Research UnitUniversity of WashingtonSeattleWashingtonUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - Paul N. Jensen
- Cardiovascular Health Research UnitUniversity of WashingtonSeattleWashingtonUSA
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Guray Erus
- Center for AI and Data Science for Integrated Diagnostics and Center for Biomedical Image Computing and AnalyticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Ilya M. Nasrallah
- Center for AI and Data Science for Integrated Diagnostics and Center for Biomedical Image Computing and AnalyticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Tanweer Rashid
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging CoreGlenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesUniversity of Texas Health Science Center San AntonioSan AntonioTexasUSA
| | - Mohamad Habes
- Center for AI and Data Science for Integrated Diagnostics and Center for Biomedical Image Computing and AnalyticsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging CoreGlenn Biggs Institute for Alzheimer's and Neurodegenerative DiseasesUniversity of Texas Health Science Center San AntonioSan AntonioTexasUSA
| | - Thomas R. Austin
- Cardiovascular Health Research UnitUniversity of WashingtonSeattleWashingtonUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
| | - James S. Floyd
- Cardiovascular Health Research UnitUniversity of WashingtonSeattleWashingtonUSA
- Department of EpidemiologyUniversity of WashingtonSeattleWashingtonUSA
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Christopher L. Schaich
- Department of SurgeryHypertension and Vascular Research CenterWake Forest University School of MedicineWinston‐SalemNorth CarolinaUSA
| | - Susan Redline
- Brigham and Women's HospitalBostonMassachusettsUSA
- Harvard Medical SchoolBostonMassachusettsUSA
| | - R. Nick Bryan
- Department of RadiologyPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Madalena D. Costa
- Harvard Medical SchoolBostonMassachusettsUSA
- Department of MedicineBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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17
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Wu Y, Chen Y, Yang Y, Lin C, Su S, Zhao J, Wu S, Wu G, Liu H, Liu X, Yang Z, Zhang J, Huang B. Predicting brain age using partition modeling strategy and atlas-based attentional enhancement in the Chinese population. Cereb Cortex 2024; 34:bhae030. [PMID: 38342684 DOI: 10.1093/cercor/bhae030] [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: 11/13/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 02/13/2024] Open
Abstract
As a biomarker of human brain health during development, brain age is estimated based on subtle differences in brain structure from those under typical developmental. Magnetic resonance imaging (MRI) is a routine diagnostic method in neuroimaging. Brain age prediction based on MRI has been widely studied. However, few studies based on Chinese population have been reported. This study aimed to construct a brain age predictive model for the Chinese population across its lifespan. We developed a partition prediction method based on transfer learning and atlas attention enhancement. The participants were separated into four age groups, and a deep learning model was trained for each group to identify the brain regions most critical for brain age prediction. The Atlas attention-enhancement method was also used to help the models focus only on critical brain regions. The proposed method was validated using 354 participants from domestic datasets. For prediction performance in the testing sets, the mean absolute error was 2.218 ± 1.801 years, and the Pearson correlation coefficient (r) was 0.969, exceeding previous results for wide-range brain age prediction. In conclusion, the proposed method could provide brain age estimation to assist in assessing the status of brain health.
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Affiliation(s)
- Yingtong Wu
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Paul C Lauterbur Research Center for Biomedical Imaging, Shenzhen Key Laboratory for MRI, Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
| | - Yingqian Chen
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Yang Yang
- Department of Radiology, Suining Central Hospital, 127 Desheng West Road, Suining 629099, Sichuan Province, China
- Medical Imaging Center of Guizhou Province, Department of Radiology, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563000, Guizhou Province, China
| | - Chuxuan Lin
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Shu Su
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Jing Zhao
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Songxiong Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Guangyao Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Heng Liu
- Medical Imaging Center of Guizhou Province, Department of Radiology, The Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Zunyi 563000, Guizhou Province, China
| | - Xia Liu
- Department of Radiology, Shenzhen Mental Health Center, Shenzhen Kangning Hospital, 1080 Cuizhu Road, Shenzhen 518118, Guangdong Province, China
| | - Zhiyun Yang
- Department of Radiology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Second Road, Guangzhou 510080, Guangdong Province, China
| | - Jian Zhang
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, 1068 Xueyuan Avenue, Shenzhen 518055, Guangdong Province, China
- School of Pharmaceutical Sciences, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
- Guangdong Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Shenzhen University Medical School, Shenzhen University, 1066 Xueyuan Avenue, Shenzhen 518060, Guangdong Province, China
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18
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Yang Z, Wen J, Abdulkadir A, Cui Y, Erus G, Mamourian E, Melhem R, Srinivasan D, Govindarajan ST, Chen J, Habes M, Masters CL, Maruff P, Fripp J, Ferrucci L, Albert MS, Johnson SC, Morris JC, LaMontagne P, Marcus DS, Benzinger TLS, Wolk DA, Shen L, Bao J, Resnick SM, Shou H, Nasrallah IM, Davatzikos C. Gene-SGAN: discovering disease subtypes with imaging and genetic signatures via multi-view weakly-supervised deep clustering. Nat Commun 2024; 15:354. [PMID: 38191573 PMCID: PMC10774282 DOI: 10.1038/s41467-023-44271-2] [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: 02/17/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024] Open
Abstract
Disease heterogeneity has been a critical challenge for precision diagnosis and treatment, especially in neurologic and neuropsychiatric diseases. Many diseases can display multiple distinct brain phenotypes across individuals, potentially reflecting disease subtypes that can be captured using MRI and machine learning methods. However, biological interpretability and treatment relevance are limited if the derived subtypes are not associated with genetic drivers or susceptibility factors. Herein, we describe Gene-SGAN - a multi-view, weakly-supervised deep clustering method - which dissects disease heterogeneity by jointly considering phenotypic and genetic data, thereby conferring genetic correlations to the disease subtypes and associated endophenotypic signatures. We first validate the generalizability, interpretability, and robustness of Gene-SGAN in semi-synthetic experiments. We then demonstrate its application to real multi-site datasets from 28,858 individuals, deriving subtypes of Alzheimer's disease and brain endophenotypes associated with hypertension, from MRI and single nucleotide polymorphism data. Derived brain phenotypes displayed significant differences in neuroanatomical patterns, genetic determinants, biological and clinical biomarkers, indicating potentially distinct underlying neuropathologic processes, genetic drivers, and susceptibility factors. Overall, Gene-SGAN is broadly applicable to disease subtyping and endophenotype discovery, and is herein tested on disease-related, genetically-associated neuroimaging phenotypes.
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Affiliation(s)
- Zhijian Yang
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Graduate Group in Applied Mathematics and Computational Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Junhao Wen
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Laboratory of AI and Biomedical Science (LABS), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Ahmed Abdulkadir
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Yuhan Cui
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Mamourian
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Randa Melhem
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dhivya Srinivasan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sindhuja T Govindarajan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jiong Chen
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohamad Habes
- Biggs Alzheimer's Institute, University of Texas San Antonio Health Science Center, San Antonio, TX, USA
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian e-Health Research Centre CSIRO, Brisbane, QLD, Australia
| | - Luigi Ferrucci
- Translational Gerontology Branch, Longitudinal Studies Section, National Institute on Aging, National Institutes of Health, MedStar Harbor Hospital, 3001 S. Hanover Street, Baltimore, MD, USA
| | - Marilyn S Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Pamela LaMontagne
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniel S Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Li Shen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Jingxuan Bao
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Haochang Shou
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilya M Nasrallah
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AI2D), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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19
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Pajewski NM, Donohue MC, Raman R, Espeland MA. Ascertainment and Statistical Issues for Randomized Trials of Cardiovascular Interventions for Cognitive Impairment and Dementia. Hypertension 2024; 81:45-53. [PMID: 37732473 PMCID: PMC10840823 DOI: 10.1161/hypertensionaha.123.19941] [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: 09/22/2023]
Abstract
There has been considerable progress in the prevention and treatment of cardiovascular disease, reducing the population burden of cardiovascular morbidity and mortality. Recently, some randomized trials, including the SPRINT (Systolic Blood Pressure Intervention Trial), have suggested that improvements in cardiovascular risk factors may also slow cognitive decline and reduce the eventual development of dementia. Unfortunately, the randomized trial template that has been used repeatedly to successfully demonstrate reductions in major adverse cardiac events faces several design and analytic obstacles when applied in the context of cognitive decline and dementia. Here, we review these obstacles, motivated by SPRINT and the context of selecting an appropriate cognitive end point for future preventive randomized trials. A few options are available, spanning neuropsychological test scores or composites reflecting specific domains of cognitive function, adjudicated cognitive impairment, or potentially physiological biomarkers. This choice entails considerations around statistical power, modes of ascertainment, the clinical relevance of treatment effects, a myriad of statistical issues (interval censoring, missing data, the competing risk of death, practice effects, etc), as well as ethical considerations around equipoise. Collectively, these considerations indicate that trials aiming to mitigate the cardiovascular contribution to cognitive decline and dementia will generally need to be large, inclusive of a wide age range of older adults, and with multiple years of follow-up.
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Affiliation(s)
- Nicholas M. Pajewski
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Michael C. Donohue
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine of the University of Southern California, San Diego, CA
| | - Rema Raman
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine of the University of Southern California, San Diego, CA
| | - Mark A. Espeland
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC
- Section of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC
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20
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Yang Z, Wen J, Erus G, Govindarajan ST, Melhem R, Mamourian E, Cui Y, Srinivasan D, Abdulkadir A, Parmpi P, Wittfeld K, Grabe HJ, Bülow R, Frenzel S, Tosun D, Bilgel M, An Y, Yi D, Marcus DS, LaMontagne P, Benzinger TL, Heckbert SR, Austin TR, Waldstein SR, Evans MK, Zonderman AB, Launer LJ, Sotiras A, Espeland MA, Masters CL, Maruff P, Fripp J, Toga A, O’Bryant S, Chakravarty MM, Villeneuve S, Johnson SC, Morris JC, Albert MS, Yaffe K, Völzke H, Ferrucci L, Bryan NR, Shinohara RT, Fan Y, Habes M, Lalousis PA, Koutsouleris N, Wolk DA, Resnick SM, Shou H, Nasrallah IM, Davatzikos C. Five dominant dimensions of brain aging are identified via deep learning: associations with clinical, lifestyle, and genetic measures. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.29.23300642. [PMID: 38234857 PMCID: PMC10793523 DOI: 10.1101/2023.12.29.23300642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Brain aging is a complex process influenced by various lifestyle, environmental, and genetic factors, as well as by age-related and often co-existing pathologies. MRI and, more recently, AI methods have been instrumental in understanding the neuroanatomical changes that occur during aging in large and diverse populations. However, the multiplicity and mutual overlap of both pathologic processes and affected brain regions make it difficult to precisely characterize the underlying neurodegenerative profile of an individual from an MRI scan. Herein, we leverage a state-of-the art deep representation learning method, Surreal-GAN, and present both methodological advances and extensive experimental results that allow us to elucidate the heterogeneity of brain aging in a large and diverse cohort of 49,482 individuals from 11 studies. Five dominant patterns of neurodegeneration were identified and quantified for each individual by their respective (herein referred to as) R-indices. Significant associations between R-indices and distinct biomedical, lifestyle, and genetic factors provide insights into the etiology of observed variances. Furthermore, baseline R-indices showed predictive value for disease progression and mortality. These five R-indices contribute to MRI-based precision diagnostics, prognostication, and may inform stratification into clinical trials.
