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Ji X, Peng X, Tang H, Pan H, Wang W, Wu J, Chen J, Wei N. Alzheimer's disease phenotype based upon the carrier status of the apolipoprotein E ɛ4 allele. Brain Pathol 2024; 34:e13208. [PMID: 37646624 PMCID: PMC10711266 DOI: 10.1111/bpa.13208] [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: 12/06/2022] [Accepted: 08/05/2023] [Indexed: 09/01/2023] Open
Abstract
The apolipoprotein E ɛ4 allele (APOE4) is universally acknowledged as the most potent genetic risk factor for Alzheimer's disease (AD). APOE4 promotes the initiation and progression of AD. Although the underlying mechanisms are unclearly understood, differences in lipid-bound affinity among the three APOE isoforms may constitute the basis. The protein APOE4 isoform has a high affinity with triglycerides and cholesterol. A distinction in lipid metabolism extensively impacts neurons, microglia, and astrocytes. APOE4 carriers exhibit phenotypic differences from non-carriers in clinical examinations and respond differently to multiple treatments. Therefore, we hypothesized that phenotypic classification of AD patients according to the status of APOE4 carrier will help specify research and promote its use in diagnosing and treating AD. Recent reviews have mainly evaluated the differences between APOE4 allele carriers and non-carriers from gene to protein structures, clinical features, neuroimaging, pathology, the neural network, and the response to various treatments, and have provided the feasibility of phenotypic group classification based on APOE4 carrier status. This review will facilitate the application of APOE phenomics concept in clinical practice and promote further medical research on AD.
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Affiliation(s)
- Xiao‐Yu Ji
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
- Brain Function and Disease LaboratoryShantou University Medical CollegeGuangdongChina
| | - Xin‐Yuan Peng
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
| | - Hai‐Liang Tang
- Fudan University Huashan Hospital, Department of Neurosurgery, State Key Laboratory for Medical NeurobiologyInstitutes of Brain Science, Shanghai Medical College‐Fudan UniversityShanghaiChina
| | - Hui Pan
- Shantou Longhu People's HospitalShantouGuangdongChina
| | - Wei‐Tang Wang
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
| | - Jie Wu
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
- Brain Function and Disease LaboratoryShantou University Medical CollegeGuangdongChina
| | - Jian Chen
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
| | - Nai‐Li Wei
- Department of NeurosurgeryThe First Affiliated Hospital of Shantou University Medical CollegeGuangdongChina
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Smith AE, Chau A, Greaves D, Keage HAD, Feuerriegel D. Resting EEG power spectra across middle to late life: associations with age, cognition, APOE-ɛ4 carriage, and cardiometabolic burden. Neurobiol Aging 2023; 130:93-102. [PMID: 37494844 DOI: 10.1016/j.neurobiolaging.2023.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 05/25/2023] [Accepted: 06/03/2023] [Indexed: 07/28/2023]
Abstract
We investigated how resting electroencephalography (EEG) measures are associated with risk factors for late-life cognitive impairment and dementia, including age, apolipoprotein E ɛ4 (APOE-ɛ4) carriage, and cardiometabolic burden. Resting EEG was recorded from 86 adults (50-80 years of age). Participants additionally completed the Addenbrooke's Cognitive Examination (ACE) III and had blood drawn to assess APOE-ɛ4 carriage status and cardiometabolic burden. EEG power spectra were decomposed into sources of periodic and aperiodic activity to derive measures of aperiodic component slope and alpha (7-14 Hz) and beta (15-30 Hz) peak power and peak frequency. Alpha and beta peak power measures were corrected for aperiodic activity. The aperiodic component slope was correlated with ACE-III scores but not age. Alpha peak frequency decreased with age. Individuals with higher cardiometabolic burden had lower alpha peak frequencies and lower beta peak power. APOE-ɛ4 carriers had lower beta peak frequencies. Our findings suggest that the slope of the aperiodic component of resting EEG power spectra is more closely associated with measures of cognitive performance rather than chronological age in older adults.
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Affiliation(s)
- Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Anson Chau
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Medical Radiation Science, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Danielle Greaves
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia; Cognitive Ageing and Impairment Neurosciences (CAIN), Justice and Society, University of South Australia, Adelaide, South Australia, Australia; UniSA Online, University of South Australia, Adelaide, South Australia, Australia
| | - Hannah A D Keage
- Cognitive Ageing and Impairment Neurosciences (CAIN), Justice and Society, University of South Australia, Adelaide, South Australia, Australia
| | - Daniel Feuerriegel
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
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Chu KT, Lei WC, Wu MH, Fuh JL, Wang SJ, French IT, Chang WS, Chang CF, Huang NE, Liang WK, Juan CH. A holo-spectral EEG analysis provides an early detection of cognitive decline and predicts the progression to Alzheimer's disease. Front Aging Neurosci 2023; 15:1195424. [PMID: 37674782 PMCID: PMC10477374 DOI: 10.3389/fnagi.2023.1195424] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 07/25/2023] [Indexed: 09/08/2023] Open
Abstract
Aims Our aim was to differentiate patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) from cognitively normal (CN) individuals and predict the progression from MCI to AD within a 3-year longitudinal follow-up. A newly developed Holo-Hilbert Spectral Analysis (HHSA) was applied to resting state EEG (rsEEG), and features were extracted and subjected to machine learning algorithms. Methods A total of 205 participants were recruited from three hospitals, with CN (n = 51, MMSE > 26), MCI (n = 42, CDR = 0.5, MMSE ≥ 25), AD1 (n = 61, CDR = 1, MMSE < 25), AD2 (n = 35, CDR = 2, MMSE < 16), and AD3 (n = 16, CDR = 3, MMSE < 16). rsEEG was also acquired from all subjects. Seventy-two MCI patients (CDR = 0.5) were longitudinally followed up with two rsEEG recordings within 3 years and further subdivided into an MCI-stable group (MCI-S, n = 36) and an MCI-converted group (MCI-C, n = 36). The HHSA was then applied to the rsEEG data, and features were extracted and subjected to machine-learning algorithms. Results (a) At the group level analysis, the HHSA contrast of MCI and different stages of AD showed augmented amplitude modulation (AM) power of lower-frequency oscillations (LFO; delta and theta bands) with attenuated AM power of higher-frequency oscillations (HFO; beta and gamma bands) compared with cognitively normal elderly controls. The alpha frequency oscillation showed augmented AM power across MCI to AD1 with a reverse trend at AD2. (b) At the individual level of cross-sectional analysis, implementation of machine learning algorithms discriminated between groups with good sensitivity (Sen) and specificity (Spec) as follows: CN elderly vs. MCI: 0.82 (Sen)/0.80 (Spec), CN vs. AD1: 0.94 (Sen)/0.80 (Spec), CN vs. AD2: 0.93 (Sen)/0.90 (Spec), and CN vs. AD3: 0.75 (Sen)/1.00 (Spec). (c) In the longitudinal MCI follow-up, the initial contrasted HHSA between MCI-S and MCI-C groups showed significantly attenuated AM power of alpha and beta band oscillations. (d) At the individual level analysis of longitudinal MCI groups, deploying machine learning algorithms with the best seven features resulted in a sensitivity of 0.9 by the support vector machine (SVM) classifier, with a specificity of 0.8 yielded by the decision tree classifier. Conclusion Integrating HHSA into EEG signals and machine learning algorithms can differentiate between CN and MCI as well as also predict AD progression at the MCI stage.
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Affiliation(s)
- Kwo-Ta Chu
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Yang-Ming Hospital, Taoyuan, Taiwan
| | - Weng-Chi Lei
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan, Taiwan
| | - Ming-Hsiu Wu
- Division of Neurology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan
- Department of Long-Term Care and Health Promotion, Min-Hwei Junior College of Health Care Management, Tainan, Taiwan
| | - Jong-Ling Fuh
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shuu-Jiun Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Isobel T. French
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Taiwan International Graduate Program in Interdisciplinary Neuroscience, National Central University and Academia Sinica, Taipei, Taiwan
| | - Wen-Sheng Chang
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
| | - Chi-Fu Chang
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
| | - Norden E. Huang
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan, Taiwan
- Key Laboratory of Data Analysis and Applications, First Institute of Oceanography, SOA, Qingdao, China
| | - Wei-Kuang Liang
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Cognitive Intelligence and Precision Healthcare Center, National Central University, Taoyuan, Taiwan
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
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Berger M, Ryu D, Reese M, McGuigan S, Evered LA, Price CC, Scott DA, Westover MB, Eckenhoff R, Bonanni L, Sweeney A, Babiloni C. A Real-Time Neurophysiologic Stress Test for the Aging Brain: Novel Perioperative and ICU Applications of EEG in Older Surgical Patients. Neurotherapeutics 2023; 20:975-1000. [PMID: 37436580 PMCID: PMC10457272 DOI: 10.1007/s13311-023-01401-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/13/2023] Open
Abstract
As of 2022, individuals age 65 and older represent approximately 10% of the global population [1], and older adults make up more than one third of anesthesia and surgical cases in developed countries [2, 3]. With approximately > 234 million major surgical procedures performed annually worldwide [4], this suggests that > 70 million surgeries are performed on older adults across the globe each year. The most common postoperative complications seen in these older surgical patients are perioperative neurocognitive disorders including postoperative delirium, which are associated with an increased risk for mortality [5], greater economic burden [6, 7], and greater risk for developing long-term cognitive decline [8] such as Alzheimer's disease and/or related dementias (ADRD). Thus, anesthesia, surgery, and postoperative hospitalization have been viewed as a biological "stress test" for the aging brain, in which postoperative delirium indicates a failed stress test and consequent risk for later cognitive decline (see Fig. 3). Further, it has been hypothesized that interventions that prevent postoperative delirium might reduce the risk of long-term cognitive decline. Recent advances suggest that rather than waiting for the development of postoperative delirium to indicate whether a patient "passed" or "failed" this stress test, the status of the brain can be monitored in real-time via electroencephalography (EEG) in the perioperative period. Beyond the traditional intraoperative use of EEG monitoring for anesthetic titration, perioperative EEG may be a viable tool for identifying waveforms indicative of reduced brain integrity and potential risk for postoperative delirium and long-term cognitive decline. In principle, research incorporating routine perioperative EEG monitoring may provide insight into neuronal patterns of dysfunction associated with risk of postoperative delirium, long-term cognitive decline, or even specific types of aging-related neurodegenerative disease pathology. This research would accelerate our understanding of which waveforms or neuronal patterns necessitate diagnostic workup and intervention in the perioperative period, which could potentially reduce postoperative delirium and/or dementia risk. Thus, here we present recommendations for the use of perioperative EEG as a "predictor" of delirium and perioperative cognitive decline in older surgical patients.
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Affiliation(s)
- Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Duke South Orange Zone Room 4315B, Box 3094, Durham, NC, 27710, USA.
- Duke Aging Center, Duke University Medical Center, Durham, NC, USA.
- Duke/UNC Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC, USA.
| | - David Ryu
- School of Medicine, Duke University, Durham, NC, USA
| | - Melody Reese
- Department of Anesthesiology, Duke University Medical Center, Duke South Orange Zone Room 4315B, Box 3094, Durham, NC, 27710, USA
- Duke Aging Center, Duke University Medical Center, Durham, NC, USA
| | - Steven McGuigan
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
| | - Lisbeth A Evered
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
- Weill Cornell Medicine, New York, NY, USA
| | - Catherine C Price
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Norman Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL, USA
| | - David A Scott
- Department of Anaesthesia and Acute Pain Medicine, St Vincent's Hospital, Melbourne, VIC, Australia
- Department of Critical Care, School of Medicine, University of Melbourne, Melbourne, Australia
| | - M Brandon Westover
- Department of Neurology, Beth Israel Deaconess Hospital, Boston, MA, USA
| | - Roderic Eckenhoff
- Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Bonanni
- Department of Medicine and Aging Sciences, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Aoife Sweeney
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
- San Raffaele of Cassino, Cassino, FR, Italy
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Ponomareva NV, Andreeva TV, Protasova MS, Kunizheva SS, Kuznetsova IL, Kolesnikova EP, Malina DD, Mitrofanov AA, Fokin VF, Illarioshkin SN, Rogaev EI. Neuronal Hyperactivation in EEG Data during Cognitive Tasks Is Related to the Apolipoprotein J/Clusterin Genotype in Nondemented Adults. Int J Mol Sci 2023; 24:6790. [PMID: 37047762 PMCID: PMC10095572 DOI: 10.3390/ijms24076790] [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: 12/26/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/08/2023] Open
Abstract
The clusterin (CLU) rs11136000 CC genotype is a probable risk factor for Alzheimer's disease (AD). CLU, also known as the apolipoprotein J gene, shares certain properties with the apolipoprotein E (APOE) gene with a well-established relationship with AD. This study aimed to determine whether the electrophysiological patterns of brain activation during the letter fluency task (LFT) depend on CLU genotypes in adults without dementia. Previous studies have shown that LFT performance involves activation of the frontal cortex. We examined EEG alpha1 and alpha2 band desynchronization in the frontal regions during the LFT in 94 nondemented individuals stratified by CLU (rs11136000) genotype. Starting at 30 years of age, CLU CC carriers exhibited more pronounced task-related alpha2 desynchronization than CLU CT&TT carriers in the absence of any differences in LFT performance. In CLU CC carriers, alpha2 desynchronization was significantly correlated with age. Increased task-related activation in individuals at genetic risk for AD may reflect greater "effort" to perform the task and/or neuronal hyperexcitability. The results show that the CLU genotype is associated with neuronal hyperactivation in the frontal cortex during cognitive tasks performances in nondemented individuals, suggesting systematic vulnerability of LFT related cognitive networks in people carrying unfavorable CLU alleles.
