1
|
Gonzalez-Gomez R, Legaz A, Moguilner S, Cruzat J, Hernández H, Baez S, Cocchi R, Coronel-Olivero C, Medel V, Tagliazuchi E, Migeot J, Ochoa-Rosales C, Maito MA, Reyes P, Santamaria Garcia H, Godoy ME, Javandel S, García AM, Matallana DL, Avila-Funes JA, Slachevsky A, Behrens MI, Custodio N, Cardona JF, Brusco IL, Bruno MA, Sosa Ortiz AL, Pina-Escudero SD, Takada LT, Resende EDPF, Valcour V, Possin KL, Okada de Oliveira M, Lopera F, Lawlor B, Hu K, Miller B, Yokoyama JS, Gonzalez Campo C, Ibañez A. Educational disparities in brain health and dementia across Latin America and the United States. Alzheimers Dement 2024. [PMID: 39136296 DOI: 10.1002/alz.14085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/09/2024] [Accepted: 05/09/2024] [Indexed: 08/22/2024]
Abstract
BACKGROUND Education influences brain health and dementia. However, its impact across regions, specifically Latin America (LA) and the United States (US), is unknown. METHODS A total of 1412 participants comprising controls, patients with Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD) from LA and the US were included. We studied the association of education with brain volume and functional connectivity while controlling for imaging quality and variability, age, sex, total intracranial volume (TIV), and recording type. RESULTS Education influenced brain measures, explaining 24%-98% of the geographical differences. The educational disparities between LA and the US were associated with gray matter volume and connectivity variations, especially in LA and AD patients. Education emerged as a critical factor in classifying aging and dementia across regions. DISCUSSION The results underscore the impact of education on brain structure and function in LA, highlighting the importance of incorporating educational factors into diagnosing, care, and prevention, and emphasizing the need for global diversity in research. HIGHLIGHTS Lower education was linked to reduced brain volume and connectivity in healthy controls (HCs), Alzheimer's disease (AD), and frontotemporal lobar degeneration (FTLD). Latin American cohorts have lower educational levels compared to the those in the United States. Educational disparities majorly drive brain health differences between regions. Educational differences were significant in both conditions, but more in AD than FTLD. Education stands as a critical factor in classifying aging and dementia across regions.
Collapse
Affiliation(s)
- Raul Gonzalez-Gomez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Center for Social and Cognitive Neuroscience, School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile
| | - Agustina Legaz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Sebastián Moguilner
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Department of Neurology, Harvard Medical School, Boston, Massachusetts, USA
| | - Josephine Cruzat
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Hernán Hernández
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Sandra Baez
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Universidad de los Andes, Bogotá, D.C., Colombia
| | - Rafael Cocchi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Carlos Coronel-Olivero
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Valparaíso, Chile
| | - Vicente Medel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Enzo Tagliazuchi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Departamento de Física, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Instituto de Física de Buenos Aires (FIBA -CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Carolina Ochoa-Rosales
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
| | - Marcelo Adrián Maito
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Pablo Reyes
- Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
| | - Hernando Santamaria Garcia
- Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
- Center for Memory and Cognition, Hospital Universitario San Ignacio Bogotá, San Ignacio, Bogotá D.C., Colombia
| | - Maria E Godoy
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Shireen Javandel
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Adolfo M García
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile
| | - Diana L Matallana
- Instituto de Envejecimiento, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá D.C., Colombia
- Center for Memory and Cognition, Hospital Universitario San Ignacio Bogotá, San Ignacio, Bogotá D.C., Colombia
| | - José Alberto Avila-Funes
- Dirección de Enseñanza, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Ciudad de México, D.C., México
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Neurology Department, Hospital del Salvador & Faculty of Medicine, University of Chile, Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Program - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, University of Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
| | - María I Behrens
- Faculty of Medicine, University of Chile, Santiago, Chile
- Centro de Investigación Clínica Avanzada (CICA), Universidad de Chile, Santiago, Chile
| | - Nilton Custodio
- Unit Cognitive Impairment and Dementia Prevention, Peruvian Institute of Neurosciences, Lima, Peru
| | - Juan F Cardona
- Facultad de Psicología, Universidad del Valle, Cali, Colombia
| | - Ignacio L Brusco
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Buenos Aires, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Martín A Bruno
- Instituto de Ciencias Biomédicas, Universidad Católica de Cuyo, San Juan, Argentina
| | - Ana L Sosa Ortiz
- Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, D.C., México
| | - Stefanie D Pina-Escudero
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | | | - Elisa de Paula França Resende
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Victor Valcour
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Katherine L Possin
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Maira Okada de Oliveira
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Cognitive Neurology and Behavioral Unit (GNCC), University of São Paulo, São Paulo, Brazil
| | - Francisco Lopera
- Neurosicence Research Group (GNA), Universidad de Antioquia, Medellín, Antioquia, Colombia
| | - Brian Lawlor
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Kun Hu
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Bruce Miller
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Jennifer S Yokoyama
- Global Brain Health Institute, University of California, San Francisco, California, USA
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, California, USA
| | - Cecilia Gonzalez Campo
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