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Affiliation(s)
- Zhijian Yang
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Graduate Group in Applied Mathematics and Computational Science, University of Pennsylvania, Philadelphia, PA, USA
| | - Junhao Wen
- Laboratory of AI and Biomedical Science (LABS), Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Guray Erus
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sindhuja T. Govindarajan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Randa Melhem
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth Mamourian
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Yuhan Cui
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dhivya Srinivasan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ahmed Abdulkadir
- Laboratory for Research in Neuroimaging, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Paraskevi Parmpi
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University of Greifswald, Germany
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Germany
| | - Duygu Tosun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA
| | - Murat Bilgel
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center Seoul National University, Seoul, Republic of Korea
| | - Daniel S. Marcus
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Pamela LaMontagne
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Tammie L.S. Benzinger
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Susan R. Heckbert
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Thomas R. Austin
- Cardiovascular Health Research Unit and Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Shari R. Waldstein
- Department of Psychology, University of Maryland, Baltimore County, Catonsville, MD, USA
| | - Michele K. Evans
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Alan B. Zonderman
- Health Disparities Research Section, Laboratory of Epidemiology and Population Sciences, NIA/NIH/IRP, Baltimore, MD, USA
| | - Lenore J. Launer
- Neuroepidemiology Section, Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA
| | - Aristeidis Sotiras
- Department of Radiology and Institute of Informatics, Washington University in St. Luis, St. Luis, MO63110, USA
| | - Mark A. Espeland
- Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Colin L. Masters
- Florey Institute, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Paul Maruff
- Florey Institute, The University of Melbourne, Parkville, VIC, 3052, Australia
| | - Jurgen Fripp
- CSIRO Health and Biosecurity, Australian e-Health Research Centre CSIRO, Brisbane, Queensland, Australia
| | - Arthur Toga
- Laboratory of Neuro Imaging, USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA
| | - Sid O’Bryant
- Institute for Translational Research University of North Texas Health Science Center Fort Worth Texas USA
| | - Mallar M. Chakravarty
- Computational Brain Anatomy (CoBrA) Laboratory, Cerebral Imaging Center, Douglas Mental Health University Institute, McGill University, Verdun, Quebec, Canada
| | - Sylvia Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Sterling C. Johnson
- Wisconsin Alzheimer’s Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - John C. Morris
- Knight Alzheimer Disease Research Center, Washington University in St. Louis, St. Louis, MO, USA
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristine Yaffe
- Departments of Neurology, Psychiatry and Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Luigi Ferrucci
- Translational Gerontology Branch, Longitudinal Studies Section, National Institute on Aging, National Institutes of Health, MedStar Harbor Hospital, 3001 S. Hanover Street, Baltimore, MD, USA
| | - Nick R. Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Russell T. Shinohara
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Yong Fan
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mohamad Habes
- Biggs Alzheimer’s Institute, University of Texas San Antonio Health Science Center, USA
| | - Paris Alexandros Lalousis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
| | - Nikolaos Koutsouleris
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, United Kingdom
- Section for Precision Psychiatry, Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - David A. Wolk
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Susan M. Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, MD, USA
| | - Haochang Shou
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, & Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | - Ilya M. Nasrallah
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Davatzikos
- Artificial Intelligence in Biomedical Imaging Laboratory (AIBIL), Center for and Data Science for Integrated Diagnostics (AID), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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21
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Guan Y, Cheng CH, Bellomo LI, Narain S, Bigornia SJ, Garelnabi MO, Scott T, Ordovás JM, Tucker KL, Bhadelia R, Koo BB. APOE4 allele-specific associations between diet, multimodal biomarkers, and cognition among Puerto Rican adults in Massachusetts. Front Aging Neurosci 2023; 15:1285333. [PMID: 38035273 PMCID: PMC10684694 DOI: 10.3389/fnagi.2023.1285333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/25/2023] [Indexed: 12/02/2023] Open
Abstract
Background Apolipoprotein E (APOE) is the strongest genetic risk factor for sporadic Alzheimer's Disease (AD), and the ε4 allele (APOE4) may interact with lifestyle factors that relate to brain structural changes, underlying the increased risk of AD. However, the exact role of APOE4 in mediating interactions between the peripheral circulatory system and the central nervous system, and how it may link to brain and cognitive aging requires further elucidation. In this analysis, we investigated the association between APOE4 carrier status and multimodal biomarkers (diet, blood markers, clinical diagnosis, brain structure, and cognition) in the context of gene-environment interactions. Methods Participants were older adults from a longitudinal observational study, the Boston Puerto Rican Health Study (BPRHS), who self-identified as of Puerto Rican descent. Demographics, APOE genotype, diet, blood, and clinical data were collected at baseline and at approximately 12th year, with the addition of multimodal brain magnetic resonance imaging (MRI) (T1-weighted and diffusion) and cognitive testing acquired at 12-year. Measures were compared between APOE4 carriers and non-carriers, and associations between multimodal variables were examined using correlation and multivariate network analyses within each group. Results A total of 156 BPRHS participants (mean age at imaging = 68 years, 77% female, mean follow-up 12.7 years) with complete multimodal data were included in the current analysis. APOE4 carriers (n = 43) showed reduced medial temporal lobe (MTL) white matter (WM) microstructural integrity and lower mini-mental state examination (MMSE) score than non-carriers (n = 113). This pattern was consistent with an independent sample from the Alzheimer's Disease Neuroimaging Initiative (ADNI) of n = 283 non-Hispanic White adults without dementia (mean age = 75, 40% female). Within BPRHS, carriers showed distinct connectivity patterns between multimodal biomarkers, characterized by stronger direct network connections between baseline diet/blood markers with 12-year blood/clinical measures, and between blood markers (especially lipids and cytokines) and WM. Cardiovascular burden (i.e., hypertension and diabetes status) was associated with WM integrity for both carriers and non-carriers. Conclusion APOE4 carrier status affects interactions between dietary factors, multimodal blood biomarkers, and MTL WM integrity across ~12 years of follow-up, which may reflect increased peripheral-central systems crosstalk following blood-brain barrier breakdown in carriers.
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Affiliation(s)
- Yi Guan
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Chia Hsin Cheng
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Luis I. Bellomo
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Sriman Narain
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
| | - Sherman J. Bigornia
- Department of Agriculture, Nutrition, and Food Systems, College of Life Sciences and Agriculture, University of New Hampshire, Durham, NH, United States
| | - Mahdi O. Garelnabi
- Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
| | - Tammy Scott
- School of Medicine, Tufts University, Boston, MA, United States
| | - José M. Ordovás
- Nutrition and Genomics Laboratory, J.M.-US Department of Agriculture Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
- IMDEA Alimentacion, Madrid, Spain
- CIBER Fisiopatologia de la Obesidad y la Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, United States
- Center for Population Health, University of Massachusetts Lowell, Lowell, MA, United States
| | - Rafeeque Bhadelia
- Neuroradiology Section, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Bang-Bon Koo
- Department of Anatomy and Neurobiology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States
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22
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Dan L, Zhang Z. Alzheimer's disease: an axonal injury disease? Front Aging Neurosci 2023; 15:1264448. [PMID: 37927337 PMCID: PMC10620718 DOI: 10.3389/fnagi.2023.1264448] [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: 07/20/2023] [Accepted: 09/14/2023] [Indexed: 11/07/2023] Open
Abstract
Alzheimer's disease (AD) is the primary cause of dementia and is anticipated to impose a substantial economic burden in the future. Over a significant period, the widely accepted amyloid cascade hypothesis has guided research efforts, and the recent FDA approval of an anti- amyloid-beta (Aβ) protofibrils antibody, believed to decelerate AD progression, has further solidified its significance. However, the excessive emphasis placed on the amyloid cascade hypothesis has overshadowed the physiological nature of Aβ and tau proteins within axons. Axons, specialized neuronal structures, sustain damage during the early stages of AD, exerting a pivotal influence on disease progression. In this review, we present a comprehensive summary of the relationship between axonal damage and AD pathology, amalgamating the physiological roles of Aβ and tau proteins, along with the impact of AD risk genes such as APOE and TREM2. Furthermore, we underscore the exceptional significance of axonal damage in the context of AD.
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Affiliation(s)
| | - Zhaohui Zhang
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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23
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Gonzales MM, Garbarino VR, Kautz TF, Palavicini JP, Lopez-Cruzan M, Dehkordi SK, Mathews JJ, Zare H, Xu P, Zhang B, Franklin C, Habes M, Craft S, Petersen RC, Tchkonia T, Kirkland JL, Salardini A, Seshadri S, Musi N, Orr ME. Senolytic therapy in mild Alzheimer's disease: a phase 1 feasibility trial. Nat Med 2023; 29:2481-2488. [PMID: 37679434 PMCID: PMC10875739 DOI: 10.1038/s41591-023-02543-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023]
Abstract
Cellular senescence contributes to Alzheimer's disease (AD) pathogenesis. An open-label, proof-of-concept, phase I clinical trial of orally delivered senolytic therapy, dasatinib (D) and quercetin (Q), was conducted in early-stage symptomatic patients with AD to assess central nervous system (CNS) penetrance, safety, feasibility and efficacy. Five participants (mean age = 76 + 5 years; 40% female) completed the 12-week pilot study. D and Q levels in blood increased in all participants (12.7-73.5 ng ml-1 for D and 3.29-26.3 ng ml-1 for Q). In cerebrospinal fluid (CSF), D levels were detected in four participants (80%) ranging from 0.281 to 0.536 ml-1 with a CSF to plasma ratio of 0.422-0.919%; Q was not detected. The treatment was well-tolerated, with no early discontinuation. Secondary cognitive and neuroimaging endpoints did not significantly differ from baseline to post-treatment further supporting a favorable safety profile. CSF levels of interleukin-6 (IL-6) and glial fibrillary acidic protein (GFAP) increased (t(4) = 3.913, P = 0.008 and t(4) = 3.354, P = 0.028, respectively) with trending decreases in senescence-related cytokines and chemokines, and a trend toward higher Aβ42 levels (t(4) = -2.338, P = 0.079). In summary, CNS penetrance of D was observed with outcomes supporting safety, tolerability and feasibility in patients with AD. Biomarker data provided mechanistic insights of senolytic effects that need to be confirmed in fully powered, placebo-controlled studies. ClinicalTrials.gov identifier: NCT04063124 .