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Affiliation(s)
- Natalya V. Ponomareva
- Research Center of Neurology, 125367 Moscow, Russia
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
| | - Tatiana V. Andreeva
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
- Centre for Genetics and Genetic Technologies, Faculty of Biology, Lomonosov Moscow State University, 119192 Moscow, Russia
| | - Maria S. Protasova
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Svetlana S. Kunizheva
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Irina L. Kuznetsova
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences, 119991 Moscow, Russia
| | | | | | | | | | | | - Evgeny I. Rogaev
- Center for Genetics and Life Science, Sirius University of Science and Technology, 354349 Sochi, Russia
- Department of Psychiatry, Umass Chan Medical School, Shrewsbury, MA 01545, USA
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Liu M, Liu B, Ye Z, Wu D. Bibliometric analysis of electroencephalogram research in mild cognitive impairment from 2005 to 2022. Front Neurosci 2023; 17:1128851. [PMID: 37021134 PMCID: PMC10067679 DOI: 10.3389/fnins.2023.1128851] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/06/2023] [Indexed: 03/22/2023] Open
Abstract
BackgroundElectroencephalogram (EEG), one of the most commonly used non-invasive neurophysiological examination techniques, advanced rapidly between 2005 and 2022, particularly when it was used for the diagnosis and prognosis of mild cognitive impairment (MCI). This study used a bibliometric approach to synthesize the knowledge structure and cutting-edge hotspots of EEG application in the MCI.MethodsRelated publications in the Web of Science Core Collection (WosCC) were retrieved from inception to 30 September 2022. CiteSpace, VOSviewer, and HistCite software were employed to perform bibliographic and visualization analyses.ResultsBetween 2005 and 2022, 2,905 studies related to the application of EEG in MCI were investigated. The United States had the highest number of publications and was at the top of the list of international collaborations. In terms of total number of articles, IRCCS San Raffaele Pisana ranked first among institutions. The Clinical Neurophysiology published the greatest number of articles. The author with the highest citations was Babiloni C. In descending order of frequency, keywords with the highest frequency were “EEG,” “mild cognitive impairment,” and “Alzheimer’s disease”.ConclusionThe application of EEG in MCI was investigated using bibliographic analysis. The research emphasis has shifted from examining local brain lesions with EEG to neural network mechanisms. The paradigm of big data and intelligent analysis is becoming more relevant in EEG analytical methods. The use of EEG to link MCI to other related neurological disorders, and to evaluate new targets for diagnosis and treatment, has become a new research trend. The above-mentioned findings have implications in the future research on the application of EEG in MCI.
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Affiliation(s)
- Mingrui Liu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baohu Liu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zelin Ye
- Department of Cardiovascular, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- *Correspondence: Dongyu Wu,
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Zeng H, Fang X, Zhao Y, Wu J, Li M, Zheng H, Xu F, Pan D, Dai G. EMCI: A Novel EEG-Based Mental Workload Assessment Index of Mild Cognitive Impairment. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2022; 16:902-914. [PMID: 35951572 DOI: 10.1109/tbcas.2022.3198265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As aging deepens, early detection of mild cognitive impairment (MCI) is increasingly important to prevent Alzheimer Dementia (AD) and improve the quality of life of older adults. In recent years, a large number of studies focus on the abnormal brain cognitive function of MCI, while ignoring the quantitative evaluation of MCI's mental workload. In this study, we propose a workload index for MCI screening, named EMCI, which is a linear discriminant cumulative estimate of subjects' electroencephalography (EEG) power spectra in α and β rhythms. Then, we design a matched prototype system to verify the effectiveness of EMCI. The results show that the EMCI is sensitive to changes of subjects' mental workload, and is significantly lower in MCI than in HC (Health control), which may be precisely caused by cognitive dysfunction. The proposed EMCI index can be used for online assessment of mental workload in older adults, which can help achieve quick screening of MCI and provide a critical window for clinical treatment interventions.
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Hidisoglu E, Kantar D, Ozdemir S, Yargicoglu P. Cognitive dysfunctions and spontaneous EEG alterations induced by hippocampal amyloid pathology in rats. Adv Med Sci 2022; 67:328-337. [PMID: 36058175 DOI: 10.1016/j.advms.2022.08.003] [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: 03/19/2022] [Revised: 06/13/2022] [Accepted: 08/17/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE We aimed to determine the effects of different doses of amyloid-beta (Aβ) peptide on learning and memory, and whether the changes in brain oscillations induced by dose-dependent accumulation of Aβ could be used as biomarkers to detect early stages of Alzheimer's disease (AD). MATERIAL AND METHODS Male albino Wistar rats aged 3 months were randomly divided into four groups (n = 12/group) obtained by i. h. Injection (to the dorsal hippocampus) of saline or different doses of 0.01 μg/μl, 0.1 μg/μl, and 1 μg/μl of Aβ. After two weeks of recovery period, open field and novel object recognition tests were performed and spontaneous EEG recordings were obtained. Later, hippocampus tissues were collected for Western blot and ELISA analysis. RESULTS A significant decrement in recognition memory was observed in 0.1 μg/μl, and 1 μg/μl injected groups. In addition, Aβ accumulation induced significant decrement of the expression of NeuN, SNAP-25, SYP, and PSD-95 proteins, and led to the increment of GFAP expression in hippocampus. Moreover, we detected remarkable alterations in spontaneous brain activity. The hippocampal Aβ levels were negatively correlated with hippocampal gamma power and positively correlated with hippocampal theta power. Also, we observed significant changes in coherence values, indicating the functional connectivity between different brain regions, after the accumulation of Aβ. Especially, there was a significant correlation between changes in frontohippocampal theta coherence and in frontotemporal theta coherence. CONCLUSIONS Our findings indicate that Aβ peptide induces AD-like molecular changes at certain doses, and these changes could be detected by evaluating brain oscillations.
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Affiliation(s)
- Enis Hidisoglu
- Department of Drug Science and Technology, Turin University, Corso Raffaello 30, 10125, Torino, Italy; Akdeniz University Faculty of Medicine Department of Biophysics, Antalya, Turkey.
| | - Deniz Kantar
- Akdeniz University Faculty of Medicine Department of Biophysics, Antalya, Turkey
| | - Semir Ozdemir
- Akdeniz University Faculty of Medicine Department of Biophysics, Antalya, Turkey
| | - Piraye Yargicoglu
- Akdeniz University Faculty of Medicine Department of Biophysics, Antalya, Turkey
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Bourdès V, Dogterom P, Aleman A, Parmantier P, Colas D, Lemarchant S, Marie S, Chou T, Abd-Elaziz K, Godfrin Y. Safety, Tolerability, Pharmacokinetics and Initial Pharmacodynamics of a Subcommissural Organ-Spondin-Derived Peptide: A Randomized, Placebo-Controlled, Double-Blind, Single Ascending Dose First-in-Human Study. Neurol Ther 2022; 11:1353-1374. [PMID: 35779189 PMCID: PMC9338184 DOI: 10.1007/s40120-022-00380-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 06/08/2022] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION This randomized, double-blind, placebo-controlled study in healthy volunteers assessed the safety, tolerability, and pharmacokinetics of single ascending doses of intravenously administered NX210-a linear peptide derived from subcommissural organ-spondin-and explored the effects on blood/urine biomarkers and cerebral activity. METHODS Participants in five cohorts (n = 8 each) were randomized to receive a single intravenous dose of NX210 (n = 6 each) (0.4, 1.25, 2.5, 5, and 10 mg/kg) or placebo (n = 2 each); in total, 10 and 29 participants received placebo and NX210, respectively. Blood samples were collected for pharmacokinetics within 180 min post dosing. Plasma and urine were collected from participants (cohorts: 2.5, 5, and 10 mg/kg) for biomarker analysis and electroencephalography (EEG) recordings within 48 h post dosing. Safety/tolerability and pharmacokinetic data were assessed before ascending to the next dose. RESULTS The study included 39 participants. All dosages were safe and well tolerated. All treatment-emergent adverse events (n = 17) were of mild severity and resolved spontaneously (except one with unknown outcome). Twelve treatment-emergent adverse events (70.6%) were deemed drug related; seven of those (58.3%) concerned nervous system disorders (dizziness, headache, and somnolence). The pharmacokinetic analysis indicated a short half-life in plasma (6-20 min), high apparent volume of distribution (1870-4120 L), and rapid clearance (7440-16,400 L/h). In plasma, tryptophan and homocysteine showed dose-related increase and decrease, respectively. No drug dose effect was found for the glutamate or glutamine plasma biomarkers. Nevertheless, decreased blood glutamate and increased glutamine were observed in participants treated with NX210 versus placebo. EEG showed a statistically significant decrease in beta and gamma bands and a dose-dependent increasing trend in alpha bands. Pharmacodynamics effects were sustained for several hours (plasma) or 48 h (urine and EEG). CONCLUSION NX210 is safe and well tolerated and may exert beneficial effects on the central nervous system, particularly in terms of cognitive processing.
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Affiliation(s)
| | | | - André Aleman
- Department of Biomedical Sciences of Cells and Systems, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | | | | | | | | | | | | | - Yann Godfrin
- Axoltis Pharma, 60 Avenue Rockefeller, 69008, Lyon, France
- Godfrin Life-Sciences, Caluire-et-Cuire, France
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10
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Ponomareva NV, Andreeva TV, Protasova M, Konovalov RN, Krotenkova MV, Kolesnikova EP, Malina DD, Kanavets EV, Mitrofanov AA, Fokin VF, Illarioshkin SN, Rogaev EI. Genetic association of apolipoprotein E genotype with EEG alpha rhythm slowing and functional brain network alterations during normal aging. Front Neurosci 2022; 16:931173. [PMID: 35979332 PMCID: PMC9376365 DOI: 10.3389/fnins.2022.931173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/27/2022] [Indexed: 12/02/2022] Open
Abstract
The ε4 allele of the apolipoprotein E (APOE4+) genotype is a major genetic risk factor for Alzheimer’s disease (AD), but the mechanisms underlying its influence remain incompletely understood. The study aimed to investigate the possible effect of the APOE genotype on spontaneous electroencephalogram (EEG) alpha characteristics, resting-state functional MRI (fMRI) connectivity (rsFC) in large brain networks and the interrelation of alpha rhythm and rsFC characteristics in non-demented adults during aging. We examined the EEG alpha subband’s relative power, individual alpha peak frequency (IAPF), and fMRI rsFC in non-demented volunteers (age range 26–79 years) stratified by the APOE genotype. The presence of the APOE4+ genotype was associated with lower IAPF and lower relative power of the 11–13 Hz alpha subbands. The age related decrease in EEG IAPF was more pronounced in the APOE4+ carriers than in the APOE4+ non-carriers (APOE4-). The APOE4+ carriers had a stronger fMRI positive rsFC of the interhemispheric regions of the frontoparietal, lateral visual and salience networks than the APOE4– individuals. In contrast, the negative rsFC in the network between the left hippocampus and the right posterior parietal cortex was reduced in the APOE4+ carriers compared to the non-carriers. Alpha rhythm slowing was associated with the dysfunction of hippocampal networks. Our results show that in adults without dementia APOE4+ genotype is associated with alpha rhythm slowing and that this slowing is age-dependent. Our data suggest predominant alterations of inhibitory processes in large-scale brain network of non-demented APOE4+ carriers. Moreover, dysfunction of large-scale hippocampal network can influence APOE-related alpha rhythm vulnerability.
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Affiliation(s)
- Natalya V. Ponomareva
- Research Center of Neurology, Moscow, Russia
- Center for Genetics and Life Science, Sirius University of Science and Technology, Sochi, Russia
- *Correspondence: Natalya V. Ponomareva,
| | - Tatiana V. Andreeva
- Center for Genetics and Life Science, Sirius University of Science and Technology, Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences (RAS), Moscow, Russia
| | - Maria Protasova
- Center for Genetics and Life Science, Sirius University of Science and Technology, Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences (RAS), Moscow, Russia
| | | | | | | | | | | | | | | | | | - Evgeny I. Rogaev
- Center for Genetics and Life Science, Sirius University of Science and Technology, Sochi, Russia
- Vavilov Institute of General Genetics, Russian Academy of Sciences (RAS), Moscow, Russia
- Brudnick Neuropsychiatric Research Institute (BNRI), University of Massachusetts Medical School, Worcester, MA, United States
- Evgeny I. Rogaev,
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11
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Smailovic U, Johansson C, Koenig T, Kåreholt I, Graff C, Jelic V. Decreased Global EEG Synchronization in Amyloid Positive Mild Cognitive Impairment and Alzheimer's Disease Patients-Relationship to APOE ε4. Brain Sci 2021; 11:brainsci11101359. [PMID: 34679423 PMCID: PMC8533770 DOI: 10.3390/brainsci11101359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
The apolipoprotein E (APOE) ε4 allele is a risk factor for Alzheimer's disease (AD) that has been linked to changes in brain structure and function as well as to different biological subtypes of the disease. The present study aimed to investigate the association of APOE ε4 genotypes with brain functional impairment, as assessed by quantitative EEG (qEEG) in patients on the AD continuum. The study population included 101 amyloid positive patients diagnosed with mild cognitive impairment (MCI) (n = 50) and AD (n = 51) that underwent resting-state EEG recording and CSF Aβ42 analysis. In total, 31 patients were APOE ε4 non-carriers, 42 were carriers of one, and 28 were carriers of two APOE ε4 alleles. Quantitative EEG analysis included computation of the global field power (GFP) and global field synchronization (GFS) in conventional frequency bands. Amyloid positive patients who were carriers of APOE ε4 allele(s) had significantly higher GFP beta and significantly lower GFS in theta and beta bands compared to APOE ε4 non-carriers. Increased global EEG power in beta band in APOE ε4 carriers may represent a brain functional compensatory mechanism that offsets global EEG slowing in AD patients. Our findings suggest that decreased EEG measures of global synchronization in theta and beta bands reflect brain functional deficits related to the APOE ε4 genotype in patients that are on a biomarker-verified AD continuum.