| | - Agustin Ibañez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago, Chile
- Cognitive Neuroscience Center, Universidad de San Andrés, Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, University of California, San Francisco, California, USA
| |
Collapse
|
3
|
Yu SP, Jiang MQ, Shim SS, Pourkhodadad S, Wei L. Extrasynaptic NMDA receptors in acute and chronic excitotoxicity: implications for preventive treatments of ischemic stroke and late-onset Alzheimer's disease. Mol Neurodegener 2023; 18:43. [PMID: 37400870 DOI: 10.1186/s13024-023-00636-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 06/01/2023] [Indexed: 07/05/2023] Open
Abstract
Stroke and late-onset Alzheimer's disease (AD) are risk factors for each other; the comorbidity of these brain disorders in aging individuals represents a significant challenge in basic research and clinical practice. The similarities and differences between stroke and AD in terms of pathogenesis and pathophysiology, however, have rarely been comparably reviewed. Here, we discuss the research background and recent progresses that are important and informative for the comorbidity of stroke and late-onset AD and related dementia (ADRD). Glutamatergic NMDA receptor (NMDAR) activity and NMDAR-mediated Ca2+ influx are essential for neuronal function and cell survival. An ischemic insult, however, can cause rapid increases in glutamate concentration and excessive activation of NMDARs, leading to swift Ca2+ overload in neuronal cells and acute excitotoxicity within hours and days. On the other hand, mild upregulation of NMDAR activity, commonly seen in AD animal models and patients, is not immediately cytotoxic. Sustained NMDAR hyperactivity and Ca2+ dysregulation lasting from months to years, nevertheless, can be pathogenic for slowly evolving events, i.e. degenerative excitotoxicity, in the development of AD/ADRD. Specifically, Ca2+ influx mediated by extrasynaptic NMDARs (eNMDARs) and a downstream pathway mediated by transient receptor potential cation channel subfamily M member (TRPM) are primarily responsible for excitotoxicity. On the other hand, the NMDAR subunit GluN3A plays a "gatekeeper" role in NMDAR activity and a neuroprotective role against both acute and chronic excitotoxicity. Thus, ischemic stroke and AD share an NMDAR- and Ca2+-mediated pathogenic mechanism that provides a common receptor target for preventive and possibly disease-modifying therapies. Memantine (MEM) preferentially blocks eNMDARs and was approved by the Federal Drug Administration (FDA) for symptomatic treatment of moderate-to-severe AD with variable efficacy. According to the pathogenic role of eNMDARs, it is conceivable that MEM and other eNMDAR antagonists should be administered much earlier, preferably during the presymptomatic phases of AD/ADRD. This anti-AD treatment could simultaneously serve as a preconditioning strategy against stroke that attacks ≥ 50% of AD patients. Future research on the regulation of NMDARs, enduring control of eNMDARs, Ca2+ homeostasis, and downstream events will provide a promising opportunity to understand and treat the comorbidity of AD/ADRD and stroke.
Collapse
Affiliation(s)
- Shan P Yu
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30322, USA.
- Center for Visual & Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, 30033, USA.
| | - Michael Q Jiang
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Center for Visual & Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, 30033, USA
| | - Seong S Shim
- Center for Visual & Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, 30033, USA
| | - Soheila Pourkhodadad
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30322, USA
- Center for Visual & Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, GA, 30033, USA
| | - Ling Wei
- Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA, 30322, USA.
| |
Collapse
|
4
|
Dubé L, Silveira PP, Nielsen DE, Moore S, Paquet C, Cisneros-Franco JM, Kemp G, Knauper B, Ma Y, Khan M, Bartlett-Esquilant G, Evans AC, Fellows LK, Armony JL, Spreng RN, Nie JY, Brown ST, Northoff G, Bzdok D. From Precision Medicine to Precision Convergence for Multilevel Resilience-The Aging Brain and Its Social Isolation. Front Public Health 2022; 10:720117. [PMID: 35865245 PMCID: PMC9294141 DOI: 10.3389/fpubh.2022.720117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laurette Dubé
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Patricia P Silveira
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Daiva E Nielsen
- Faculty of Agricultural and Environmental Sciences, School of Human Nutrition, McGill University, Montreal, QC, Canada
| | - Spencer Moore
- Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Catherine Paquet
- Faculté des Sciences de l'Administration, Université Laval, Quebec City, QC, Canada
| | - J Miguel Cisneros-Franco
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Gina Kemp
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada.,Centre for Research in Neuroscience, The Research Institute of McGill University Health Center, Montreal, QC, Canada
| | - Bärbel Knauper
- Department of Psychology, Faculty of Arts, McGill University, Montreal, QC, Canada
| | - Yu Ma
- Desautels Faculty of Management, McGill Center for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Mehmood Khan
- Life Biosciences Chief Executive Officer (CEO), Boston, MA, United States.,Council on Competitiveness (Chairman of the Board), Washington, DC, United States
| | | | - Alan C Evans
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Lesley K Fellows
- Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.,Chronic Mental Illness Service, Montreal Neurological Institute, Montreal, QC, Canada
| | - Jorge L Armony
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada
| | - R Nathan Spreng
- Laboratory of Brain and Cognition, Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.,Douglas Mental Health University Institute, Montreal, QC, Canada.,Departments of Psychiatry and Psychology, McGill University, Montreal, QC, Canada.,McConnell Brain Imaging Centre, McGill University, Montreal, QC, Canada
| | - Jian-Yun Nie
- Department of Computer Science and Operations Research, University of Montreal, Montreal, QC, Canada
| | - Shawn T Brown
- Pittsburgh Supercomputing Center, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Georg Northoff
- Chronic Mental Illness Service, Montreal Neurological Institute, Montreal, QC, Canada.,Faculty of Medicine, Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McConnell Brain Imaging Centre (BIC), Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada.,Mila-Quebec Artificial Intelligence Institute, Montreal, QC, Canada
| |
Collapse
|