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Affiliation(s)
- Mitzi M Gonzales
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Valentina R Garbarino
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tiffany F Kautz
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Juan Pablo Palavicini
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Barshop Institute for Longevity and Aging Studies, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Marisa Lopez-Cruzan
- Department of Psychiatry & Behavioral Sciences, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shiva Kazempour Dehkordi
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Julia J Mathews
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Habil Zare
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Peng Xu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Suzanne Craft
- Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Tamara Tchkonia
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - James L Kirkland
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arash Salardini
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Nicolas Musi
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Miranda E Orr
- Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
- Salisbury VA Medical Center, Salisbury, NC, USA.
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24
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Dougherty RJ, Wanigatunga AA, An Y, Tian Q, Simonsick EM, Albert MS, Resnick SM, Schrack JA. Walking energetics and white matter hyperintensities in mid-to-late adulthood. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12501. [PMID: 38026756 PMCID: PMC10646278 DOI: 10.1002/dad2.12501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) increase with age and contribute to cognitive and motor function decline. Energy costs for mobility worsen with age, as the energetic cost of walking increases and energetic capacity declines. We examined the cross-sectional associations of multiple measures of walking energetics with WMHs in mid- to late-aged adults. METHODS A total of 601 cognitively unimpaired adults (mean age 66.9 ± 15.3 years, 54% women) underwent brain magnetic resonance imaging scans and completed standardized slow- and peak-paced walking assessments with metabolic measurement (V̇O2). T1-weighted scans and fluid-attenuated inversion recovery images were used to quantify WMHs. Separate multivariable linear regression models examined associations adjusted for covariates. RESULTS Lower slow-paced V̇O2 (B = 0.07; P = 0.030), higher peak-paced V̇O2 (B = -0.10; P = 0.007), and lower cost-to-capacity ratio (B = .12; P < 0.0001) were all associated with lower WMH volumes. DISCUSSION The cost-to-capacity ratio, which describes the percentage of capacity required for ambulation, was the walking energetic measure most strongly associated with WMHs.
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Affiliation(s)
- Ryan J. Dougherty
- Department of NeurologyJohns Hopkins School of MedicineBaltimoreMarylandUSA
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
| | - Amal A. Wanigatunga
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Yang An
- Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Qu Tian
- Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | | | - Marilyn S. Albert
- Department of NeurologyJohns Hopkins School of MedicineBaltimoreMarylandUSA
| | - Susan M. Resnick
- Intramural Research ProgramNational Institute on AgingBaltimoreMarylandUSA
| | - Jennifer A. Schrack
- Center on Aging and HealthJohns Hopkins UniversityBaltimoreMarylandUSA
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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25
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Tian Q, Mitchell BA, Erus G, Davatzikos C, Moaddel R, Resnick SM, Ferrucci L. Sex differences in plasma lipid profiles of accelerated brain aging. Neurobiol Aging 2023; 129:178-184. [PMID: 37336172 PMCID: PMC10527719 DOI: 10.1016/j.neurobiolaging.2023.05.013] [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: 11/06/2022] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/21/2023]
Abstract
Lipids are essential components of brain structure and shown to affect brain function. Previous studies have shown that aging men undergo greater brain atrophy than women, but whether the associations between lipids and brain atrophy differ by sex is unclear. We examined sex differences in the associations between circulating lipids by liquid chromatography-tandem mass spectrometry and the progression of MRI-derived brain atrophy index Spatial Patterns of Atrophy for Recognition of Brain Aging (SPARE-BA) over an average of 4.7 (SD = 2.3) years in 214 men and 261 women aged 60 or older who were initially cognitively normal using multivariable linear regression, adjusted for age, race, education, and baseline SPARE-BA. We found significant sex interactions for beta-oxidation rate, short-chain acylcarnitines, long-chain ceramides, and very long-chain triglycerides. Lower beta-oxidation rate and short-chain acylcarnitines in women and higher long-chain ceramides and very long-chain triglycerides in men were associated with faster increases in SPARE-BA (accelerated brain aging). Circulating lipid profiles of accelerated brain aging are sex-specific and vary by lipid classes and structure. Mechanisms underlying these sex-specific lipid profiles of brain aging warrant further investigation.
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Affiliation(s)
- Qu Tian
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA.
| | - Brendan A Mitchell
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Guray Erus
- Radiology Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Christos Davatzikos
- Radiology Department, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruin Moaddel
- Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, MD, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
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26
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Qin Q, Qu J, Yin Y, Liang Y, Wang Y, Xie B, Liu Q, Wang X, Xia X, Wang M, Zhang X, Jia J, Xing Y, Li C, Tang Y. Unsupervised machine learning model to predict cognitive impairment in subcortical ischemic vascular disease. Alzheimers Dement 2023; 19:3327-3338. [PMID: 36786521 DOI: 10.1002/alz.12971] [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: 11/29/2022] [Revised: 01/06/2023] [Accepted: 01/09/2023] [Indexed: 02/15/2023]
Abstract
INTRODUCTION It is challenging to predict which patients who meet criteria for subcortical ischemic vascular disease (SIVD) will ultimately progress to subcortical vascular cognitive impairment (SVCI). METHODS We collected clinical information, neuropsychological assessments, T1 imaging, diffusion tensor imaging, and resting-state functional magnetic resonance imaging from 83 patients with SVCI and 53 age-matched patients with SIVD without cognitive impairment. We built an unsupervised machine learning model to isolate patients with SVCI. The model was validated using multimodal data from an external cohort comprising 45 patients with SVCI and 32 patients with SIVD without cognitive impairment. RESULTS The accuracy, sensitivity, and specificity of the unsupervised machine learning model were 86.03%, 79.52%, and 96.23% and 80.52%, 71.11%, and 93.75% for internal and external cohort, respectively. DISCUSSION We developed an accurate and accessible clinical tool which requires only data from routine imaging to predict patients at risk of progressing from SIVD to SVCI. HIGHLIGHTS Our unsupervised machine learning model provides an accurate and accessible clinical tool to predict patients at risk of progressing from subcortical ischemic vascular disease (SIVD) to subcortical vascular cognitive impairment (SVCI) and requires only data from imaging routinely used during the diagnosis of suspected SVCI. The model yields good accuracy, sensitivity, and specificity and is portable to other cohorts and to clinical practice to distinguish patients with SIVD at risk for progressing to SVCI. The model combines assessment of diffusion tensor imaging and functional magnetic resonance imaging measures in patients with SVCI to analyze whether the "disconnection hypothesis" contributes to functional and structural changes and to the clinical presentation of SVCI.
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Affiliation(s)
- Qi Qin
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Junda Qu
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yunsi Yin
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Ying Liang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yan Wang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Bingxin Xie
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Qingqing Liu
- Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuan Wang
- Department of Endocrinology, The Second People's Hospital of Mudanjiang, Mudanjiang, China
| | - Xinyi Xia
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Meng Wang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Xu Zhang
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Jianping Jia
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
- Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China
- National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Yi Xing
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
| | - Chunlin Li
- School of Biomedical Engineering, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, China
| | - Yi Tang
- Department of Neurology & Innovation Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China
- Key Laboratory of Neurodegenerative Diseases, Ministry of Education of the People's Republic of China, Beijing, China
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27
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Wang L, Kolobaric A, Aizenstein H, Lopresti B, Tudorascu D, Snitz B, Klunk W, Wu M. Identifying sex-specific risk architectures for predicting amyloid deposition using neural networks. Neuroimage 2023; 275:120147. [PMID: 37156449 PMCID: PMC10905666 DOI: 10.1016/j.neuroimage.2023.120147] [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: 02/06/2023] [Revised: 04/08/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023] Open
Abstract
In older adults without dementia, White Matter Hyperintensities (WMH) in MRI have been shown to be highly associated with cerebral amyloid deposition, measured by the Pittsburgh compound B (PiB) PET. However, the relation to age, sex, and education in explaining this association is not well understood. We use the voxel counts of regional WMH, age, one-hot encoded sex, and education to predict the regional PiB using a multilayer perceptron with only rectilinear activations using mean squared error. We then develop a novel, robust metric to understand the relevance of each input variable for prediction. Our observations indicate that sex is the most relevant predictor of PiB and that WMH is not relevant for prediction. These results indicate that there is a sex-specific risk architecture for Aβ deposition.
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Affiliation(s)
- Linghai Wang
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States.
| | | | - Howard Aizenstein
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Brian Lopresti
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Dana Tudorascu
- Department of Biostatistics, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Beth Snitz
- University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - William Klunk
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States; School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
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28
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Reynolds M, Chaudhary T, Eshaghzadeh Torbati M, Tudorascu DL, Batmanghelich K. ComBat Harmonization: Empirical Bayes versus fully Bayes approaches. Neuroimage Clin 2023; 39:103472. [PMID: 37506457 PMCID: PMC10412957 DOI: 10.1016/j.nicl.2023.103472] [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: 04/14/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
Studying small effects or subtle neuroanatomical variation requires large-scale sample size data. As a result, combining neuroimaging data from multiple datasets is necessary. Variation in acquisition protocols, magnetic field strength, scanner build, and many other non-biologically related factors can introduce undesirable bias into studies. Hence, harmonization is required to remove the bias-inducing factors from the data. ComBat is one of the most common methods applied to features from structural images. ComBat models the data using a hierarchical Bayesian model and uses the empirical Bayes approach to infer the distribution of the unknown factors. The empirical Bayes harmonization method is computationally efficient and provides valid point estimates. However, it tends to underestimate uncertainty. This paper investigates a new approach, fully Bayesian ComBat, where Monte Carlo sampling is used for statistical inference. When comparing fully Bayesian and empirical Bayesian ComBat, we found Empirical Bayesian ComBat more effectively removed scanner strength information and was much more computationally efficient. Conversely, fully Bayesian ComBat better preserved biological disease and age-related information while performing more accurate harmonization on traveling subjects. The fully Bayesian approach generates a rich posterior distribution, which is useful for generating simulated imaging features for improving classifier performance in a limited data setting. We show the generative capacity of our model for augmenting and improving the detection of patients with Alzheimer's disease. Posterior distributions for harmonized imaging measures can also be used for brain-wide uncertainty comparison and more principled downstream statistical analysis.Code for our new fully Bayesian ComBat extension is available at https://github.com/batmanlab/BayesComBat.