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Affiliation(s)
- Una Smailovic
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14152 Huddinge, Sweden;
- Department of Clinical Neurophysiology, Karolinska University Hospital, 14186 Huddinge, Sweden
- Correspondence:
| | - Charlotte Johansson
- Division of Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14152 Huddinge, Sweden; (C.J.); (C.G.)
- Clinic for Cognitive Disorders, Karolinska University Hospital, 14186 Huddinge, Sweden
| | - Thomas Koenig
- Translational Research Center, University Hospital of Psychiatry, University of Bern, 3012 Bern, Switzerland;
| | - Ingemar Kåreholt
- Aging Research Centre, Karolinska Institutet and Stockholm University, 17165 Solna, Sweden;
- School of Health and Welfare, Aging Research Network—Jönköping (ARN-J), Institute for Gerontology, Jönköping University, 55111 Jönköping, Sweden
| | - Caroline Graff
- Division of Neurogeriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14152 Huddinge, Sweden; (C.J.); (C.G.)
- Unit for Hereditary Dementia, Karolinska University Hospital-Solna, 17176 Solna, Sweden
| | - Vesna Jelic
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 14152 Huddinge, Sweden;
- Clinic for Cognitive Disorders, Karolinska University Hospital, 14186 Huddinge, Sweden
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12
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Babiloni C, Noce G, Ferri R, Lizio R, Lopez S, Lorenzo I, Tucci F, Soricelli A, Zurrón M, Díaz F, Nobili F, Arnaldi D, Famà F, Buttinelli C, Giubilei F, Cipollini V, Marizzoni M, Güntekin B, Yıldırım E, Hanoğlu L, Yener G, Gündüz DH, Onorati P, Stocchi F, Vacca L, Maestú F, Frisoni GB, Del Percio C. Resting State Alpha Electroencephalographic Rhythms Are Affected by Sex in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment: A Retrospective and Exploratory Study. Cereb Cortex 2021; 32:2197-2215. [PMID: 34613369 DOI: 10.1093/cercor/bhab348] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/07/2021] [Accepted: 08/21/2021] [Indexed: 11/14/2022] Open
Abstract
In the present retrospective and exploratory study, we tested the hypothesis that sex may affect cortical sources of resting state eyes-closed electroencephalographic (rsEEG) rhythms recorded in normal elderly (Nold) seniors and patients with Alzheimer's disease and mild cognitive impairment (ADMCI). Datasets in 69 ADMCI and 57 Nold individuals were taken from an international archive. The rsEEG rhythms were investigated at individual delta, theta, and alpha frequency bands and fixed beta (14-30 Hz) and gamma (30-40 Hz) bands. Each group was stratified into matched females and males. The sex factor affected the magnitude of rsEEG source activities in the Nold seniors. Compared with the males, the females were characterized by greater alpha source activities in all cortical regions. Similarly, the parietal, temporal, and occipital alpha source activities were greater in the ADMCI-females than the males. Notably, the present sex effects did not depend on core genetic (APOE4), neuropathological (Aβ42/phospho-tau ratio in the cerebrospinal fluid), structural neurodegenerative and cerebrovascular (MRI) variables characterizing sporadic AD-related processes in ADMCI seniors. These results suggest the sex factor may significantly affect neurophysiological brain neural oscillatory synchronization mechanisms underpinning the generation of dominant rsEEG alpha rhythms to regulate cortical arousal during quiet vigilance.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
- San Raffaele of Cassino, Cassino (FR), Italy
| | | | | | | | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Federico Tucci
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy
- Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Montserrat Zurrón
- Departamento de Psicología Experimental, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando Díaz
- Departamento de Psicología Experimental, Facultad de Psicología, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Flavio Nobili
- Clinica neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Dario Arnaldi
- Clinica neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
- Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Francesco Famà
- Clinica neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Virginia Cipollini
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey
| | - Ebru Yıldırım
- Istanbul Medipol University, Vocational School, Program of Electroneurophysiology, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev Yener
- Izmir School of Economics, Faculty of Medicine, Izmir, Turkey
| | - Duygu Hünerli Gündüz
- Health Sciences Institute, Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Paolo Onorati
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | | | - Fernando Maestú
- Departamento de Psicología Experimental, Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
- Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
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13
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Babiloni C, Ferri R, Noce G, Lizio R, Lopez S, Lorenzo I, Tucci F, Soricelli A, Nobili F, Arnaldi D, Famà F, Orzi F, Buttinelli C, Giubilei F, Cipollini V, Marizzoni M, Güntekin B, Aktürk T, Hanoğlu L, Yener G, Özbek Y, Stocchi F, Vacca L, Frisoni GB, Del Percio C. Resting State Alpha Electroencephalographic Rhythms Are Differently Related to Aging in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment. J Alzheimers Dis 2021; 82:1085-1114. [PMID: 34151788 DOI: 10.3233/jad-201271] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND In relaxed adults, staying in quiet wakefulness at eyes closed is related to the so-called resting state electroencephalographic (rsEEG) rhythms, showing the highest amplitude in posterior areas at alpha frequencies (8-13 Hz). OBJECTIVE Here we tested the hypothesis that age may affect rsEEG alpha (8-12 Hz) rhythms recorded in normal elderly (Nold) seniors and patients with mild cognitive impairment due to Alzheimer's disease (ADMCI). METHODS Clinical and rsEEG datasets in 63 ADMCI and 60 Nold individuals (matched for demography, education, and gender) were taken from an international archive. The rsEEG rhythms were investigated at individual delta, theta, and alpha frequency bands, as well as fixed beta (14-30 Hz) and gamma (30-40 Hz) bands. Each group was stratified into three subgroups based on age ranges (i.e., tertiles). RESULTS As compared to the younger Nold subgroups, the older one showed greater reductions in the rsEEG alpha rhythms with major topographical effects in posterior regions. On the contrary, in relation to the younger ADMCI subgroups, the older one displayed a lesser reduction in those rhythms. Notably, the ADMCI subgroups pointed to similar cerebrospinal fluid AD diagnostic biomarkers, gray and white matter brain lesions revealed by neuroimaging, and clinical and neuropsychological scores. CONCLUSION The present results suggest that age may represent a deranging factor for dominant rsEEG alpha rhythms in Nold seniors, while rsEEG alpha rhythms in ADMCI patients may be more affected by the disease variants related to earlier versus later onset of the AD.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.,San Raffaele of Cassino, Cassino (FR), Italy
| | | | | | | | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Federico Tucci
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Flavio Nobili
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Genova, Italy
| | - Dario Arnaldi
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Genova, Italy
| | - Francesco Famà
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Virginia Cipollini
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Laboratory, Istanbul Medipol University, Istanbul, Turkey
| | - Tuba Aktürk
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Laboratory, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev Yener
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Laura Vacca
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
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14
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Joseph S, Patterson R, Wang W, Blumberger DM, Rajji T, Kumar S. Quantitative Assessment of Cortical Excitability in Alzheimer's Dementia and Its Association with Clinical Symptoms: A Systematic Review and Meta-Analyses. J Alzheimers Dis 2021; 88:867-891. [PMID: 34219724 DOI: 10.3233/jad-210311] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is characterized by cognitive and neuropsychiatric symptoms (NPS) due to underlying neurodegenerative pathology. Some studies using electroencephalography (EEG) have shown increased epileptiform and epileptic activity in AD. OBJECTIVE This review and meta-analyses aims to synthesize the existing evidence for quantitative abnormalities of cortical excitability in AD and their relationship with clinical symptoms. METHODS We systematically searched and reviewed publications that quantitatively assessed cortical excitability, using transcranial magnetic stimulation (TMS) resting motor threshold (rMT), active motor threshold (aMT), motor evoked potential (MEP) or directly from the cortex using TMS-EEG via TMS-evoked potential (TEP). We meta-analyzed studies that assessed rMT and aMT using random effects model. RESULTS We identified 895 publications out of which 37 were included in the qualitative review and 30 studies using rMT or aMT were included in the meta-analyses. The AD group had reduced rMT (Hedges' g = -0.99, 95%CI [-1.29, -0.68], p < 0.00001) and aMT (Hedges' g = -0.87, 95%CI [-1.50, -0.24], p < 0.00001) as compared with control groups, indicative of higher cortical excitability. Qualitative review found some evidence of increased MEP amplitude, whereas findings related to TEP were inconsistent. There was some evidence supporting an inverse association between cortical excitability and global cognition. No publications reported on the relationship between cortical excitability and NPS. CONCLUSION There is strong evidence of increased motor cortex excitability in AD and some evidence of an inverse association between excitability and cognition. Future studies should assess cortical excitability from non-motor areas using TMS-EEG and examine its relationship with cognition and NPS.
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Affiliation(s)
- Shaylyn Joseph
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Rachel Patterson
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Wei Wang
- Centre for Addiction and Mental Health, Toronto, Canada
| | - Daniel M Blumberger
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
| | - Tarek Rajji
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada.,Toronto Dementia Research Alliance, Toronto, Canada
| | - Sanjeev Kumar
- Centre for Addiction and Mental Health, Toronto, Canada.,University of Toronto, Toronto, Canada
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15
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Briels CT, Stam CJ, Scheltens P, Gouw AA. The predictive value of normal EEGs in dementia due to Alzheimer's disease. Ann Clin Transl Neurol 2021; 8:1038-1048. [PMID: 33835723 PMCID: PMC8108419 DOI: 10.1002/acn3.51339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/13/2021] [Accepted: 02/21/2021] [Indexed: 12/05/2022] Open
Abstract
Objective To determine differences in clinical presentation and disease progression between patients with dementia due to AD with visually normal and abnormal EEG recordings. We hypothesized that patients with normal electroencephalographs (EEGs) are a representation of the heterogeneity of AD. We expected this group to have a phenotype with relatively predominant hippocampal atrophy, memory deficits, and a slower disease progression. Methods Patients were included based on diagnosis of dementia due to AD, positive amyloid and tau cerebrospinal fluid (CSF) biomarkers, and the availability of EEG recordings. Patients were categorized in groups of normal (N = 208) and abnormal (N = 336) EEG recordings based on visual assessment by experienced neurophysiologists. At baseline demographics, cognitive, MRI, and CSF measures were compared between groups. Cognitive data from follow‐up visits were assessed by linear mixed‐effects models (LMMs), and corrected for baseline value, sex, age, and educational level, to compare cognitive deterioration over time between groups. Results About 1 in 4.5 patients with AD dementia had a visually normal EEG and this group showed better overall cognitive performance compared to the abnormal group, where memory was the most prominent affected domain. The normal group showed less global and parietal but similar medial temporal atrophy. Follow‐up data showed a slower deterioration on all tested cognitive domains in the normal EEG group. Interpretation Patients with dementia due to AD and visually normal EEG recordings showed a milder clinical presentation and had a milder disease progression compared to patients with an abnormal EEG. These results provide evidence of clinical and biological heterogeneity within AD dementia.
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Affiliation(s)
- Casper T Briels
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Neurophysiology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Alida A Gouw
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Neurophysiology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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16
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Resting-state electroencephalographic delta rhythms may reflect global cortical arousal in healthy old seniors and patients with Alzheimer's disease dementia. Int J Psychophysiol 2020; 158:259-270. [DOI: 10.1016/j.ijpsycho.2020.08.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 08/25/2020] [Accepted: 08/27/2020] [Indexed: 12/23/2022]
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17
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Rossini PM, Cappa SF, Lattanzio F, Perani D, Spadin P, Tagliavini F, Vanacore N. The Italian INTERCEPTOR Project: From the Early Identification of Patients Eligible for Prescription of Antidementia Drugs to a Nationwide Organizational Model for Early Alzheimer's Disease Diagnosis. J Alzheimers Dis 2020; 72:373-388. [PMID: 31594234 DOI: 10.3233/jad-190670] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease is the most common age-related neurodegenerative disorder and its burden on patients, families, and society grows significantly with lifespan. Early modifications of risk-enhancing lifestyles and treatment initiation expand personal autonomy and reduce management costs. Many clinical trials with potentially disease-modifying drugs are devoted to mild cognitive impairment (MCI) prodromal-to-Alzheimer's disease. The identification of biomarkers for early diagnosis may thus be crucial for early intervention and identification of high-risk subjects, the most appropriate target of new drugs as soon as they will be discovered. INTERCEPTOR is a strategic project by the Italian Ministry of Health and the Italian Medicines Agency (AIFA), aiming to validate the best combination (highly accurate, non-invasive, available on the whole national territory and financially sustainable) of biomarkers and organizational model for early diagnosis. 500 MCI subjects will be enrolled at baseline and followed-up for 3 years for at least 400 of them in order to define a "hub & spoke" nationwide model with recruiting (spokes) centers for MCI identification and expert (hubs) centers for risk diagnosis.