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Affiliation(s)
- Maxwell Reynolds
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Blvd. Suite 500, Pittsburgh, PA 15206, USA.
| | - Tigmanshu Chaudhary
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Blvd. Suite 500, Pittsburgh, PA 15206, USA.
| | - Mahbaneh Eshaghzadeh Torbati
- Intelligent System Program, University of Pittsburgh School of Computing and Information, 210 South Bouquet Street, Pittsburgh, PA 15260, USA.
| | - Dana L Tudorascu
- Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O'Hara Street, Pittsburgh, PA 15213, USA; Department of Biostatistics, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15213, USA.
| | - Kayhan Batmanghelich
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, 5607 Baum Blvd. Suite 500, Pittsburgh, PA 15206, USA.
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Twait EL, Min B, Beran M, Vonk JMJ, Geerlings MI. The cross-sectional association between amyloid burden and white matter hyperintensities in older adults without cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2023; 88:101952. [PMID: 37178806 DOI: 10.1016/j.arr.2023.101952] [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: 01/04/2023] [Revised: 05/08/2023] [Accepted: 05/09/2023] [Indexed: 05/15/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia, characterized by the aggregation of amyloid-beta (Aβ) proteins into plaques. Individuals with AD frequently show mixed pathologies, often caused by cerebral small vessel disease (CSVD), resulting in lesions such as white matter hyperintensities (WMH). The current systematic review and meta-analysis investigated the cross-sectional relationship between amyloid burden and WMH in older adults without objective cognitive impairment. A systematic search performed in PubMed, Embase, and PsycINFO yielded 13 eligible studies. Aβ was assessed using PET, CSF, or plasma measurements. Two meta-analyses were performed: one on Cohen's d metrics and one on correlation coefficients. The meta-analyses revealed an overall weighted small-to-medium Cohen's d of 0.55 (95% CI: 0.31-0.78) in CSF, an overall correlation of 0.31 (0.09-0.50) in CSF, and a large Cohen's d of 0.96 (95% CI: 0.66-1.27) in PET. Only two studies assessed this relationship in plasma, with an effect size of - 0.20 (95% CI: -0.75 to 0.34). These findings indicate a relationship between both amyloid and vascular pathologies in cognitively normal adults in PET and CSF. Future studies should assess the possible relationship of blood amyloid-beta and WMH for broader identification of at risk individuals showing mixed pathology in preclinical stages.
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Affiliation(s)
- Emma L Twait
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Amsterdam UMC, Location Vrije Universiteit, Department of General Practice, Amsterdam, The Netherlands; Research Institute Amsterdam Public Health, Research Programme Aging & Later life, and Research Programme Personalized Medicine, Amsterdam, The Netherlands
| | - Britt Min
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Bachelor Program Biomedical Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
| | - Magdalena Beran
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; School for Cardiovascular Disease (CARIM), Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Jet M J Vonk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Department of Neurology, Memory and Aging Center, University of California San Francisco (UCSF), San Francisco, CA, USA
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands; Research Institute Amsterdam Public Health, Research Programme Aging & Later life, and Research Programme Personalized Medicine, Amsterdam, The Netherlands; Research Institute Amsterdam Neuroscience, Research Programme Neurodegeneration, and Research Programme Mood, Anxiety, Psychosis, Stress, and Sleep, Amsterdam, The Netherlands; Amsterdam UMC, location University of Amsterdam, Department of General Practice, Amsterdam, The Netherlands.
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30
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Fletcher E, Farias S, DeCarli C, Gavett B, Widaman K, De Leon F, Mungas D. Toward a statistical validation of brain signatures as robust measures of behavioral substrates. Hum Brain Mapp 2023; 44:3094-3111. [PMID: 36939069 PMCID: PMC10171525 DOI: 10.1002/hbm.26265] [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: 05/15/2022] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 03/21/2023] Open
Abstract
The "brain signature of cognition" concept has garnered interest as a data-driven, exploratory approach to better understand key brain regions involved in specific cognitive functions, with the potential to maximally characterize brain substrates of behavioral outcomes. Previously we presented a method for computing signatures of episodic memory. However, to be a robust brain measure, the signature approach requires a rigorous validation of model performance across a variety of cohorts. Here we report validation results and provide an example of extending it to a second behavioral domain. In each of two discovery data cohorts, we derived regional brain gray matter thickness associations for two domains: neuropsychological and everyday cognition memory. We computed regional association to outcome in 40 randomly selected discovery subsets of size 400 in each cohort. We generated spatial overlap frequency maps and defined high-frequency regions as "consensus" signature masks. Using separate validation datasets, we evaluated replicability of cohort-based consensus model fits and explanatory power by comparing signature model fits with each other and with competing theory-based models. Spatial replications produced convergent consensus signature regions. Consensus signature model fits were highly correlated in 50 random subsets of each validation cohort, indicating high replicability. In comparisons over each full cohort, signature models outperformed other models. In this validation study, we produced signature models that replicated model fits to outcome and outperformed other commonly used measures. Signatures in two memory domains suggested strongly shared brain substrates. Robust brain signatures may therefore be achievable, yielding reliable and useful measures for modeling substrates of behavioral domains.
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Affiliation(s)
- Evan Fletcher
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Sarah Farias
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Charles DeCarli
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
| | - Brandon Gavett
- School of Psychological ScienceUniversity of Western AustraliaPerthAustralia
| | - Keith Widaman
- School of EducationUniversity of California, RiversideRiversideCaliforniaUSA
| | - Fransia De Leon
- School of MedicineUniversity of California, DavisDavisCaliforniaUSA
| | - Dan Mungas
- Department of NeurologyUniversity of California, DavisDavisCaliforniaUSA
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31
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Habes M, Jacobson AM, Braffett BH, Rashid T, Ryan CM, Shou H, Cui Y, Davatzikos C, Luchsinger JA, Biessels GJ, Bebu I, Gubitosi-Klug RA, Bryan RN, Nasrallah IM. Patterns of Regional Brain Atrophy and Brain Aging in Middle- and Older-Aged Adults With Type 1 Diabetes. JAMA Netw Open 2023; 6:e2316182. [PMID: 37261829 PMCID: PMC10236234 DOI: 10.1001/jamanetworkopen.2023.16182] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 04/09/2023] [Indexed: 06/02/2023] Open
Abstract
Importance Little is known about structural brain changes in type 1 diabetes (T1D) and whether there are early manifestations of a neurodegenerative condition like Alzheimer disease (AD) or evidence of premature brain aging. Objective To evaluate neuroimaging markers of brain age and AD-like atrophy in participants with T1D in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) study, identify which brain regions are associated with the greatest changes in patients with T1D, and assess the association between cognition and brain aging indices. Design, Setting, and Participants This cohort study leveraged data collected during the combined DCCT (randomized clinical trial, 1983-1993) and EDIC (observational study, 1994 to present) studies at 27 clinical centers in the US and Canada. A total of 416 eligible EDIC participants and 99 demographically similar adults without diabetes were enrolled in the magnetic resonance imaging (MRI) ancillary study, which reports cross-sectional data collected in 2018 to 2019 and relates it to factors measured longitudinally in DCCT/EDIC. Data analyses were performed between July 2020 and April 2022. Exposure T1D diagnosis. Main Outcomes and Measures Psychomotor and mental efficiency were evaluated using verbal fluency, digit symbol substitution test, trail making part B, and the grooved pegboard. Immediate memory scores were derived from the logical memory subtest of the Wechsler memory scale and the Wechsler digit symbol substitution test. MRI and machine learning indices were calculated to predict brain age and quantify AD-like atrophy. Results This study included 416 EDIC participants with a median (range) age of 60 (44-74) years (87 of 416 [21%] were older than 65 years) and a median (range) diabetes duration of 37 (30-51) years. EDIC participants had consistently higher brain age values compared with controls without diabetes, indicative of approximately 6 additional years of brain aging (EDIC participants: β, 6.16; SE, 0.71; control participants: β, 1.04; SE, 0.04; P < .001). In contrast, AD regional atrophy was comparable between the 2 groups. Regions with atrophy in EDIC participants vs controls were observed mainly in the bilateral thalamus and putamen. Greater brain age was associated with lower psychomotor and mental efficiency among EDIC participants (β, -0.04; SE, 0.01; P < .001), but not among controls. Conclusions and Relevance The findings of this study suggest an increase in brain aging among individuals with T1D without any early signs of AD-related neurodegeneration. These increases were associated with reduced cognitive performance, but overall, the abnormal patterns seen in this sample were modest, even after a mean of 38 years with T1D.
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Affiliation(s)
- Mohamad Habes
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Alan M. Jacobson
- NYU Long Island School of Medicine, NYU Langone Hospital-Long Island, Mineola, New York
| | | | - Tanweer Rashid
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center San Antonio, San Antonio
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
| | - Yuhan Cui
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | | | - Geert J. Biessels
- Department of Neurology, UMCU Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ionut Bebu
- George Washington University, Biostatistics Center, Rockville, Maryland
| | - Rose A. Gubitosi-Klug
- Case Western Reserve University School of Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - R. Nick Bryan
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Ilya M. Nasrallah
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
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32
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Gonzales MM, Garbarino VR, Kautz T, Palavicini JP, Lopez-Cruzan M, Dehkordi SK, Mathews J, Zare H, Xu P, Zhang B, Franklin C, Habes M, Craft S, Petersen RC, Tchkonia T, Kirkland J, Salardini A, Seshadri S, Musi N, Orr ME. Senolytic therapy to modulate the progression of Alzheimer's Disease (SToMP-AD) - Outcomes from the first clinical trial of senolytic therapy for Alzheimer's disease. RESEARCH SQUARE 2023:rs.3.rs-2809973. [PMID: 37162971 PMCID: PMC10168460 DOI: 10.21203/rs.3.rs-2809973/v1] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Cellular senescence has been identified as a pathological mechanism linked to tau and amyloid beta (Aβ) accumulation in mouse models of Alzheimer's disease (AD). Clearance of senescent cells using the senolytic compounds dasatinib (D) and quercetin (Q) reduced neuropathological burden and improved clinically relevant outcomes in the mice. Herein, we conducted a vanguard open-label clinical trial of senolytic therapy for AD with the primary aim of evaluating central nervous system (CNS) penetrance, as well as exploratory data collection relevant to safety, feasibility, and efficacy. Participants with early-stage symptomatic AD were enrolled in an open-label, 12-week pilot study of intermittent orally-delivered D+Q. CNS penetrance was assessed by evaluating drug levels in cerebrospinal fluid (CSF) using high performance liquid chromatography with tandem mass spectrometry. Safety was continuously monitored with adverse event reporting, vitals, and laboratory work. Cognition, neuroimaging, and plasma and CSF biomarkers were assessed at baseline and post-treatment. Five participants (mean age: 76±5 years; 40% female) completed the trial. The treatment increased D and Q levels in the blood of all participants ranging from 12.7 to 73.5 ng/ml for D and 3.29-26.30 ng/ml for Q. D levels were detected in the CSF of four participants ranging from 0.281 to 0.536 ng/ml (t(4)=3.123, p=0.035); Q was not detected. Treatment was well-tolerated with no early discontinuation and six mild to moderate adverse events occurring across the study. Cognitive and neuroimaging endpoints did not significantly differ from baseline to post-treatment. CNS levels of IL-6 and GFAP increased from baseline to post-treatment (t(4)=3.913, p=008 and t(4)=3.354, p=0.028, respectively) concomitant with decreased levels of several cytokines and chemokines associated with senescence, and a trend toward higher levels of Aβ42 (t(4)=-2.338, p=0.079). Collectively the data indicate the CNS penetrance of D and provide preliminary support for the safety, tolerability, and feasibility of the intervention and suggest that astrocytes and Aβ may be particularly responsive to the treatment. While early results are promising, fully powered, placebo-controlled studies are needed to evaluate the potential of AD modification with the novel approach of targeting cellular senescence.