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Affiliation(s)
- Paolo Maria Rossini
- Area of Neuroscience, University Policlinic A. Gemelli Foundation-IRCCS, Rome, Italy.,Institute of Neurology, Catholic University, Rome, Italy
| | - Stefano F Cappa
- University School for Advanced Studies IUSS Pavia, Pavia, Italy.,IRCCS St. John of God, Brescia, Italy
| | | | - Daniela Perani
- Nuclear Medicine Unit and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Patrizia Spadin
- President "Associazione Italiana Malattia di Alzheimer" - AIMA, Italy
| | | | - Nicola Vanacore
- National Center for Disease Prevention and Health Promotion, National Institute of Health, Rome, Italy
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18
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The Role of Physical Fitness in Cognitive-Related Biomarkers in Persons at Genetic Risk of Familial Alzheimer's Disease. J Clin Med 2019; 8:jcm8101639. [PMID: 31591322 PMCID: PMC6832576 DOI: 10.3390/jcm8101639] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction: Nondemented people with a family history of Alzheimer’s disease (ADFH) and the ApoE-4 allele have been demonstrated to show a trend for a higher probability of cognitive decline and aberrant levels of cognitive-related biomarkers. However, the potential interactive effects on physical fitness have not been investigated. Purpose: The primary purpose of this study was to determine whether ADFH individuals with the ApoE-4 genotype show deviant brain event-related neural oscillatory performance and cognitively-related molecular indices. A secondary purpose was to examine the interactive effects on physical fitness. Methods: Blood samples were provided from 110 individuals with ADFH to assess molecular biomarkers and the ApoE genotype for the purpose of dividing them into an ApoE-4 group (n = 16) and a non-ApoE-4 group (n = 16) in order for them to complete a visuospatial working memory task while simultaneously recording electroencephalographic signals. They also performed a senior functional physical fitness (SFPF) test. Results: While performing the cognitive task, the ApoE-4 relative to non-ApoE-4 group showed worse accuracy rates (ARs) and brain neural oscillatory performance. There were no significant between-group differences with regard to any molecular biomarkers (e.g., IL-1β, IL-6, IL-8, BDNF, Aβ1-40, Aβ1-42). VO2max was significantly correlated with the neuropsychological performance (i.e., ARs and RTs) in the 2-item and 4-item conditions in the ApoE-4 group and across the two groups. However, the electroencephalogram (EEG) oscillations during visuospatial working memory processing in the two conditions were not correlated with any SFPF scores or cardiorespiratory tests in the two groups. Conclusions: ADFH individuals with the ApoE-4 genotype only showed deviant neuropsychological (e.g., ARs) and neural oscillatory performance when performing the cognitive task with a higher visuospatial working memory load. Cardiorespiratory fitness potentially played an important role in neuropsychological impairment in this group.
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19
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Del Percio C, Derambure P, Noce G, Lizio R, Bartrés-Faz D, Blin O, Payoux P, Deplanque D, Méligne D, Chauveau N, Bourriez JL, Casse-Perrot C, Lanteaume L, Thalamas C, Dukart J, Ferri R, Pascarelli MT, Richardson JC, Bordet R, Babiloni C. Sleep deprivation and Modafinil affect cortical sources of resting state electroencephalographic rhythms in healthy young adults. Clin Neurophysiol 2019; 130:1488-1498. [PMID: 31295717 DOI: 10.1016/j.clinph.2019.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 05/06/2019] [Accepted: 06/03/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE It has been reported that sleep deprivation affects the neurophysiological mechanisms underpinning the vigilance. Here, we tested the following hypotheses in the PharmaCog project (www.pharmacog.org): (i) sleep deprivation may alter posterior cortical delta and alpha sources of resting state eyes-closed electroencephalographic (rsEEG) rhythms in healthy young adults; (ii) after the sleep deprivation, a vigilance enhancer may recover those rsEEG source markers. METHODS rsEEG data were recorded in 36 healthy young adults before (Pre-sleep deprivation) and after (Post-sleep deprivation) one night of sleep deprivation. In the Post-sleep deprivation, these data were collected after a single dose of PLACEBO or MODAFINIL. rsEEG cortical sources were estimated by eLORETA freeware. RESULTS In the PLACEBO condition, the sleep deprivation induced an increase and a decrease in posterior delta (2-4 Hz) and alpha (8-13 Hz) source activities, respectively. In the MODAFINIL condition, the vigilance enhancer partially recovered those source activities. CONCLUSIONS The present results suggest that posterior delta and alpha source activities may be both related to the regulation of human brain arousal and vigilance in quiet wakefulness. SIGNIFICANCE Future research in healthy young adults may use this methodology to preselect new symptomatic drug candidates designed to normalize brain arousal and vigilance in seniors with dementia.
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Affiliation(s)
- Claudio Del Percio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Philippe Derambure
- Univ Lille, Inserm, CHU Lille, UMR_S 1171 - Degenerative and Vascular Cognitive Disorders, F59000 Lille, France
| | | | | | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Healthy Sciences, University of Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Olivier Blin
- Aix Marseille University, UMR-CNRS 7289, Service de Pharmacologie Clinique, AP-HM, Marseille, France
| | - Pierre Payoux
- INSERM, Imagerie Cérébrale et Handicaps Neurologiques, Toulouse, France
| | - Dominique Deplanque
- Univ Lille, Inserm, CHU Lille, CIC1403 & UMR_S 1171 - Degenerative and Vascular Cognitive Disorders, F59000 Lille, France
| | - Déborah Méligne
- INSERM UMR 825 Brain Imaging and Neurological Dysfunctions, Toulouse, France
| | - Nicolas Chauveau
- INSERM UMR 825 Brain Imaging and Neurological Dysfunctions, Toulouse, France
| | - Jean Louis Bourriez
- Univ Lille, Inserm, CHU Lille, UMR_S 1171 - Degenerative and Vascular Cognitive Disorders, F59000 Lille, France
| | - Catherine Casse-Perrot
- Aix Marseille University, UMR-CNRS 7289, Service de Pharmacologie Clinique, AP-HM, Marseille, France
| | - Laura Lanteaume
- Service de Neurologie et Neuropsychologie, APHM Hôpital Timone Adultes, Marseille, France
| | - Claire Thalamas
- Department of Medical Pharmacology, INSERM CIC 1436, Toulouse University Medical Center, Toulouse, France
| | - Juergen Dukart
- F. Hoffmann-La Roche, Pharma Research Early Development, Roche Innovation Centre Basel, Basel, Switzerland
| | | | | | | | - Regis Bordet
- Univ Lille, Inserm, CHU Lille, UMR_S 1171 - Degenerative and Vascular Cognitive Disorders, F59000 Lille, France
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, FR, Italy.
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Creating an Internal Environment of Cognitive and Psycho-Emotional Well-Being through an External Movement-Based Environment: An Overview of Quadrato Motor Training. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122160. [PMID: 31216778 PMCID: PMC6616507 DOI: 10.3390/ijerph16122160] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/14/2019] [Accepted: 06/17/2019] [Indexed: 11/26/2022]
Abstract
In this overview, we discuss the internal and external environmental factors associated with cognitive and psycho-emotional well-being in the context of physical activity and Mindful Movement. Our key argument is that improved cognitive and emotional functions associated with mental well-being can be achieved by an external, Mindful Movement-based environment training called Quadrato Motor Training (QMT). QMT is a structured sensorimotor training program aimed at improving coordination, attention, and emotional well-being through behavioral, electrophysiological, neuroanatomical, and molecular changes. In accordance with this argument, we first describe the general neurobiological mechanisms underpinning emotional states and emotion regulation. Next, we review the relationships between QMT, positive emotional state, and increased emotion regulation, and discuss the neurobiological mechanisms underlying these relationships. We consider the relationships between motion, emotion, and cognition, and highlight the need for integrated training paradigms involving these three trajectories. Such training paradigms provide cognitively engaging exercises to improve emotion regulation, which in turn affects adaptive behaviors. Finally, we address the broader implications of improving cognitive and emotional functioning through Mindful Movement training for environmental research and public health.
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Koelewijn L, Lancaster TM, Linden D, Dima DC, Routley BC, Magazzini L, Barawi K, Brindley L, Adams R, Tansey KE, Bompas A, Tales A, Bayer A, Singh K. Oscillatory hyperactivity and hyperconnectivity in young APOE-ɛ4 carriers and hypoconnectivity in Alzheimer's disease. eLife 2019; 8:e36011. [PMID: 31038453 PMCID: PMC6491037 DOI: 10.7554/elife.36011] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 04/17/2019] [Indexed: 11/14/2022] Open
Abstract
We studied resting-state oscillatory connectivity using magnetoencephalography in healthy young humans (N = 183) genotyped for APOE-ɛ4, the greatest genetic risk for Alzheimer's disease (AD). Connectivity across frequencies, but most prevalent in alpha/beta, was increased in APOE-ɛ4 in a set of mostly right-hemisphere connections, including lateral parietal and precuneus regions of the Default Mode Network. Similar regions also demonstrated hyperactivity, but only in gamma (40-160 Hz). In a separate study of AD patients, hypoconnectivity was seen in an extended bilateral network that partially overlapped with the hyperconnected regions seen in young APOE-ɛ4 carriers. Using machine-learning, AD patients could be distinguished from elderly controls with reasonable sensitivity and specificity, while young APOE-e4 carriers could also be distinguished from their controls with above chance performance. These results support theories of initial hyperconnectivity driving eventual profound disconnection in AD and suggest that this is present decades before the onset of AD symptomology.
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Affiliation(s)
- Loes Koelewijn
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Thomas M Lancaster
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
- Neuroscience and Mental Health Research Institute, Cardiff UniversityCardiffUnited Kingdom
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUnited Kingdom
| | - David Linden
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
- Neuroscience and Mental Health Research Institute, Cardiff UniversityCardiffUnited Kingdom
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUnited Kingdom
| | - Diana C Dima
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Bethany C Routley
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Lorenzo Magazzini
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Kali Barawi
- MRC Centre for Neuropsychiatric Genetics and GenomicsCardiff UniversityCardiffUnited Kingdom
| | - Lisa Brindley
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Rachael Adams
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Katherine E Tansey
- Core Bioinformatics and Statistics Team, College of Biomedical and Life Sciences, Cardiff UniversityCardiffUnited Kingdom
| | - Aline Bompas
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
| | - Andrea Tales
- Department of PsychologyCollege of Human and Health Sciences, Swansea UniversitySwanseaUnited Kingdom
| | - Antony Bayer
- School of Medicine, Cardiff UniversityCardiffUnited Kingdom
| | - Krish Singh
- Cardiff University Brain Research Imaging Centre, School of PsychologyCardiff UniversityCardiffUnited Kingdom
- Neuroscience and Mental Health Research Institute, Cardiff UniversityCardiffUnited Kingdom
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22
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Ishii R, Canuet L, Aoki Y, Hata M, Iwase M, Ikeda S, Nishida K, Ikeda M. Healthy and Pathological Brain Aging: From the Perspective of Oscillations, Functional Connectivity, and Signal Complexity. Neuropsychobiology 2018; 75:151-161. [PMID: 29466802 DOI: 10.1159/000486870] [Citation(s) in RCA: 95] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 01/14/2018] [Indexed: 12/24/2022]
Abstract
Healthy aging is associated with impairment in cognitive information processing. Several neuroimaging methods such as functional magnetic resonance imaging, positron emission tomography and near-infrared spectroscopy have been used to explore healthy and pathological aging by relying on hemodynamic or metabolic changes that occur in response to brain activity. Since electroencephalography (EEG) and magnetoencephalography (MEG) are able to measure neural activity directly with a high temporal resolution of milliseconds, these neurophysiological techniques are particularly important to investigate the dynamics of brain activity underlying neurocognitive aging. It is well known that age is a major risk factor for Alzheimer's disease (AD), and that synaptic dysfunction represents an early sign of this disease associated with hallmark neuropathological findings. However, the neurophysiological mechanisms underlying AD are not fully elucidated. This review addresses healthy and pathological brain aging from a neurophysiological perspective, focusing on oscillatory activity changes during the resting state, event-related potentials and stimulus-induced oscillatory responses during cognitive or motor tasks, functional connectivity between brain regions, and changes in signal complexity. We also highlight the accumulating evidence on age-related EEG/MEG changes and biological markers of brain neurodegeneration, including genetic factors, structural abnormalities on magnetic resonance images, and the biochemical changes associated with Aβ deposition and tau pathology.