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Affiliation(s)
- Mitzi M Gonzales
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Valentina R Garbarino
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tiffany Kautz
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Juan Pablo Palavicini
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Marisa Lopez-Cruzan
- Department of Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Shiva Kazempour Dehkordi
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Julia Mathews
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Habil Zare
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Peng Xu
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mount Sinai Center for Transformative Disease Modeling, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Radiology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Suzanne Craft
- Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Tamara Tchkonia
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA
| | - James Kirkland
- Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Arash Salardini
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Nicolas Musi
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Geriatric Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Miranda E Orr
- Department of Internal Medicine Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Wang R, Bashyam V, Yang Z, Yu F, Tassopoulou V, Chintapalli SS, Skampardoni I, Sreepada LP, Sahoo D, Nikita K, Abdulkadir A, Wen J, Davatzikos C. Applications of generative adversarial networks in neuroimaging and clinical neuroscience. Neuroimage 2023; 269:119898. [PMID: 36702211 PMCID: PMC9992336 DOI: 10.1016/j.neuroimage.2023.119898] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 12/16/2022] [Accepted: 01/21/2023] [Indexed: 01/25/2023] Open
Abstract
Generative adversarial networks (GANs) are one powerful type of deep learning models that have been successfully utilized in numerous fields. They belong to the broader family of generative methods, which learn to generate realistic data with a probabilistic model by learning distributions from real samples. In the clinical context, GANs have shown enhanced capabilities in capturing spatially complex, nonlinear, and potentially subtle disease effects compared to traditional generative methods. This review critically appraises the existing literature on the applications of GANs in imaging studies of various neurological conditions, including Alzheimer's disease, brain tumors, brain aging, and multiple sclerosis. We provide an intuitive explanation of various GAN methods for each application and further discuss the main challenges, open questions, and promising future directions of leveraging GANs in neuroimaging. We aim to bridge the gap between advanced deep learning methods and neurology research by highlighting how GANs can be leveraged to support clinical decision making and contribute to a better understanding of the structural and functional patterns of brain diseases.
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Affiliation(s)
- Rongguang Wang
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA.
| | - Vishnu Bashyam
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Zhijian Yang
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Fanyang Yu
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Vasiliki Tassopoulou
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Sai Spandana Chintapalli
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Ioanna Skampardoni
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA; School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Lasya P Sreepada
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Dushyant Sahoo
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Konstantina Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Ahmed Abdulkadir
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA; Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Junhao Wen
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA
| | - Christos Davatzikos
- Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania, Philadelphia, USA; Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
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34
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Zhou Z, Li H, Srinivasan D, Abdulkadir A, Nasrallah IM, Wen J, Doshi J, Erus G, Mamourian E, Bryan NR, Wolk DA, Beason-Held L, Resnick SM, Satterthwaite TD, Davatzikos C, Shou H, Fan Y. Multiscale functional connectivity patterns of the aging brain learned from harmonized rsfMRI data of the multi-cohort iSTAGING study. Neuroimage 2023; 269:119911. [PMID: 36731813 PMCID: PMC9992322 DOI: 10.1016/j.neuroimage.2023.119911] [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: 10/14/2022] [Revised: 01/06/2023] [Accepted: 01/28/2023] [Indexed: 02/03/2023] Open
Abstract
To learn multiscale functional connectivity patterns of the aging brain, we built a brain age prediction model of functional connectivity measures at seven scales on a large fMRI dataset, consisting of resting-state fMRI scans of 4186 individuals with a wide age range (22 to 97 years, with an average of 63) from five cohorts. We computed multiscale functional connectivity measures of individual subjects using a personalized functional network computational method, harmonized the functional connectivity measures of subjects from multiple datasets in order to build a functional brain age model, and finally evaluated how functional brain age gap correlated with cognitive measures of individual subjects. Our study has revealed that functional connectivity measures at multiple scales were more informative than those at any single scale for the brain age prediction, the data harmonization significantly improved the brain age prediction performance, and the data harmonization in the functional connectivity measures' tangent space worked better than in their original space. Moreover, brain age gap scores of individual subjects derived from the brain age prediction model were significantly correlated with clinical and cognitive measures. Overall, these results demonstrated that multiscale functional connectivity patterns learned from a large-scale multi-site rsfMRI dataset were informative for characterizing the aging brain and the derived brain age gap was associated with cognitive and clinical measures.
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Affiliation(s)
- Zhen Zhou
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Hongming Li
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Dhivya Srinivasan
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ahmed Abdulkadir
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Ilya M Nasrallah
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Junhao Wen
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jimit Doshi
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Guray Erus
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Elizabeth Mamourian
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Nick R Bryan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX, 78705, USA
| | - David A Wolk
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Neurology and Penn Memory Center, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Lori Beason-Held
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, 20892, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, 20892, USA
| | - Theodore D Satterthwaite
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Statistic in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychiatry, Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychiatry, Brain Behavior Laboratory and Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, 19104, USA
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Haochang Shou
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Penn Statistic in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Yong Fan
- Center for Biomedical Image Computing and Analytics, Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Brenowitz WD, Fornage M, Launer LJ, Habes M, Davatzikos C, Yaffe K. Alzheimer's Disease Genetic Risk, Cognition, and Brain Aging in Midlife. Ann Neurol 2023; 93:629-634. [PMID: 36511390 PMCID: PMC9974745 DOI: 10.1002/ana.26569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/10/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022]
Abstract
We examined associations of an Alzheimer's disease (AD) Genetic Risk Score (AD-GRS) and midlife cognitive and neuroimaging outcomes in 1,252 middle-aged participants (311 with brain MRI). A higher AD-GRS based on 25 previously identified loci (excluding apolipoprotein E [APOE]) was associated with worse Montreal Cognitive Assessment (-0.14 standard deviation [SD] [95% confidence interval {CI}: -0.26, -0.02]), older machine learning predicted brain age (2.35 years[95%CI: 0.01, 4.69]), and white matter hyperintensity volume (0.35 SD [95% CI: 0.00, 0.71]), but not with a composite cognitive outcome, total brain, or hippocampal volume. APOE ε4 allele was not associated with any outcomes. AD risk genes beyond APOE may contribute to subclinical differences in cognition and brain health in midlife. ANN NEUROL 2023;93:629-634.
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Affiliation(s)
- Willa D Brenowitz
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Myriam Fornage
- The University of Texas, Health Science Center at Houston, Houston, Texas, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland, USA
| | - Mohamad Habes
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Christos Davatzikos
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristine Yaffe
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- San Francisco VA Medical Center, San Francisco, California, USA
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Rashid T, Liu H, Ware JB, Li K, Romero JR, Fadaee E, Nasrallah IM, Hilal S, Bryan RN, Hughes TM, Davatzikos C, Launer L, Seshadri S, Heckbert SR, Habes M. Deep Learning Based Detection of Enlarged Perivascular Spaces on Brain MRI. NEUROIMAGE. REPORTS 2023; 3:100162. [PMID: 37035520 PMCID: PMC10078801 DOI: 10.1016/j.ynirp.2023.100162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Deep learning has been demonstrated effective in many neuroimaging applications. However, in many scenarios, the number of imaging sequences capturing information related to small vessel disease lesions is insufficient to support data-driven techniques. Additionally, cohort-based studies may not always have the optimal or essential imaging sequences for accurate lesion detection. Therefore, it is necessary to determine which imaging sequences are crucial for precise detection. This study introduces a deep learning framework to detect enlarged perivascular spaces (ePVS) and aims to find the optimal combination of MRI sequences for deep learning-based quantification. We implemented an effective lightweight U-Net adapted for ePVS detection and comprehensively investigated different combinations of information from SWI, FLAIR, T1-weighted (T1w), and T2-weighted (T2w) MRI sequences. The experimental results showed that T2w MRI is the most important for accurate ePVS detection, and the incorporation of SWI, FLAIR and T1w MRI in the deep neural network had minor improvements in accuracy and resulted in the highest sensitivity and precision (sensitivity =0.82, precision =0.83). The proposed method achieved comparable accuracy at a minimal time cost compared to manual reading. The proposed automated pipeline enables robust and time-efficient readings of ePVS from MR scans and demonstrates the importance of T2w MRI for ePVS detection and the potential benefits of using multimodal images. Furthermore, the model provides whole-brain maps of ePVS, enabling a better understanding of their clinical correlates compared to the clinical rating methods within only a couple of brain regions.
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Affiliation(s)
- Tanweer Rashid
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Hangfan Liu
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
| | - Jeffrey B. Ware
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Karl Li
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jose Rafael Romero
- Department of Neurology, School of Medicine, Boston University, Boston, MA, USA
| | - Elyas Fadaee
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ilya M. Nasrallah
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - R. Nick Bryan
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
- Department of Diagnostic Medicine, Dell Medical School, University of Texas at Austin, Austin, TX, USA
| | - Timothy M. Hughes
- Department of Internal Medicine and Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Christos Davatzikos
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Sudha Seshadri
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Susan R. Heckbert
- Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, WA, USA
| | - Mohamad Habes
- Neuroimage Analytics Laboratory and Biggs Institute Neuroimaging Core, Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, USA
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Zhang K, Zhang K, Liu Q, Wu J. The Relationship Between Sarcopenia, Cognitive Impairment, and Cerebral White Matter Hyperintensity in the Elderly. Clin Interv Aging 2023; 18:547-555. [PMID: 37026080 PMCID: PMC10072150 DOI: 10.2147/cia.s404734] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
Purpose To explore the relationship between sarcopenia-related indices, cognitive impairment and cerebral white matter hyperintensities. Patients and methods Ninety-five hospitalized older adults aged 60 years and older were used in this study. Three sarcopenia-related indicators were measured: hand grip strength (Measured with a spring-type dynamometer), gait speed (6m step speed method), and appendicular skeletal muscle mass (ASM, bioelectrical impedance). Sarcopenia was defined according to the Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was assessed using Montreal Cognitive Assessment (MoCA). Cerebral white matter hyperintensity was assessed using 3.0T superconducting magnetic resonance imaging. Results In both men and women, these three indices of sarcopenia were significantly and negatively correlated with WMH grades, except for appendicular skeletal muscle mass and WMH grades in women. Scores on the MoCA scale were significantly positive correlated with grip strength, and ASM, both in men and women. After adjusting for confounders and WMHs, regression analyses showed an increased incidence of cognitive impairment in patients with sarcopenia relative to those without sarcopenia. Conclusion Lower sarcopenia-related indices were significantly associated with cognitive impairment. WMHs may be one of the factors linking sarcopenia and cognitive function.
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Affiliation(s)
- Kangrui Zhang
- Graduate School, Bengbu Medical College, Bengbu, 233000, People’s Republic of China
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
| | - Kangdi Zhang
- Graduate School, Anhui Medical University, Hefei, 230000, People’s Republic of China
| | - Qiuwan Liu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
| | - Juncang Wu
- Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China
- Correspondence: Juncang Wu, Department of Neurology, The Second People’s Hospital of Hefei, Hefei, 230000, People’s Republic of China, Email
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Dintica CS, Habes M, Erus G, Vittinghoff E, Davatzikos C, Nasrallah IM, Launer LJ, Sidney S, Yaffe K. Elevated blood pressure is associated with advanced brain aging in mid-life: A 30-year follow-up of The CARDIA Study. Alzheimers Dement 2023; 19:924-932. [PMID: 35779250 PMCID: PMC9806185 DOI: 10.1002/alz.12725] [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: 01/31/2022] [Revised: 05/24/2022] [Accepted: 05/25/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND High blood pressure (BP) is a risk factor for late-life brain health; however, the association of elevated BP with brain health in mid-life is unclear. METHODS We identified 661 participants from the Coronary Artery Risk Development in Young Adults Study (age 18-30 at baseline) with 30 years of follow-up and brain magnetic resonance imaging at year 30. Cumulative exposure of BP was estimated by time-weighted averages (TWA). Ideal cardiovascular health was defined as systolic BP < 120 mm Hg, diastolic BP < 80 mm Hg. Brain age was calculated using previously validated high dimensional machine learning pattern analyses. RESULTS Every 5 mmHg increment in TWA systolic BP was associated with approximately 1-year greater brain age (95% confidence interval [CI]: 0.50-1.36) Participants with TWA systolic or diastolic BP over the recommended guidelines for ideal cardiovascular health, had on average 3-year greater brain age (95% CI: 1.00-4.67; 95% CI: 1.45-5.13, respectively). CONCLUSION Elevated BP from early to mid adulthood, even below clinical cut-offs, is associated with advanced brain aging in mid-life.
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Affiliation(s)
| | - Mohamad Habes
- University of Pennsylvania, Philadelphia, PA
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, TX, USA
| | - Guray Erus
- University of Pennsylvania, Philadelphia, PA
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Toledo JB, Abdelnour C, Weil RS, Ferreira D, Rodriguez-Porcel F, Pilotto A, Wyman-Chick KA, Grothe MJ, Kane JPM, Taylor A, Rongve A, Scholz S, Leverenz JB, Boeve BF, Aarsland D, McKeith IG, Lewis S, Leroi I, Taylor JP. Dementia with Lewy bodies: Impact of co-pathologies and implications for clinical trial design. Alzheimers Dement 2023; 19:318-332. [PMID: 36239924 PMCID: PMC9881193 DOI: 10.1002/alz.12814] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 08/29/2022] [Accepted: 09/09/2022] [Indexed: 02/01/2023]
Abstract
Dementia with Lewy bodies (DLB) is clinically defined by the presence of visual hallucinations, fluctuations, rapid eye movement (REM) sleep behavioral disorder, and parkinsonism. Neuropathologically, it is characterized by the presence of Lewy pathology. However, neuropathological studies have demonstrated the high prevalence of coexistent Alzheimer's disease, TAR DNA-binding protein 43 (TDP-43), and cerebrovascular pathologic cases. Due to their high prevalence and clinical impact on DLB individuals, clinical trials should account for these co-pathologies in their design and selection and the interpretation of biomarkers values and outcomes. Here we discuss the frequency of the different co-pathologies in DLB and their cross-sectional and longitudinal clinical impact. We then evaluate the utility and possible applications of disease-specific and disease-nonspecific biomarkers and how co-pathologies can impact these biomarkers. We propose a framework for integrating multi-modal biomarker fingerprints and step-wise selection and assessment of DLB individuals for clinical trials, monitoring target engagement, and interpreting outcomes in the setting of co-pathologies.
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Affiliation(s)
- Jon B Toledo
- Nantz National Alzheimer Center, Stanley H. Appel Department of Neurology, Houston Methodist Hospital, Houston, Texas, USA
| | - Carla Abdelnour
- Fundació ACE. Barcelona Alzheimer Treatment and Research Center, Universitat Autónoma de Barcelona, Barcelona, Spain
| | - Rimona S Weil
- Dementia Research Centre, Wellcome Centre for Human Neuroimaging, Movement Disorders Consortium, National Hospital for Neurology and Neurosurgery, University College London, London, UK
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Center for Alzheimer's Research, Karolinska Institutet, Stockholm, Sweden
| | | | - Andrea Pilotto
- Department of Clinical and Experimental Sciences, University of Brescia, Parkinson's Disease Rehabilitation Centre, FERB ONLUS-S, Isidoro Hospital, Trescore Balneario (BG), Italy
| | - Kathryn A Wyman-Chick
- HealthPartners Center for Memory and Aging and Struthers Parkinson's Center, Saint Paul, Minnesota, USA
| | - Michel J Grothe
- Instituto de Biomedicina de Sevilla (IBiS), Unidad de Trastornos del Movimiento, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain
| | - Joseph P M Kane
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Angela Taylor
- Lewy Body Dementia Association, Lilburn, Georgia, USA
| | - Arvid Rongve
- Department of Research and Innovation, Institute of Clinical Medicine (K1), Haugesund Hospital, Norway and The University of Bergen, Bergen, Norway
| | - Sonja Scholz
- Department of Neurology, National Institute of Neurological Disorders and Stroke, Neurodegenerative Diseases Research Unit, Johns Hopkins University Medical Center, Baltimore, Maryland, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, Ohio, USA
| | - Bradley F Boeve
- Department of Neurology and Center for Sleep Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, UK
| | - Ian G McKeith
- Newcastle University Translational and Clinical Research Institute (NUTCRI, Newcastle upon Tyne, UK
| | - Simon Lewis
- ForeFront Parkinson's Disease Research Clinic, School of Medical Sciences, Brain and Mind Centre, University of Sydney, Camperdown, New South Wales, Australia
| | - Iracema Leroi
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - John P Taylor
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
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Dintica CS, Habes M, Erus G, Simone T, Schreiner P, Yaffe K. Long-term depressive symptoms and midlife brain age. J Affect Disord 2023; 320:436-441. [PMID: 36202300 PMCID: PMC10115134 DOI: 10.1016/j.jad.2022.09.164] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Evidence suggests that depression may be a risk factor for dementia in older adults, but the link between depressive symptoms and brain health earlier in life is less understood. Our aim was to investigate the association between long-term depressive symptoms in young to mid-adulthood and a measure of brain age derived from structural MRI. METHODS From the Coronary Artery Risk Development in Young Adults study, we identified 649 participants (age 23-36 at baseline) with brain MRI and cognitive testing. Long-term depressive symptoms were measured with the Center for Epidemiological Studies Depression scale (CESD) six times across 25 years and analyzed as time-weighted averages (TWA). Brain age was derived using previously validated high dimensional neuroimaging pattern analysis, quantifying individual differences in age-related atrophy. Elevated depressive symptoms were defined as CES-D ≥16. Linear regression was used to test the association between TWA depressive symptoms, brain aging, and cognition. RESULTS Each standard deviation (5-points) increment in TWA depression symptoms over 25 years was associated with one-year greater brain age (β: 1.14, 95 % confidence interval [CI]: 0.57 to 1.71). Participants with elevated TWA depressive symptoms had on average a 3-year greater brain age (β: 2.75, 95 % CI: 0.43 to 5.08). Moreover, elevated depressive symptoms were associated with higher odds of poor cognitive function in midlife (OR: 3.30, 95 % CI: 1.37 to 7.97). LIMITATIONS Brain age was assessed at one time, limiting our ability to evaluate the temporality of depressive symptoms and brain aging. CONCLUSIONS Elevated depressive symptoms in early adulthood may have implications for brain health as early as in midlife.
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Affiliation(s)
| | - Mohamad Habes
- University of Pennsylvania, Philadelphia, PA, USA; Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, TX, USA.
| | - Guray Erus
- University of Pennsylvania, Philadelphia, PA, USA.
| | - Tamar Simone
- Northern California Institute for Research and Education, San Francisco, CA, USA.
| | - Pamela Schreiner
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA.
| | - Kristine Yaffe
- University of California, San Francisco, California, CA, USA; VA Medical Center, San Francisco, CA, USA.
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Li K, Rashid T, Li J, Honnorat N, Nirmala AB, Fadaee E, Wang D, Charisis S, Liu H, Franklin C, Maybrier M, Katragadda H, Abazid L, Ganapathy V, Valaparla VL, Badugu P, Vasquez E, Solano L, Clarke G, Maestre G, Richardson T, Walker J, Fox PT, Bieniek K, Seshadri S, Habes M. Postmortem Brain Imaging in Alzheimer's Disease and Related Dementias: The South Texas Alzheimer's Disease Research Center Repository. J Alzheimers Dis 2023; 96:1267-1283. [PMID: 37955086 PMCID: PMC10693476 DOI: 10.3233/jad-230389] [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: 09/24/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Neuroimaging bears the promise of providing new biomarkers that could refine the diagnosis of dementia. Still, obtaining the pathology data required to validate the relationship between neuroimaging markers and neurological changes is challenging. Existing data repositories are focused on a single pathology, are too small, or do not precisely match neuroimaging and pathology findings. OBJECTIVE The new data repository introduced in this work, the South Texas Alzheimer's Disease research center repository, was designed to address these limitations. Our repository covers a broad diversity of dementias, spans a wide age range, and was specifically designed to draw exact correspondences between neuroimaging and pathology data. METHODS Using four different MRI sequences, we are reaching a sample size that allows for validating multimodal neuroimaging biomarkers and studying comorbid conditions. Our imaging protocol was designed to capture markers of cerebrovascular disease and related lesions. Quantification of these lesions is currently underway with MRI-guided histopathological examination. RESULTS A total of 139 postmortem brains (70 females) with mean age of 77.9 years were collected, with 71 brains fully analyzed. Of these, only 3% showed evidence of AD-only pathology and 76% had high prevalence of multiple pathologies contributing to clinical diagnosis. CONCLUSION This repository has a significant (and increasing) sample size consisting of a wide range of neurodegenerative disorders and employs advanced imaging protocols and MRI-guided histopathological analysis to help disentangle the effects of comorbid disorders to refine diagnosis, prognosis and better understand neurodegenerative disorders.