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Affiliation(s)
- Ryouhei Ishii
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Palliative Care, Ashiya Municipal Hospital, Ashiya, Japan
| | - Leonides Canuet
- Department of Cognitive, Social and Organizational Psychology, La Laguna University, Tenerife, Spain
| | - Yasunori Aoki
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.,Department of Psychiatry, Nissay Hospital, Osaka, Japan
| | - Masahiro Hata
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masao Iwase
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Shunichiro Ikeda
- Department of Psychiatry, Kansai Medical University, Moriguchi, Japan
| | - Keiichiro Nishida
- Department of Psychiatry, Kansai Medical University, Moriguchi, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
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23
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de Frutos-Lucas J, López-Sanz D, Zuluaga P, Rodríguez-Rojo IC, Luna R, López ME, Delgado-Losada ML, Marcos A, Barabash A, López-Higes R, Maestú F, Fernández A. Physical activity effects on the individual alpha peak frequency of older adults with and without genetic risk factors for Alzheimer’s Disease: A MEG study. Clin Neurophysiol 2018; 129:1981-1989. [DOI: 10.1016/j.clinph.2018.06.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/29/2018] [Accepted: 06/25/2018] [Indexed: 11/30/2022]
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24
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Babiloni C, Del Percio C, Lizio R, Noce G, Cordone S, Lopez S, Soricelli A, Ferri R, Pascarelli MT, Nobili F, Arnaldi D, Famà F, Aarsland D, Orzi F, Buttinelli C, Giubilei F, Onofrj M, Stocchi F, Stirpe P, Fuhr P, Gschwandtner U, Ransmayr G, Caravias G, Garn H, Sorpresi F, Pievani M, D'Antonio F, De Lena C, Güntekin B, Hanoğlu L, Başar E, Yener G, Emek-Savaş DD, Triggiani AI, Franciotti R, Frisoni GB, Bonanni L, De Pandis MF. Abnormalities of Cortical Neural Synchronization Mechanisms in Subjects with Mild Cognitive Impairment due to Alzheimer's and Parkinson's Diseases: An EEG Study. J Alzheimers Dis 2018. [PMID: 28621693 DOI: 10.3233/jad-160883] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The aim of this retrospective and exploratory study was that the cortical sources of resting state eyes-closed electroencephalographic (rsEEG) rhythms might reveal different abnormalities in cortical neural synchronization in groups of patients with mild cognitive impairment due to Alzheimer's disease (ADMCI) and Parkinson's disease (PDMCI) as compared to healthy subjects. Clinical and rsEEG data of 75 ADMCI, 75 PDMCI, and 75 cognitively normal elderly (Nold) subjects were available in an international archive. Age, gender, and education were carefully matched in the three groups. The Mini-Mental State Evaluation (MMSE) was matched between the ADMCI and PDMCI groups. Individual alpha frequency peak (IAF) was used to determine the delta, theta, alpha1, alpha2, and alpha3 frequency band ranges. Fixed beta1, beta2, and gamma bands were also considered. eLORETA estimated the rsEEG cortical sources. Receiver operating characteristic curve (ROC) classified these sources across individuals. Results showed that compared to the Nold group, the posterior alpha2 and alpha3 source activities were more abnormal in the ADMCI than the PDMCI group, while the parietal delta source activities were more abnormal in the PDMCI than the ADMCI group. The parietal delta and alpha sources correlated with MMSE score and correctly classified the Nold and diseased individuals (area under the ROC = 0.77-0.79). In conclusion, the PDMCI and ADMCI patients showed different features of cortical neural synchronization at delta and alpha frequencies underpinning brain arousal and vigilance in the quiet wakefulness. Future prospective cross-validation studies will have to test these rsEEG markers for clinical applications and drug discovery.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy.,Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | | | - Roberta Lizio
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy.,Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Noce
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy
| | - Susanna Cordone
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy
| | - Andrea Soricelli
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Raffaele Ferri
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy
| | - Maria Teresa Pascarelli
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Enna, Italy
| | - Flavio Nobili
- Clinical Neurology, dept of Neuroscience (DiNOGMI), University of Genoa and IRCCS AOU S Martino-IST, Genoa, Italy
| | - Dario Arnaldi
- Clinical Neurology, dept of Neuroscience (DiNOGMI), University of Genoa and IRCCS AOU S Martino-IST, Genoa, Italy
| | - Francesco Famà
- Clinical Neurology, dept of Neuroscience (DiNOGMI), University of Genoa and IRCCS AOU S Martino-IST, Genoa, Italy
| | - Dag Aarsland
- Department of Old Age Psychiatry, King's College University, London, UK
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Marco Onofrj
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paola Stirpe
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Peter Fuhr
- Universitätsspital Basel, Abteilung Neurophysiologie, Basel, Switzerland
| | - Ute Gschwandtner
- Universitätsspital Basel, Abteilung Neurophysiologie, Basel, Switzerland
| | - Gerhard Ransmayr
- Department of Neurology and Psychiatry and Faculty of Medicine, Johannes Kepler University Linz, General Hospital of the City of Linz, Linz, Austria
| | - Georg Caravias
- Department of Neurology and Psychiatry and Faculty of Medicine, Johannes Kepler University Linz, General Hospital of the City of Linz, Linz, Austria
| | - Heinrich Garn
- AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | | | - Michela Pievani
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Fabrizia D'Antonio
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Italy
| | - Carlo De Lena
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Italy
| | - Bahar Güntekin
- Department of Biophysics, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, University of Istanbul-Medipol, Istanbul, Turkey
| | - Erol Başar
- Department of Neurosciences and Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey
| | - Görsev Yener
- Department of Psychology and Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Derya Durusu Emek-Savaş
- Department of Psychology and Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | | | - Raffaella Franciotti
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
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25
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Babiloni C, Del Percio C, Lizio R, Noce G, Cordone S, Lopez S, Soricelli A, Ferri R, Pascarelli MT, Nobili F, Arnaldi D, Aarsland D, Orzi F, Buttinelli C, Giubilei F, Onofrj M, Stocchi F, Stirpe P, Fuhr P, Gschwandtner U, Ransmayr G, Caravias G, Garn H, Sorpresi F, Pievani M, Frisoni GB, D'Antonio F, De Lena C, Güntekin B, Hanoğlu L, Başar E, Yener G, Emek-Savaş DD, Triggiani AI, Franciotti R, De Pandis MF, Bonanni L. Abnormalities of cortical neural synchronization mechanisms in patients with dementia due to Alzheimer's and Lewy body diseases: an EEG study. Neurobiol Aging 2017; 55:143-158. [PMID: 28454845 DOI: 10.1016/j.neurobiolaging.2017.03.030] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 12/15/2022]
Abstract
The aim of this retrospective exploratory study was that resting state eyes-closed electroencephalographic (rsEEG) rhythms might reflect brain arousal in patients with dementia due to Alzheimer's disease dementia (ADD), Parkinson's disease dementia (PDD), and dementia with Lewy body (DLB). Clinical and rsEEG data of 42 ADD, 42 PDD, 34 DLB, and 40 healthy elderly (Nold) subjects were available in an international archive. Demography, education, and Mini-Mental State Evaluation score were not different between the patient groups. Individual alpha frequency peak (IAF) determined the delta, theta, alpha 1, alpha 2, and alpha 3 frequency bands. Fixed beta 1, beta 2, and gamma bands were also considered. rsEEG cortical sources were estimated by means of the exact low-resolution brain electromagnetic source tomography and were then classified across individuals, on the basis of the receiver operating characteristic curves. Compared to Nold, IAF showed marked slowing in PDD and DLB and moderate slowing in ADD. Furthermore, all patient groups showed lower posterior alpha 2 source activities. This effect was dramatic in ADD, marked in DLB, and moderate in PDD. These groups also showed higher occipital delta source activities, but this effect was dramatic in PDD, marked in DLB, and moderate in ADD. The posterior delta and alpha sources allowed good classification accuracy (approximately 0.85-0.90) between the Nold subjects and patients, and between ADD and PDD patients. In quiet wakefulness, delta and alpha sources unveiled different spatial and frequency features of the cortical neural synchronization underpinning brain arousal in ADD, PDD, and DLB patients. Future prospective cross-validation studies should test these rsEEG markers for clinical applications and drug discovery.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy; Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy.
| | | | - Roberta Lizio
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy; Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giuseppe Noce
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy
| | - Susanna Cordone
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", University of Rome "La Sapienza", Rome, Italy
| | - Andrea Soricelli
- Department of Integrated Imaging, IRCCS SDN, Naples, Italy; Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Raffaele Ferri
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy
| | - Maria Teresa Pascarelli
- Department of Neurology, IRCCS Oasi Institute for Research on Mental Retardation and Brain Aging, Troina, Italy
| | - Flavio Nobili
- Department of Neuroscience (DiNOGMI), Clinical Neurology, University of Genoa and IRCCS AOU S Martino-IST, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience (DiNOGMI), Clinical Neurology, University of Genoa and IRCCS AOU S Martino-IST, Genoa, Italy
| | - Dag Aarsland
- Department of Old Age Psychiatry, King's College University, London, UK
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, University of Rome "La Sapienza", Rome, Italy
| | - Marco Onofrj
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Paola Stirpe
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Peter Fuhr
- Universitätsspital Basel, Abteilung Neurophysiologie, Basel, Switzerland
| | - Ute Gschwandtner
- Universitätsspital Basel, Abteilung Neurophysiologie, Basel, Switzerland
| | - Gerhard Ransmayr
- Department of Neurology and Psychiatry and Faculty of Medicine, Johannes Kepler University Linz, General Hospital of the City of Linz, Linz, Austria
| | - Georg Caravias
- Department of Neurology and Psychiatry and Faculty of Medicine, Johannes Kepler University Linz, General Hospital of the City of Linz, Linz, Austria
| | - Heinrich Garn
- AIT Austrian Institute of Technology GmbH, Vienna, Austria
| | | | - Michela Pievani
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy; Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Fabrizia D'Antonio
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy
| | - Carlo De Lena
- Department of Neurology and Psychiatry, Sapienza, University of Rome, Rome, Italy
| | - Bahar Güntekin
- Department of Biophysics, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, University of Istanbul-Medipol, Istanbul, Turkey
| | - Erol Başar
- Department of Neurosciences, Dokuz Eylül University Medical School, Izmir, Turkey; Department of Neurology, Dokuz Eylül University Medical School, Izmir, Turkey
| | - Görsev Yener
- Department of Psychology, Dokuz Eylül University, Izmir, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | - Derya Durusu Emek-Savaş
- Department of Psychology, Dokuz Eylül University, Izmir, Turkey; Department of Neurosciences, Dokuz Eylül University, Izmir, Turkey
| | | | - Raffaella Franciotti
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences and CESI, University G d'Annunzio of Chieti-Pescara, Chieti, Italy
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26
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Ponomareva NV, Andreeva TV, Protasova MS, Shagam LI, Malina DD, Goltsov AY, Fokin VF, Illarioshkin SN, Rogaev EI. Quantitative EEG during normal aging: association with the Alzheimer's disease genetic risk variant in PICALM gene. Neurobiol Aging 2017; 51:177.e1-177.e8. [DOI: 10.1016/j.neurobiolaging.2016.12.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Revised: 11/14/2016] [Accepted: 12/11/2016] [Indexed: 10/20/2022]
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Babiloni C, Del Percio C, Caroli A, Salvatore E, Nicolai E, Marzano N, Lizio R, Cavedo E, Landau S, Chen K, Jagust W, Reiman E, Tedeschi G, Montella P, De Stefano M, Gesualdo L, Frisoni GB, Soricelli A. Cortical sources of resting state EEG rhythms are related to brain hypometabolism in subjects with Alzheimer's disease: an EEG-PET study. Neurobiol Aging 2016; 48:122-134. [DOI: 10.1016/j.neurobiolaging.2016.08.021] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/05/2016] [Accepted: 08/24/2016] [Indexed: 11/24/2022]
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Babiloni C, Pennica A, Capotosto P, Onorati P, Muratori C, Ferracuti S, Roma P, Correr V, Piccinni E, Noce G, Del Percio C, Cordone S, Limatola C, Soricelli A, Di Campli F, Gianserra L, Ciullini L, Aceti A, Viscione M, Teti E, Sarmati L, Andreoni M. Brain and cognitive functions in two groups of naïve HIV patients selected for a different plan of antiretroviral therapy: A qEEG study. Clin Neurophysiol 2016; 127:3455-3469. [PMID: 27716535 DOI: 10.1016/j.clinph.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 08/24/2016] [Accepted: 09/04/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Cortical sources of electroencephalographic (EEG) rhythms were investigated in two sub-populations of naïve HIV subjects, grouped based on clinical criteria to receive different combination anti-retroviral therapies (cARTs). These EEG sources were hypothesized to reflect beneficial effects of both regimes. METHODS Eyes-closed resting state EEG data were collected in 19 (Group A) and 39 (Group B) naïve HIV subjects at baseline (i.e. pre-treatment; T0) and after 5months of cART (T5). Compared with the Group A, the Group B was characterized by slightly worse serological parameters and higher cardiovascular risk. At T0, mean viral load (VL) and CD4 count were 87,694copies/ml and 435cells/μl in the Group A and 187,370copies/ml and 331cells/μl in the Group B. The EEG data were also collected in 50 matched control HIV-negative subjects. Cortical EEG sources were assessed by LORETA software. RESULTS Compared to the Control Group, the HIV Groups showed lower alpha (8-12Hz) source activity at T0 while the Group B also exhibited higher delta source activity. The treatment partially normalized alpha and delta source activity in the Group A and B, respectively, in association with improved VL, CD4, and cognitive functions. CONCLUSIONS Different cART regimens induced diverse beneficial effects in delta or alpha source activity in the two naïve HIV Groups. SIGNIFICANCE These sources might unveil different neurophysiological effects of diverse cART on brain function in naïve HIV Groups as a function of clinical status and/or therapeutic compounds.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; IRCCS S. Raffaele Pisana, Rome, Italy.
| | - Alfredo Pennica
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | | | - Paolo Onorati
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; IRCCS S. Raffaele Pisana, Rome, Italy
| | | | - Stefano Ferracuti
- Psychiatry, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Paolo Roma
- Psychiatry, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Valentina Correr
- Psychiatry, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Elisa Piccinni
- Psychiatry, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | | | | | - Susanna Cordone
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | - Cristina Limatola
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Naples, Italy; Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Francesco Di Campli
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Laura Gianserra
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Lorenzo Ciullini
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Antonio Aceti
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy
| | - Magdalena Viscione
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, University of Rome "Tor Vergata", Rome, Italy
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Babiloni C, Pennica A, Del Percio C, Noce G, Cordone S, Lopez S, Berry K, Muratori C, Ferracuti S, Roma P, Correr V, Di Campli F, Gianserra L, Ciullini L, Aceti A, Soricelli A, Teti E, Viscione M, Limatola C, Onorati P, Capotosto P, Andreoni M. Antiretroviral therapy affects the z-score index of deviant cortical EEG rhythms in naïve HIV individuals. Neuroimage Clin 2016; 12:144-56. [PMID: 27408799 PMCID: PMC4933036 DOI: 10.1016/j.nicl.2016.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 05/12/2016] [Accepted: 06/06/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Here we tested the effect of combined antiretroviral therapy (cART) on deviant electroencephalographic (EEG) source activity in treatment-naïve HIV individuals. METHODS Resting state eyes-closed EEG data were recorded before and after 5 months of cART in 48 male HIV subjects, who were naïve at the study start. The EEG data were also recorded in 59 age- and sex-matched healthy subjects as a control group. Frequency bands of interest included delta, theta, alpha1, alpha2 and alpha3, based on alpha frequency peak specific to each individual. They also included beta1 (13-20 Hz) and beta2 (20-30 Hz). Low-resolution brain electromagnetic tomography (LORETA) estimated EEG cortical source activity in frontal, central, temporal, parietal, and occipital regions. RESULTS Before the therapy, the HIV group showed greater parietal delta source activity and lower spatially diffuse alpha source activity compared to the control group. Thus, the ratio of parietal delta and alpha3 source activity served as an EEG marker. The z-score showed a statistically deviant EEG marker (EEG +) in 50% of the HIV individuals before therapy (p < 0.05). After 5 months of cART, delta source activity decreased, and alpha3 source activity increased in the HIV subjects with EEG + (about 50% of them showed a normalized EEG marker). CONCLUSIONS This procedure detected a deviant EEG marker before therapy and its post-therapy normalization in naïve HIV single individuals. SIGNIFICANCE The parietal delta/alpha3 EEG marker may be used to monitor cART effects on brain function in such individuals.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
- IRCCS S. Raffaele Pisana, Rome, Italy
| | - Alfredo Pennica
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | | | | | - Susanna Cordone
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Susanna Lopez
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Ketura Berry
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | | | - Stefano Ferracuti
- Psychiatry, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Paolo Roma
- Psychiatry, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Valentina Correr
- Psychiatry, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Francesco Di Campli
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Laura Gianserra
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Lorenzo Ciullini
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Antonio Aceti
- Infectious Diseases, Faculty of Medicine and Psychology, University of Rome “La Sapienza”, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Naples, Italy
- Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, University of Rome “Tor Vergata”, Rome, Italy
| | - Magdalena Viscione
- Clinical Infectious Diseases, University of Rome “Tor Vergata”, Rome, Italy
| | - Cristina Limatola
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
| | - Paolo Onorati
- Department of Physiology and Pharmacology, University of Rome “La Sapienza”, Rome, Italy
- IRCCS S. Raffaele Pisana, Rome, Italy
| | | | - Massimo Andreoni
- Clinical Infectious Diseases, University of Rome “Tor Vergata”, Rome, Italy
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López ME, Cuesta P, Garcés P, Castellanos PN, Aurtenetxe S, Bajo R, Marcos A, Delgado ML, Montejo P, López-Pantoja JL, Maestú F, Fernandez A. MEG spectral analysis in subtypes of mild cognitive impairment. AGE (DORDRECHT, NETHERLANDS) 2014; 36:9624. [PMID: 24532390 PMCID: PMC4082569 DOI: 10.1007/s11357-014-9624-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 01/23/2014] [Indexed: 05/16/2023]
Abstract
Mild cognitive impairment (MCI) has been described as an intermediate stage between normal aging and dementia. Previous studies characterized the alterations of brain oscillatory activity at this stage, but little is known about the differences between single and multidomain amnestic MCI patients. In order to study the patterns of oscillatory magnetic activity in amnestic MCI subtypes, a total of 105 subjects underwent an eyes-closed resting-state magnetoencephalographic recording: 36 healthy controls, 33 amnestic single domain MCIs (a-sd-MCI), and 36 amnestic multidomain MCIs (a-md-MCI). Relative power values were calculated and compared among groups. Subsequently, relative power values were correlated with neuropsychological tests scores and hippocampal volumes. Both MCI groups showed an increase in relative power in lower frequency bands (delta and theta frequency ranges) and a decrease in power values in higher frequency bands (alpha and beta frequency ranges), as compared with the control group. More importantly, clear differences emerged from the comparison between the two amnestic MCI subtypes. The a-md-MCI group showed a significant power increase within delta and theta ranges and reduced relative power within alpha and beta ranges. Such pattern correlated with the neuropsychological performance, indicating that the a-md-MCI subtype is associated not only with a "slowing" of the spectrum but also with a poorer cognitive status. These results suggest that a-md-MCI patients are characterized by a brain activity profile that is closer to that observed in Alzheimer disease. Therefore, it might be hypothesized that the likelihood of conversion to dementia would be higher within this subtype.
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Affiliation(s)
- M. E. López
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
| | - P. Cuesta
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
| | - P. Garcés
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />CEI Campus Moncloa, UCM-UPM, Madrid, Spain
| | - P. N. Castellanos
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
| | - S. Aurtenetxe
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
| | - R. Bajo
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />Department of Mathematics, UNIR Universidad Internacional de La Rioja, Logroño, La Rioja Spain
| | - A. Marcos
- />Neurology Department, San Carlos University Hospital, c/Martín Lagos s/n, 28040 Madrid, Spain
| | - M. L. Delgado
- />Seniors Center of the District of Chamartin, Chamartin S/N, 28002 Madrid, Spain
| | - P. Montejo
- />Memory Decline Prevention Center Madrid Salud, Ayuntamiento de Madrid, c/ Montesa, 22, 28006 Madrid, Spain
| | - J. L. López-Pantoja
- />Department of Psychiatry and Laboratory of Neuroendocrinology, San Carlos University Hospital, c/Martín Lagos s/n, 28040 Madrid, Spain
| | - F. Maestú
- />Laboratory of Cognitive and Computational Neuroscience (UCM-UPM), Centre for Biomedical Technology (CTB), Campus de Montegancedo s/n, Pozuelo de Alarcón, 28223 Madrid, Spain
- />Department of Basic Psychology II, Complutense University of Madrid, Madrid, Spain
| | - A. Fernandez
- />Department of Psychiatry and Medical Psychology School of Medicine, Complutense University of Madrid, Madrid, Spain
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Impaired cortical oscillatory coupling in mild cognitive impairment: anatomical substrate and ApoE4 effects. Brain Struct Funct 2014; 220:1721-37. [PMID: 24682246 DOI: 10.1007/s00429-014-0757-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 03/16/2014] [Indexed: 01/04/2023]
Abstract
Our current knowledge about the anatomical substrate of impaired resting-state cortical oscillatory coupling in mild cognitive impairment is still rudimentary. Here, we show that both resting-state oscillatory coupling and its anatomical correlates clearly distinguish healthy older (HO) adults from individuals with amnestic mild cognitive impairment (aMCI). aMCI showed failures in neural-phase coupling of resting-state electroencephalographic alpha activity mostly evident between fronto-temporal and parietal regions. As oligomers of amyloid-beta (Aβ) are linked to synaptic dysfunction in Alzheimer's disease (AD), we further investigated whether plasma concentrations of these oligomers (Aβ40 and Aβ42) accounted for impaired patterns of oscillatory coupling in aMCI. Results revealed that decreased plasma Aβ42 was associated with augmented coupling of parieto-temporal regions in HO subjects, but no relationship was found in aMCI. Oscillatory coupling of frontal regions was also significantly reduced in aMCI carriers of the ε4 allele of the Apolipoprotein E (ApoE) compared to ε4 noncarriers, although neither neuroanatomical nor plasma Aβ changes accounted for this difference. However, the abnormal pattern of oscillatory coupling in aMCI was negatively related to volume of the angular gyrus, and positively related to volume of the precuneus and the splenium of the corpus callosum. Previous evidence suggests that all these regions are neuropathological targets of AD. The current study takes that scenario one step further, suggesting that this anatomical damage could be responsible for disrupted cortical oscillatory coupling in aMCI. Together, these data shed light on how the MCI status modifies anatomo-functional relationships underlying coordination of large-scale cortical systems in the resting-state.
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Ponomareva N, Andreeva T, Protasova M, Shagam L, Malina D, Goltsov A, Fokin V, Mitrofanov A, Rogaev E. Age-dependent effect of Alzheimer's risk variant of CLU on EEG alpha rhythm in non-demented adults. Front Aging Neurosci 2013; 5:86. [PMID: 24379779 PMCID: PMC3861782 DOI: 10.3389/fnagi.2013.00086] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Accepted: 11/19/2013] [Indexed: 12/22/2022] Open
Abstract
Polymorphism in the genomic region harboring the CLU gene (rs11136000) has been associated with the risk for Alzheimer’s disease (AD). CLU C allele is assumed to confer risk for AD and the allele T may have a protective effect. We investigated the influence of the AD-associated CLU genotype on a common neurophysiological trait of brain activity (resting-state alpha-rhythm activity) in non-demented adults and elucidated whether this influence is modified over the course of aging. We examined quantitative electroencephalography (EEG) in a cohort of non-demented individuals (age range 20–80) divided into young (age range 20–50) and old (age range 51–80) cohorts and stratified by CLU polymorphism. To rule out the effect of the apolipoprotein E (ApoE) genotype on EEG characteristics, only subjects without the ApoE ε4 allele were included in the study. The homozygous presence of the AD risk variant CLU CC in non-demented subjects was associated with an increase of alpha3 absolute power. Moreover, the influence of CLU genotype on alpha3 was found to be higher in the subjects older than 50 years of age. The study also showed age-dependent alterations of alpha topographic distribution that occur independently of the CLU genotype. The increase of upper alpha power has been associated with hippocampal atrophy in patients with mild cognitive impairment (Moretti etal., 2012a). In our study, the CLU CC-dependent increase in upper alpha rhythm, particularly enhanced in elderly non-demented individuals, may imply that the genotype is related to preclinical dysregulation of hippocampal neurophysiology in aging and that this factor may contribute to the pathogenesis of AD.
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Affiliation(s)
- Natalya Ponomareva
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | - Tatiana Andreeva
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia ; Center of Brain Neurobiology and Neurogenetics, Institute of Cytogenetics and Genetics, Russian Academy of Sciences Novosibirsk, Russia
| | - Maria Protasova
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Lev Shagam
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Daria Malina
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | - Andrei Goltsov
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia
| | - Vitaly Fokin
- Brain Research Department, Research Center of Neurology Russian Academy of Medical Science Moscow, Russia
| | | | - Evgeny Rogaev
- Vavilov Institute of General Genetics, Russian Academy of Sciences Moscow, Russia ; Center of Brain Neurobiology and Neurogenetics, Institute of Cytogenetics and Genetics, Russian Academy of Sciences Novosibirsk, Russia ; University of Massachusetts Medical School, Department of Psychiatry, BNRI Worcester, MA, USA
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Babiloni C, Vecchio F, Altavilla R, Tibuzzi F, Lizio R, Altamura C, Palazzo P, Maggio P, Ursini F, Ercolani M, Soricelli A, Noce G, Rossini PM, Vernieri F. Hypercapnia affects the functional coupling of resting state electroencephalographic rhythms and cerebral haemodynamics in healthy elderly subjects and in patients with amnestic mild cognitive impairment. Clin Neurophysiol 2013; 125:685-693. [PMID: 24238990 DOI: 10.1016/j.clinph.2013.10.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 10/03/2013] [Accepted: 10/03/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Cerebral vasomotor reactivity (VMR) and coherence of resting state electroencephalographic (EEG) rhythms are impaired in Alzheimer's disease (AD) patients. Here we tested the hypothesis that these two variables could be related. METHODS We investigated VMR and coherence of resting state EEG rhythms in nine normal elderly (Nold) and in 10 amnesic mild cognitive impairment (MCI) subjects. Resting state eyes-closed EEG data were recorded at baseline pre-CO₂ (ambient air, 2 min), during 7% CO₂/air mixture inhalation (hypercapnia, 90 s) and post-CO₂ (ambient air, 2 min) conditions. Simultaneous frontal bilateral near-infrared spectroscopy (NIRS) was performed to assess VMR by cortical oxy- and deoxy-haemoglobin concentration changes. EEG coherence across all electrodes was computed at delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz) and gamma (30-40 Hz) bands. RESULTS In Nold subjects, 'total coherence' of EEG across all frequency bands and electrode pairs decreased during hypercapnia, with full recovery during post-CO₂. Total coherence resulted lower in pre-CO₂ and post-CO₂ and presented poor reactivity during CO₂ inhalation in MCI patients compared with Nold subjects. Hypercapnia increased oxy-haemoglobin and decreased deoxy-haemoglobin concentrations in both groups. Furthermore, the extent of changes in these variables during CO₂ challenge was correlated with the EEG coherence, as a reflection of neurovascular coupling. CONCLUSIONS Hypercapnia induced normal frontal VMR that was detected by NIRS in both Nold and amnesic MCI groups, while it produced a reactivity of global functional coupling of resting state EEG rhythms only in the Nold group. SIGNIFICANCE In amnesic MCI patients, global EEG functional coupling is basically low in amplitude and does not react to hypercapnia.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome "La Sapienza", Rome, Italy; IRCCS San Raffaele Pisana, Rome, Italy.