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Affiliation(s)
- Karl Li
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tanweer Rashid
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Jinqi Li
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Nicolas Honnorat
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Anoop Benet Nirmala
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Elyas Fadaee
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Di Wang
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Sokratis Charisis
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Hangfan Liu
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Crystal Franklin
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mallory Maybrier
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Haritha Katragadda
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Leen Abazid
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Vinutha Ganapathy
- Department of Neurology, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Pradeepthi Badugu
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Eliana Vasquez
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Leigh Solano
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Geoffrey Clarke
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Gladys Maestre
- Department of Neuroscience, School of Medicine, University of Texas Rio Grande Valley, Harlingen, TX, USA
- Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | - Tim Richardson
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jamie Walker
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter T. Fox
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Kevin Bieniek
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Department of Pathology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Mohamad Habes
- Glenn Biggs Institute for Neurodegenerative Disorders, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Research Imaging Institute, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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Walker JM, Dehkordi SK, Schaffert J, Goette W, White CL, Richardson TE, Zare H. The Spectrum of Alzheimer-Type Pathology in Cognitively Normal Individuals. J Alzheimers Dis 2023; 91:683-695. [PMID: 36502330 PMCID: PMC11184733 DOI: 10.3233/jad-220898] [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: 12/12/2022]
Abstract
BACKGROUND The strongest risk factor for the development of Alzheimer's disease (AD) is age. The progression of Braak stage and Thal phase with age has been demonstrated. However, prior studies did not include cognitive status. OBJECTIVE We set out to define normative values for Alzheimer-type pathologic changes in individuals without cognitive decline, and then define levels that would qualify them to be resistant to or resilient against these changes. METHODS Utilizing neuropathology data obtained from the National Alzheimer's Coordinating Center (NACC), we demonstrate the age-related progression of Alzheimer-type pathologic changes in cognitively normal individuals (CDR = 0, n = 542). With plots generated from these data, we establish standard lines that may be utilized to measure the extent to which an individual's Alzheimer-type pathology varies from the estimated normal range of pathology. RESULTS Although Braak stage and Thal phase progressively increase with age in cognitively normal individuals, the Consortium to Establish a Registry for Alzheimer's Disease neuritic plaque score and Alzheimer's disease neuropathologic change remain at low levels. CONCLUSION These findings suggest that an increasing burden of neuritic plaques is a strong predictor of cognitive decline, whereas, neurofibrillary degeneration and amyloid-β (diffuse) plaque deposition, both to some degree, are normal pathologic changes of aging that occur in almost all individuals regardless of cognitive status. Furthermore, we have defined the amount of neuropathologic change in cognitively normal individuals that would qualify them to be "resilient" against the pathology (significantly above the normative values for age, but still cognitively normal) or "resistant" to the development of pathology (significantly below the normative values for age).
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Affiliation(s)
- Jamie M. Walker
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Shiva Kazempour Dehkordi
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Jeff Schaffert
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - William Goette
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Charles L. White
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Timothy E. Richardson
- Department of Pathology, Molecular and Cell Based Medicine, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Habil Zare
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
- Department of Cell Systems and Anatomy, University of Texas Health San Antonio, San Antonio, TX, USA
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Kia SM, Huijsdens H, Rutherford S, de Boer A, Dinga R, Wolfers T, Berthet P, Mennes M, Andreassen OA, Westlye LT, Beckmann CF, Marquand AF. Closing the life-cycle of normative modeling using federated hierarchical Bayesian regression. PLoS One 2022; 17:e0278776. [PMID: 36480551 PMCID: PMC9731431 DOI: 10.1371/journal.pone.0278776] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/22/2022] [Indexed: 12/13/2022] Open
Abstract
Clinical neuroimaging data availability has grown substantially in the last decade, providing the potential for studying heterogeneity in clinical cohorts on a previously unprecedented scale. Normative modeling is an emerging statistical tool for dissecting heterogeneity in complex brain disorders. However, its application remains technically challenging due to medical data privacy issues and difficulties in dealing with nuisance variation, such as the variability in the image acquisition process. Here, we approach the problem of estimating a reference normative model across a massive population using a massive multi-center neuroimaging dataset. To this end, we introduce a federated probabilistic framework using hierarchical Bayesian regression (HBR) to complete the life-cycle of normative modeling. The proposed model provides the possibilities to learn, update, and adapt the model parameters on decentralized neuroimaging data. Our experimental results confirm the superiority of HBR in deriving more accurate normative ranges on large multi-site neuroimaging datasets compared to the current standard methods. In addition, our approach provides the possibility to recalibrate and reuse the learned model on local datasets and even on datasets with very small sample sizes. The proposed method will facilitate applications of normative modeling as a medical tool for screening the biological deviations in individuals affected by complex illnesses such as mental disorders.
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Affiliation(s)
- Seyed Mostafa Kia
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Hester Huijsdens
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Saige Rutherford
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Augustijn de Boer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Richard Dinga
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thomas Wolfers
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Pierre Berthet
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Maarten Mennes
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Ole A. Andreassen
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lars T. Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Christian F. Beckmann
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Centre for Functional MRI of the Brain, University of Oxford, Oxford, United Kingdom
| | - Andre F. Marquand
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
- Department for Cognitive Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Neuroimaging, Institute of Psychiatry, King’s College London, London, United Kingdom
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44
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Moonen JE, Nasrallah IM, Detre JA, Dolui S, Erus G, Davatzikos C, Meirelles O, Bryan NR, Launer LJ. Race, sex, and mid-life changes in brain health: Cardia MRI substudy. Alzheimers Dement 2022; 18:2428-2437. [PMID: 35142033 PMCID: PMC9360196 DOI: 10.1002/alz.12560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 09/20/2021] [Accepted: 12/03/2021] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To examine longitudinal race and sex differences in mid-life brain health and to evaluate whether cardiovascular health (CVH) or apolipoprotein E (APOE) ε4 explain differences. METHODS The study included 478 Black and White participants (mean age: 50 years). Total (TBV), gray (GMV), white (WMV), and white matter hyperintensity (WMH) volumes and GM-cerebral blood flow (CBF) were acquired with 3T-magnetic resonance imaging at baseline and 5-year follow-up. Analyses were based on general linear models. RESULTS There were race x sex interactions for GMV (P-interaction = .004) and CBF (P-interaction = .01) such that men showed more decline than women, and this was most evident in Blacks. Blacks compared to Whites had a significantly greater increase in WMH (P = .002). All sex-race differences in change were marginally attenuated by CVH and APOE ε4. CONCLUSION Race-sex differences in brain health emerge by mid-life. Identifying new environmental factors beyond CVH is needed to develop early interventions to maintain brain health.
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Affiliation(s)
- Justine E Moonen
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, LEPS/IRP/NIA/NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD 21224, USA, Tel: 410-558-8292
| | - Ilya M Nasrallah
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA 19104, US
| | - John A Detre
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA 19104, US
| | - Sudipto Dolui
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA 19104, US
| | - Guray Erus
- Department of Radiology, University of Pennsylvania Health System, Philadelphia, PA 19104, US
| | - Christos Davatzikos
- Center for Biomedical Image Computing and Analytics, Perelman School for advanced Medicine, 3400 Civic Center Boulevard Atrium, Ground Floor, Philadelphia, PA 19104, US
| | - Osorio Meirelles
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, LEPS/IRP/NIA/NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD 21224, USA, Tel: 410-558-8292
| | - Nick R Bryan
- Department of Radiology, University of Texas Medical Branch, 301 University Blvd, Galveston, TX 77555, Austin, US
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institute of Health, LEPS/IRP/NIA/NIH, 251 Bayview Blvd, Suite 100, Baltimore, MD 21224, USA, Tel: 410-558-8292
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45
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Brenowitz WD, Yaffe K. Observational studies in Alzheimer disease: bridging preclinical studies and clinical trials. Nat Rev Neurol 2022; 18:747-757. [PMID: 36316487 PMCID: PMC9894623 DOI: 10.1038/s41582-022-00733-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 11/29/2022]
Abstract
Recent high-profile failures of Alzheimer disease treatments at the clinical trial stage have led to renewed efforts to identify and test novel interventions for Alzheimer disease and related dementias (ADRD). In this Perspective, we highlight the importance of including well-designed observational studies as part of these efforts. Observational research is an important cornerstone for gathering evidence on risk factors and causes of ADRD; this evidence can then be combined with data from preclinical studies and randomized controlled trials to inform the development of effective interventions. Observational study designs can be particularly beneficial for hypothesis generation, posing questions that are unethical or impractical for a trial setting, studying life-course associations, research in populations typically not included in trials, and public health surveillance. Here, we discuss each of these situations in the specific context of ADRD research. We also highlight novel approaches to enhance causal inference and provide a timely discussion on how observational epidemiological studies help provide a bridge between preclinical studies and successful interventions for ADRD.
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Affiliation(s)
- Willa D Brenowitz
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Kristine Yaffe
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- San Francisco VA Medical Center, San Francisco, CA, USA.
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Kühn AL, Frenzel S, Teumer A, Wittfeld K, Garvert L, Weihs A, Homuth G, Prokisch H, Bülow R, Nauck M, Völker U, Völzke H, Grabe HJ, Van der Auwera S. TREML2 Gene Expression and Its Missense Variant rs3747742 Associate with White Matter Hyperintensity Volume and Alzheimer's Disease-Related Brain Atrophy in the General Population. Int J Mol Sci 2022; 23:ijms232213764. [PMID: 36430248 PMCID: PMC9692564 DOI: 10.3390/ijms232213764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/02/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022] Open
Abstract
Although the common pathology of Alzheimer's disease (AD) and white matter hyperintensities (WMH) is disputed, the gene TREML2 has been implicated in both conditions: its whole-blood gene expression was associated with WMH volume and its missense variant rs3747742 with AD risk. We re-examined those associations within one comprehensive dataset of the general population, additionally searched for cross-relations and illuminated the role of the apolipoprotein E (APOE) ε4 status in the associations. For our linear regression and linear mixed effect models, we used 1949 participants from the Study of Health in Pomerania (Germany). AD was assessed using a continuous pre-symptomatic MRI-based score evaluating a participant's AD-related brain atrophy. In our study, increased whole-blood TREML2 gene expression was significantly associated with reduced WMH volume but not with the AD score. Conversely, rs3747742-C was significantly associated with a reduced AD score but not with WMH volume. The APOE status did not influence the associations. In sum, TREML2 robustly associated with WMH volume and AD-related brain atrophy on different molecular levels. Our results thus underpin TREML2's role in neurodegeneration, might point to its involvement in AD and WMH via different biological mechanisms, and highlight TREML2 as a worthwhile target for disentangling the two pathologies.