| | - Fabrizio Vecchio
- IRCCS San Raffaele Pisana, Rome, Italy; A.Fa.R. Dip. Neurosci, Ospedale 'San Giovanni Calibita' Fatebenefratelli, Isola Tiberina, Rome, Italy
| | | | - Francesco Tibuzzi
- A.Fa.R. Dip. Neurosci, Ospedale 'San Giovanni Calibita' Fatebenefratelli, Isola Tiberina, Rome, Italy
| | | | - Claudia Altamura
- Unità di Neurologia, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Paola Palazzo
- Unità di Neurologia, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Paola Maggio
- Unità di Neurologia, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Francesca Ursini
- Unità di Neurologia, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Matilde Ercolani
- A.Fa.R. Dip. Neurosci, Ospedale 'San Giovanni Calibita' Fatebenefratelli, Isola Tiberina, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy; Department of Studies of Institutions and Territorial Systems, University of Naples Parthenope, Naples, Italy
| | | | - Paolo Maria Rossini
- IRCCS San Raffaele Pisana, Rome, Italy; Department of Geriatrics, Neuroscience & Orthopedics, Institute of Neurology Catholic University "Sacro Cuore", Rome, Italy
| | - Fabrizio Vernieri
- Unità di Neurologia, Università Campus Bio-Medico di Roma, Rome, Italy
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Babiloni C, Del Percio C, Lizio R, Marzano N, Infarinato F, Soricelli A, Salvatore E, Ferri R, Bonforte C, Tedeschi G, Montella P, Baglieri A, Rodriguez G, Famà F, Nobili F, Vernieri F, Ursini F, Mundi C, Frisoni GB, Rossini PM. Cortical sources of resting state electroencephalographic alpha rhythms deteriorate across time in subjects with amnesic mild cognitive impairment. Neurobiol Aging 2013; 35:130-42. [PMID: 23906617 DOI: 10.1016/j.neurobiolaging.2013.06.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 06/21/2013] [Accepted: 06/30/2013] [Indexed: 11/13/2022]
Abstract
Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with mild cognitive impairment (MCI). Here, we tested the hypothesis that these sources in amnesic MCI subjects further deteriorate over 1 year. To this aim, the resting state eyes-closed EEG data were recorded in 54 MCI subjects at baseline (Mini Mental State Examination I = 26.9; standard error [SE], 0.2) and at approximately 1-year follow-up (13.8 months; SE, 0.5; Mini Mental State Examination II = 25.8; SE, 0.2). As a control, EEG recordings were also performed in 45 normal elderly and in 50 mild Alzheimer's disease subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), and beta2 (20-30 Hz). Cortical EEG sources were estimated using low-resolution brain electromagnetic tomography. Compared with the normal elderly and mild Alzheimer's disease subjects, the MCI subjects were characterized by an intermediate power of posterior alpha1 sources. In the MCI subjects, the follow-up EEG recordings showed a decreased power of posterior alpha1 and alpha2 sources. These results suggest that the resting state EEG alpha sources were sensitive-at least at the group level-to the cognitive decline occurring in the amnesic MCI group over 1 year, and might represent cost-effective, noninvasive and widely available markers to follow amnesic MCI populations in large clinical trials.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology, University of Rome La Sapienza, Rome, Italy.
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Babiloni C, Del Percio C, Bordet R, Bourriez JL, Bentivoglio M, Payoux P, Derambure P, Dix S, Infarinato F, Lizio R, Triggiani AI, Richardson JC, Rossini PM. Effects of acetylcholinesterase inhibitors and memantine on resting-state electroencephalographic rhythms in Alzheimer’s disease patients. Clin Neurophysiol 2013; 124:837-50. [DOI: 10.1016/j.clinph.2012.09.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Revised: 09/21/2012] [Accepted: 09/24/2012] [Indexed: 10/27/2022]
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36
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de Waal H, Stam CJ, de Haan W, van Straaten ECW, Blankenstein MA, Scheltens P, van der Flier WM. Alzheimer's disease patients not carrying the apolipoprotein E ε4 allele show more severe slowing of oscillatory brain activity. Neurobiol Aging 2013; 34:2158-63. [PMID: 23587637 DOI: 10.1016/j.neurobiolaging.2013.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 02/22/2013] [Accepted: 03/11/2013] [Indexed: 11/17/2022]
Abstract
The objective of this study was to quantitatively assess the relationship between apolipoprotein (APOE) genotype and electroencephalographic oscillatory brain dynamics in Alzheimer's disease (AD) patients and control subjects and its regional distribution. We obtained resting-state electroencephalographs of 320 AD patients and 246 control subjects, categorized into APOE ε4 carriers and noncarriers. Peak frequency and relative power in 4 different frequency bands were calculated. We tested the associations between APOE genotype and relative power in 4 brain regions. Peak frequency was comparable in APOE ε4 carrying and noncarrying control subjects, but lower in APOE ε4 noncarrying AD patients. In control subjects, APOE ε4 carriers had a different regional distribution of alpha power than noncarriers. We found no APOE effect in beta, delta, and theta bands. In AD, APOE ε4 noncarriers had lower alpha and higher delta power than carriers. This difference was most pronounced in the parieto-occipital region. In the theta band, APOE ε4 noncarriers had a different regional distribution of power compared with carriers. In conclusion, the most pronounced effect of genotype was seen in AD patients, and APOE ε4 noncarriers showed slower activity, especially in parieto-occipital regions.
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Affiliation(s)
- Hanneke de Waal
- Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, the Netherlands.
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Babiloni C, Infarinato F, Aujard F, Bastlund JF, Bentivoglio M, Bertini G, Del Percio C, Fabene PF, Forloni G, Herrero Ezquerro MT, Noè FM, Pifferi F, Ros-Bernal F, Christensen DZ, Dix S, Richardson JC, Lamberty Y, Drinkenburg W, Rossini PM. Effects of pharmacological agents, sleep deprivation, hypoxia and transcranial magnetic stimulation on electroencephalographic rhythms in rodents: Towards translational challenge models for drug discovery in Alzheimer’s disease. Clin Neurophysiol 2013; 124:437-51. [DOI: 10.1016/j.clinph.2012.07.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Revised: 07/05/2012] [Accepted: 07/21/2012] [Indexed: 10/27/2022]
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Babiloni C, Vecchio F, Buffo P, Onorati P, Muratori C, Ferracuti S, Roma P, Battuello M, Donato N, Pellegrini P, Di Campli F, Gianserra L, Teti E, Aceti A, Rossini PM, Pennica A. Cortical sources of resting-state EEG rhythms are abnormal in naïve HIV subjects. Clin Neurophysiol 2012; 123:2163-71. [DOI: 10.1016/j.clinph.2012.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 05/02/2012] [Accepted: 06/02/2012] [Indexed: 10/28/2022]
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Canuet L, Tellado I, Couceiro V, Fraile C, Fernandez-Novoa L, Ishii R, Takeda M, Cacabelos R. Resting-state network disruption and APOE genotype in Alzheimer's disease: a lagged functional connectivity study. PLoS One 2012; 7:e46289. [PMID: 23050006 PMCID: PMC3457973 DOI: 10.1371/journal.pone.0046289] [Citation(s) in RCA: 105] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 08/28/2012] [Indexed: 01/07/2023] Open
Abstract
Background The apolipoprotein E epsilon 4 (APOE-4) is associated with a genetic vulnerability to Alzheimer's disease (AD) and with AD-related abnormalities in cortical rhythms. However, it is unclear whether APOE-4 is linked to a specific pattern of intrinsic functional disintegration of the brain after the development of the disease or during its different stages. This study aimed at identifying spatial patterns and effects of APOE genotype on resting-state oscillations and functional connectivity in patients with AD, using a physiological connectivity index called “lagged phase synchronization”. Methodology/Principal Findings Resting EEG was recorded during awake, eyes-closed state in 125 patients with AD and 60 elderly controls. Source current density and functional connectivity were determined using eLORETA. Patients with AD exhibited reduced parieto-occipital alpha oscillations compared with controls, and those carrying the APOE-4 allele had reduced alpha activity in the left inferior parietal and temporo-occipital cortex relative to noncarriers. There was a decreased alpha2 connectivity pattern in AD, involving the left temporal and bilateral parietal cortex. Several brain regions exhibited increased lagged phase synchronization in low frequencies, specifically in the theta band, across and within hemispheres, where temporal lobe connections were particularly compromised. Areas with abnormal theta connectivity correlated with cognitive scores. In patients with early AD, we found an APOE-4-related decrease in interhemispheric alpha connectivity in frontal and parieto-temporal regions. Conclusions/Significance In addition to regional cortical dysfunction, as indicated by abnormal alpha oscillations, there are patterns of functional network disruption affecting theta and alpha bands in AD that associate with the level of cognitive disturbance or with the APOE genotype. These functional patterns of nonlinear connectivity may potentially represent neurophysiological or phenotypic markers of AD, and aid in early detection of the disorder.
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Affiliation(s)
- Leonides Canuet
- EuroEspes Biomedical Research Center, Institute for CNS Disorders and Genomic Medicine, Corunna, Spain.
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Cortical sources of EEG rhythms in congestive heart failure and Alzheimer's disease. Int J Psychophysiol 2012; 86:98-107. [PMID: 22771500 DOI: 10.1016/j.ijpsycho.2012.06.053] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Revised: 06/14/2012] [Accepted: 06/29/2012] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The brain needs continuous oxygen supply even in resting-state. Hypoxia enhances resting-state electroencephalographic (EEG) rhythms in the delta range, and reduces those in the alpha range, with a pattern similar to that observed in Alzheimer's disease (AD). Here we tested whether resting-state cortical EEG rhythms in patients with congestive heart failure (CHF), as a model of acute hypoxia, present frequency similarities with AD patients, comparable by cognitive status revealed by the mini mental state examination (MMSE). METHODS Eyes-closed EEG data were recorded in 10 CHF patients, 20 AD patients, and 20 healthy elderly subjects (Nold) as controls. LORETA software estimated cortical EEG generators. RESULTS Compared to Nold, both AD and CHF groups presented higher delta (2-4Hz) and lower alpha (8-13Hz) temporal sources. The highest delta and lowest alpha sources were observed in CHF subjects. In these subjects, the global amplitude of delta sources correlated with brain natriuretic peptide (BNP) level in the blood, as a marker of disease severity. CONCLUSIONS Resting-state delta and alpha rhythms suggest analogies between the effects of acute hypoxia and AD neurodegeneration on the cortical neurons' synchronization. SIGNIFICANCE Acute ischemic hypoxia could affect the mechanisms of cortical neural synchronization generating resting state EEG rhythms, inducing the "slowing" of EEG rhythms typically observed in AD patients.
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The Influence of Apolipoprotein E Epsilon4 Polymorphism on qEEG Profiles in Healthy Young Females: A Resting EEG Study. Brain Topogr 2012; 25:431-42. [DOI: 10.1007/s10548-012-0229-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2011] [Accepted: 04/23/2012] [Indexed: 12/23/2022]
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Babiloni C, Carducci F, Lizio R, Vecchio F, Baglieri A, Bernardini S, Cavedo E, Bozzao A, Buttinelli C, Esposito F, Giubilei F, Guizzaro A, Marino S, Montella P, Quattrocchi CC, Redolfi A, Soricelli A, Tedeschi G, Ferri R, Rossi-Fedele G, Ursini F, Scrascia F, Vernieri F, Pedersen TJ, Hardemark HG, Rossini PM, Frisoni GB. Resting state cortical electroencephalographic rhythms are related to gray matter volume in subjects with mild cognitive impairment and Alzheimer's disease. Hum Brain Mapp 2012; 34:1427-46. [PMID: 22331654 DOI: 10.1002/hbm.22005] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Revised: 10/31/2011] [Accepted: 11/01/2011] [Indexed: 11/06/2022] Open
Abstract
Cortical gray matter volume and resting state cortical electroencephalographic rhythms are typically abnormal in subjects with amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here we tested the hypothesis that in amnesic MCI and AD subjects, abnormalities of EEG rhythms are a functional reflection of cortical atrophy across the disease. Eyes-closed resting state EEG data were recorded in 57 healthy elderly (Nold), 102 amnesic MCI, and 108 AD patients. Cortical gray matter volume was indexed by magnetic resonance imaging recorded in the MCI and AD subjects according to Alzheimer's disease neuroimaging initiative project (http://www.adni-info.org/). EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), beta2 (20-30 Hz), and gamma (30-40 Hz). These rhythms were indexed by LORETA. Compared with the Nold, the MCI showed a decrease in amplitude of alpha 1 sources. With respect to the Nold and MCI, the AD showed an amplitude increase of delta sources, along with a strong amplitude reduction of alpha 1 sources. In the MCI and AD subjects as a whole group, the lower the cortical gray matter volume, the higher the delta sources, the lower the alpha 1 sources. The better the score to cognitive tests the higher the gray matter volume, the lower the pathological delta sources, and the higher the alpha sources. These results suggest that in amnesic MCI and AD subjects, abnormalities of resting state cortical EEG rhythms are not epiphenomena but are strictly related to neurodegeneration (atrophy of cortical gray matter) and cognition.