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Affiliation(s)
- Annemarie Luise Kühn
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
- Correspondence: (A.L.K.); (S.V.d.A.)
| | - Stefan Frenzel
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Alexander Teumer
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Katharina Wittfeld
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Linda Garvert
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Antoine Weihs
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Holger Prokisch
- Institute of Human Genetics, Technical University Munich, 81675 Munich, Germany
- Institute of Neurogenomics, Helmholtz Zentrum München-German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Robin Bülow
- Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17475 Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475 Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475 Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 17475 Greifswald, Germany
| | - Hans Jörgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
| | - Sandra Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475 Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, 17489 Greifswald, Germany
- Correspondence: (A.L.K.); (S.V.d.A.)
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Sone D, Beheshti I. Neuroimaging-Based Brain Age Estimation: A Promising Personalized Biomarker in Neuropsychiatry. J Pers Med 2022; 12:jpm12111850. [PMID: 36579560 PMCID: PMC9695293 DOI: 10.3390/jpm12111850] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022] Open
Abstract
It is now possible to estimate an individual's brain age via brain scans and machine-learning models. This validated technique has opened up new avenues for addressing clinical questions in neurology, and, in this review, we summarize the many clinical applications of brain-age estimation in neuropsychiatry and general populations. We first provide an introduction to typical neuroimaging modalities, feature extraction methods, and machine-learning models that have been used to develop a brain-age estimation framework. We then focus on the significant findings of the brain-age estimation technique in the field of neuropsychiatry as well as the usefulness of the technique for addressing clinical questions in neuropsychiatry. These applications may contribute to more timely and targeted neuropsychiatric therapies. Last, we discuss the practical problems and challenges described in the literature and suggest some future research directions.
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Affiliation(s)
- Daichi Sone
- Department of Psychiatry, Jikei University School of Medicine, Tokyo 105-8461, Japan
- Correspondence: ; Tel.: +81-03-3433
| | - Iman Beheshti
- Department of Human Anatomy and Cell Science, University of Manitoba, Winnipeg, MB R3E 3P5, Canada
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Structural and Functional MRI Data Differentially Predict Chronological Age and Behavioral Memory Performance. eNeuro 2022; 9:9/6/ENEURO.0212-22.2022. [PMID: 36376083 PMCID: PMC9665883 DOI: 10.1523/eneuro.0212-22.2022] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Human cognitive abilities decline with increasing chronological age, with decreased explicit memory performance being most strongly affected. However, some older adults show "successful aging," that is, relatively preserved cognitive ability in old age. One explanation for this could be higher brain-structural integrity in these individuals. Alternatively, the brain might recruit existing resources more efficiently or employ compensatory cognitive strategies. Here, we approached this question by testing multiple candidate variables from structural and functional neuroimaging for their ability to predict chronological age and memory performance, respectively. Prediction was performed using support vector machine (SVM) classification and regression across and within two samples of young (N = 106) and older (N = 153) adults. The candidate variables were (1) behavioral response frequencies in an episodic memory test; (2) recently described functional magnetic resonance imaging (fMRI) scores reflecting preservation of functional memory networks; (3) whole-brain fMRI contrasts for novelty processing and subsequent memory; (4) resting-state fMRI maps quantifying voxel-wise signal fluctuation; and (5) gray matter volume estimated from structural MRIs. While age group could be reliably decoded from all variables, chronological age within young and older subjects was best predicted from gray matter volume. In contrast, memory performance was best predicted from task-based fMRI contrasts and particularly single-value fMRI scores, whereas gray matter volume has no predictive power with respect to memory performance in healthy adults. Our results suggest that superior memory performance in healthy older adults is better explained by efficient recruitment of memory networks rather than by preserved brain structure.
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Toledo JB, Rashid T, Liu H, Launer L, Shaw LM, Heckbert SR, Weiner M, Seshadri S, Habes M. SPARE-Tau: A flortaucipir machine-learning derived early predictor of cognitive decline. PLoS One 2022; 17:e0276392. [PMID: 36327215 PMCID: PMC9632811 DOI: 10.1371/journal.pone.0276392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/05/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Recently, tau PET tracers have shown strong associations with clinical outcomes in individuals with cognitive impairment and cognitively unremarkable elderly individuals. flortaucipir PET scans to measure tau deposition in multiple brain areas as the disease progresses. This information needs to be summarized to evaluate disease severity and predict disease progression. We, therefore, sought to develop a machine learning-derived index, SPARE-Tau, which successfully detects pathology in the earliest disease stages and accurately predicts progression compared to a priori-based region of interest approaches (ROI). METHODS 587 participants of the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort had flortaucipir scans, structural MRI scans, and an Aβ biomarker test (CSF or florbetapir PET) performed on the same visit. We derived the SPARE-Tau index in a subset of 367 participants. We evaluated associations with clinical measures for CSF p-tau, SPARE-MRI, and flortaucipir PET indices (SPARE-Tau, meta-temporal, and average Braak ROIs). Bootstrapped multivariate adaptive regression splines linear regression analyzed the association between the biomarkers and baseline ADAS-Cog13 scores. Bootstrapped multivariate linear regression models evaluated associations with clinical diagnosis. Cox-hazards and mixed-effects models investigated clinical progression and longitudinal ADAS-Cog13 changes. The Aβ positive cognitively unremarkable participants, not included in the SPARE-Tau training, served as an independent validation group. RESULTS Compared to CSF p-tau, meta-temporal, and averaged Braak tau PET ROIs, SPARE-Tau showed the strongest association with baseline ADAS-cog13 scores and diagnosis. SPARE-Tau also presented the strongest association with clinical progression in cognitively unremarkable participants and longitudinal ADAS-Cog13 changes. Results were confirmed in the Aβ+ cognitively unremarkable hold-out sample participants. CSF p-tau showed the weakest cross-sectional associations and longitudinal prediction. DISCUSSION Flortaucipir indices showed the strongest clinical association among the studied biomarkers (flortaucipir, florbetapir, structural MRI, and CSF p-tau) and were predictive in the preclinical disease stages. Among the flortaucipir indices, the machine-learning derived SPARE-Tau index was the most sensitive clinical progression biomarker. The combination of different biomarker modalities better predicted cognitive performance.
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Affiliation(s)
- Jon B. Toledo
- Department of Neurology, University of Florida College of Medicine, Gainesville, Florida, United States of America
- Department of Neurology Houston Methodist Hospital, Houston, Texas, United States of America
| | - Tanweer Rashid
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, Texas, United States of America
| | - Hangfan Liu
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, Texas, United States of America
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, Bethesda, Maryland, United States of America
| | - Leslie M. Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Susan R. Heckbert
- Department of Epidemiology and Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, United States of America
| | - Michael Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, California, United States of America
- Department of Radiology, University of California, San Francisco, California, United States of America
- Department of Medicine, University of California, San Francisco, California, United States of America
- Department of Psychiatry, University of California, San Francisco, California, United States of America
- Department of Neurology, University of California, San Francisco, California, United States of America
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, United States of America
| | - Mohamad Habes
- Neuroimage Analytics Laboratory (NAL) and the Biggs Institute Neuroimaging Core (BINC), Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health Science Center San Antonio (UTHSCSA), San Antonio, Texas, United States of America
- Center for Biomedical Image Computing and Analytics (CBICA), University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, United States of America
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50
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Bayer JMM, Thompson PM, Ching CRK, Liu M, Chen A, Panzenhagen AC, Jahanshad N, Marquand A, Schmaal L, Sämann PG. Site effects how-to and when: An overview of retrospective techniques to accommodate site effects in multi-site neuroimaging analyses. Front Neurol 2022; 13:923988. [PMID: 36388214 PMCID: PMC9661923 DOI: 10.3389/fneur.2022.923988] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/12/2022] [Indexed: 09/12/2023] Open
Abstract
Site differences, or systematic differences in feature distributions across multiple data-acquisition sites, are a known source of heterogeneity that may adversely affect large-scale meta- and mega-analyses of independently collected neuroimaging data. They influence nearly all multi-site imaging modalities and biomarkers, and methods to compensate for them can improve reliability and generalizability in the analysis of genetics, omics, and clinical data. The origins of statistical site effects are complex and involve both technical differences (scanner vendor, head coil, acquisition parameters, imaging processing) and differences in sample characteristics (inclusion/exclusion criteria, sample size, ancestry) between sites. In an age of expanding international consortium research, there is a growing need to disentangle technical site effects from sample characteristics of interest. Numerous statistical and machine learning methods have been developed to control for, model, or attenuate site effects - yet to date, no comprehensive review has discussed the benefits and drawbacks of each for different use cases. Here, we provide an overview of the different existing statistical and machine learning methods developed to remove unwanted site effects from independently collected neuroimaging samples. We focus on linear mixed effect models, the ComBat technique and its variants, adjustments based on image quality metrics, normative modeling, and deep learning approaches such as generative adversarial networks. For each method, we outline the statistical foundation and summarize strengths and weaknesses, including their assumptions and conditions of use. We provide information on software availability and comment on the ease of use and the applicability of these methods to different types of data. We discuss validation and comparative reports, mention caveats and provide guidance on when to use each method, depending on context and specific research questions.
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Affiliation(s)
- Johanna M. M. Bayer
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Paul M. Thompson
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States
| | - Christopher R. K. Ching
- Imaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA, United States
| | - Mengting Liu
- School of Biomedical Engineering, Sun Yat-sen University, Shenzhen, China
| | - Andrew Chen
- Department of Biostatistics, Epidemiology, and Informatics, Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia, PA, United States
- Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia, PA, United States
| | - Alana C. Panzenhagen
- Programa de Pós-graduação em Ciências Biológicas: Bioquímica, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Department of Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Neda Jahanshad
- Laboratory of Brain eScience, Mark and Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Marina del Rey, CA, United States
| | - Andre Marquand
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboudumc, Nijmegen, Netherlands
| | - Lianne Schmaal
- Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
- Orygen, Parkville, VIC, Australia
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