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Affiliation(s)
- Claudio Babiloni
- Department of Biomedical Sciences, University of Foggia, Viale Pinto 7, Foggia, Italy.
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Ponomareva NV, Goltsov AY, Kunijeva SS, Scheglova NS, Malina DD, Mitrofanov AA, Boikova TI, Rogaev EI. Age- and genotype-related neurophysiologic reactivity to oxidative stress in healthy adults. Neurobiol Aging 2011; 33:839.e11-21. [PMID: 22206848 DOI: 10.1016/j.neurobiolaging.2011.11.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Revised: 07/15/2011] [Accepted: 11/08/2011] [Indexed: 10/14/2022]
Abstract
The epsilon4 allele of the apolipoprotein E gene (ApoE), as well as aging increase the risk of Alzheimer's and vascular diseases. Electroencephalogram (EEG) reactivity to hyperventilation (HV) depends on hypocapnia-induced cerebral vasoconstriction, which may be impaired in subjects with subclinical cerebrovascular disease. Quantitative EEG at rest and under 3-minute HV was examined in 125 healthy subjects divided into younger (age range 28-50) and older (age range 51-82) cohorts and stratified by ApoE genotype. The younger ApoE-epsilon4 carriers had excessive EEG reactivity to HV characterized by the manifestation of high-voltage delta, theta activity and sharp waves, and larger HV-induced changes in EEG relative powers than in the younger ApoE-epsilon4 noncarriers. EEG reactivity to HV decreased with aging, and in the ApoE-epsilon4 carriers the decrease was more pronounced than in the ApoE-epsilon4 noncarriers. The older ApoE-epsilon4 carriers had smaller HV-induced changes in EEG relative powers than the older ApoE-epsilon4 noncarriers. A marked decline of EEG reactivity to HV in the older ApoE-epsilon4 carriers suggests the possible impact of vascular factors on the pathogenesis of ApoE-induced Alzheimer disease.
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Babiloni C, Frisoni GB, Vecchio F, Lizio R, Pievani M, Cristina G, Fracassi C, Vernieri F, Rodriguez G, Nobili F, Ferri R, Rossini PM. Stability of clinical condition in mild cognitive impairment is related to cortical sources of alpha rhythms: an electroencephalographic study. Hum Brain Mapp 2011; 32:1916-31. [PMID: 21181798 PMCID: PMC6869969 DOI: 10.1002/hbm.21157] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 06/10/2010] [Accepted: 08/10/2010] [Indexed: 11/10/2022] Open
Abstract
Previous evidence has shown that resting eyes-closed cortical alpha rhythms are higher in amplitude in mild cognitive impairment (MCI) than Alzheimer's disease (AD) subjects (Babiloni et al. [2006a]: Human Brain Mapp 27:162-172; [2006b]: Clin Neurophysiol 117:252-268; [2006c]: Neuroimage 29:948-964; [2006d]: Ann Neurol 59:323-334; [2006e]: Clin Neurophysiol 117:1113-1129; [2006f]: Neuroimage 31:1650-1665). This study tested the hypothesis that, in amnesic MCI subjects, high amplitude of baseline cortical alpha rhythms is related to long-term stability of global cognition on clinical follow-up. Resting electroencephalographic (EEG) data were recorded in 100 amnesic MCI subjects during eyes-closed condition. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), and beta2 (20-30 Hz). Cortical EEG sources were estimated by low-resolution brain electromagnetic tomography (LORETA). Global cognition was indexed by mini mental state evaluation (MMSE) score at the time of EEG recordings (baseline) and about after 1 year. Based on the MMSE percentage difference between baseline and 1-year follow-up (MMSEvar), the MCI subjects were retrospectively divided into three arbitrary groups: DECREASED (MMSEvar ≤ -4%; N = 43), STABLE (MMSEvar ≈ 0; N = 27), and INCREASED (MMSEvar ≥ +4%; N = 30). Subjects' age, education, individual alpha frequency, gender, and MMSE scores were used as covariates for statistical analysis. Baseline posterior cortical sources of alpha 1 rhythms were higher in amplitude in the STABLE than in the DECREASED and INCREASED groups. These results suggest that preserved resting cortical neural synchronization at alpha frequency is related to a long-term (1 year) stable cognitive function in MCI subjects. Future studies should use serial MMSE measurements to confirm and refine the present results.
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Affiliation(s)
- Claudio Babiloni
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy.
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Jiang L, Yin X, Yin C, Zhou S, Dan W, Sun X. Different quantitative EEG alterations induced by TBI among patients with different APOE genotypes. Neurosci Lett 2011; 505:160-4. [PMID: 22015765 DOI: 10.1016/j.neulet.2011.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Revised: 10/03/2011] [Accepted: 10/04/2011] [Indexed: 11/20/2022]
Abstract
Although several studies have revealed the EEG alterations in AD and TBI patients, the influence of APOE (apolipoprotein E) genotype in EEG at the early stage of TBI has not been reported yet. We have previously studied EEG alterations caused by TBI among different APOE genotype carriers. In this study, we firstly investigated the relationship between APOE polymorphisms and quantitative EEG (QEEG) changes after TBI. A total of 118 consecutive TBI patients with a Glasgow Coma Scale (GCS) of 9 or higher were recruited, and 40 normal adults were also included as a control group. APOE genotype was determined by PCR-RFLP for each subject, and QEEG recordings were performed in rest, relaxed, awake and with eyes closed in normal subjects and TBI patients during 1-3 days after TBI. In the normal control group, both APOEɛ4 carriers and non-carriers had normal EEG, and no significant difference of QEEG data was found between APOEɛ4 carriers and non-carriers. But in the TBI group, APOEɛ4 carriers had more focal or global irregular slow wave activities than APOEɛ4 non-carriers. APOE gene did not influence brain electrical activity under normal conditions, but TBI can induce different alterations among different APOE gene carriers, and APOEɛ4 allele enhances the EEG abnormalities at the early stage of TBI.
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Affiliation(s)
- Li Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, PR China
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Babiloni C, De Pandis MF, Vecchio F, Buffo P, Sorpresi F, Frisoni GB, Rossini PM. Cortical sources of resting state electroencephalographic rhythms in Parkinson's disease related dementia and Alzheimer's disease. Clin Neurophysiol 2011; 122:2355-64. [PMID: 21924950 DOI: 10.1016/j.clinph.2011.03.029] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 03/03/2011] [Accepted: 03/26/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Here we test the hypothesis that cortical source mapping of resting state electroencephalographic (EEG) rhythms could characterize neurodegenerative disorders inducing cognitive impairment such as Parkinson's disease related dementia (PDD) and Alzheimer's disease (AD). METHODS To address this issue, eyes-closed resting state EEG rhythms were recorded in 13 PDD, 20 AD, and 20 normal elderly (Nold) subjects. Age, gender, and education were carefully matched across the three groups. Mini Mental State Evaluation (MMSE) score probed subjects' global cognitive status, and was matched between the PDD and AD groups. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha1 (8-10.5 Hz), alpha2 (10.5-13 Hz), beta1 (13-20 Hz), and beta2 (20-30 Hz). EEG cortical sources were estimated by low resolution brain electromagnetic source tomography (LORETA). RESULTS With respect to the Nold and AD groups, the PPD group was characterized by peculiar abnormalities of central delta sources and posterior cortical sources of theta and beta1 rhythms. With respect to the Nold group, the PDD and AD groups mainly pointed to lower posterior cortical sources of alpha1 rhythms, which were positively correlated to MMSE score across all PDD and AD subjects as a whole (the lower the alpha sources, the lower the MMSE score). This alpha decrease was greater in the AD than PPD patients. CONCLUSIONS The results suggest that topography and frequency of eyes-closed resting state cortical EEG rhythms distinguished PDD and AD groups. SIGNIFICANCE We report the existence of different effects of neurodegeneration on the cortical neural synchronization mechanisms generating resting state EEG rhythms in PDD and AD patients.
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Affiliation(s)
- Claudio Babiloni
- Department of Biomedical Sciences, University of Foggia, Foggia, Italy
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Roh JH, Park MH, Ko D, Park KW, Lee DH, Han C, Jo SA, Yang KS, Jung KY. Region and frequency specific changes of spectral power in Alzheimer's disease and mild cognitive impairment. Clin Neurophysiol 2011; 122:2169-76. [PMID: 21715226 DOI: 10.1016/j.clinph.2011.03.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Revised: 02/08/2011] [Accepted: 03/19/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To find out whether healthy control (HC), amnestic mild cognitive impairment (aMCI), and Alzheimer's disease (AD) subjects exhibit region and frequency specific spectral power differences and whether the spectral power changes correlate with domain-specific cognitive function. METHODS Forty-one AD, 38 aMCI, and 39 HC subjects underwent quantitative EEG and comprehensive neuropsychological tests. Repeated measures analysis of variance was performed to identify differences in EEG spectral power among the three groups by scalp region and EEG frequency. Correlations between region and frequency specific spectral powers and neuropsychological test scores were evaluated. RESULTS Temporal and parieto-occipital theta band powers were highest in AD. Whereas, parieto-occipital alpha and frontal and temporal beta 2 band powers were highest in HC and lowest in AD (p<0.05). Temporal and parieto-occipital theta powers negatively correlated with verbal and visuospatial memory recall, while parieto-occipital alpha and temporal beta 2 powers positively correlated with verbal memory recall (p<0.01). CONCLUSIONS Region and frequency specific oscillatory characteristics of EEG reflect domain-specific cognitive function in patients with aMCI and AD. SIGNIFICANCE Region and frequency specific spectral powers have clinical implications as additional markers differentiating AD, aMCI, and HC.
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Affiliation(s)
- Jee Hoon Roh
- Department of Neurology, Korea University College of Medicine, Korea University Medical Center, South Korea
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Lizio R, Vecchio F, Frisoni GB, Ferri R, Rodriguez G, Babiloni C. Electroencephalographic rhythms in Alzheimer's disease. Int J Alzheimers Dis 2011; 2011:927573. [PMID: 21629714 PMCID: PMC3100729 DOI: 10.4061/2011/927573] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 03/13/2011] [Indexed: 11/20/2022] Open
Abstract
Physiological brain aging is characterized by synapses loss and neurodegeneration that slowly lead to an age-related decline of cognition. Neural/synaptic redundancy and plastic remodelling of brain networking, also due to mental and physical training, promotes maintenance of brain activity in healthy elderly subjects for everyday life and good social behaviour and intellectual capabilities. However, age is the major risk factor for most common neurodegenerative disorders that impact on cognition, like Alzheimer's disease (AD). Brain electromagnetic activity is a feature of neuronal network function in various brain regions. Modern neurophysiological techniques, such as electroencephalography (EEG) and event-related potentials (ERPs), are useful tools in the investigation of brain cognitive function in normal and pathological aging with an excellent time resolution. These techniques can index normal and abnormal brain aging analysis of corticocortical connectivity and neuronal synchronization of rhythmic oscillations at various frequencies. The present review suggests that discrimination between physiological and pathological brain aging clearly emerges at the group level, with suggested applications also at the level of single individual. The possibility of combining the use of EEG together with biological/neuropsychological markers and structural/functional imaging is promising for a low-cost, non-invasive, and widely available assessment of groups of individuals at-risk.
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Vecchio F, Babiloni C. Direction of Information Flow in Alzheimer's Disease and MCI Patients. Int J Alzheimers Dis 2011; 2011:214580. [PMID: 21547216 PMCID: PMC3087446 DOI: 10.4061/2011/214580] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/13/2011] [Indexed: 11/20/2022] Open
Abstract
Is directionality of electroencephalographic (EEG) synchronization abnormal in amnesic mild cognitive impairment (MCI) and Alzheimer's disease (AD)? And, do cerebrovascular and AD lesions represent additive factors in the development of MCI as a putative preclinical stage of AD? Here we reported two studies that tested these hypotheses. EEG data were recorded in normal elderly (Nold), amnesic MCI, and mild AD subjects at rest condition (closed eyes). Direction of information flow within EEG electrode pairs was performed by directed transfer function (DTF) at δ (2-4 Hz), θ (4-8 Hz), α1 (8-10 Hz), α2 (10-12 Hz), β1 (13-20 Hz), β2 (20-30 Hz), and γ (30-40 Hz). Parieto-to-frontal direction was stronger in Nold than in MCI and/or AD subjects for α and β rhythms. In contrast, the directional flow within interhemispheric EEG functional coupling did not discriminate among the groups. More interestingly, this coupling was higher at θ, α1, α2, and β1 in MCI with higher than in MCI with lower vascular load. These results suggest that directionality of parieto-to-frontal EEG synchronization is abnormal not only in AD but also in amnesic MCI, supporting the additive model according to which MCI state would result from the combination of cerebrovascular and neurodegenerative lesions.
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Affiliation(s)
- Fabrizio Vecchio
- AfaR, Department of Neuroscience, Fatebenefratelli Hospital, Isola Tiberina, 00186 Rome, Italy
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Irimajiri R, Golob EJ, Starr A. ApoE genotype and abnormal auditory cortical potentials in healthy older females. Neurobiol Aging 2010; 31:1799-804. [DOI: 10.1016/j.neurobiolaging.2008.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2008] [Revised: 09/18/2008] [Accepted: 09/18/2008] [Indexed: 11/26/2022]
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