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Fastame MC, Mulas I, Putzu V, Asoni G, Viale D, Mameli I, Pau M. The efficiency of activities of daily living (ADLs) skills in late adulthood: A mediational approach. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:1132-1143. [PMID: 35981564 DOI: 10.1080/23279095.2022.2111261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The term "Activities of Daily Living" (ADLs) refers to a set of fundamental tasks (i.e., toileting, bathing, personal care, eating, grooming, and getting dressed) considered necessary for living and being autonomous in everyday life. Although in the clinical setting ADLs efficiency is a marker to diagnose dementia, limited evidence on the mechanism implicating muscular function and cognitive alterations in ADLs skills in late adulthood exists. This study primarily intended to determine the extent to which executive functions mediate between muscular strength, as assessed through handgrip strength (HGS) measurement, and ADLs skills of older community-dwellers. A further goal was to explore the impact of gender and cognitive status on ADLs and HGS scores, using education as a covariate. Three hundred and thirty-four older participants, 199 females and 135 males (Mage = 77.5 years, SD = 5.6 years, age range = 63-93 years) completed a battery of tests assessing ADLs, HGS, and executive functions. The results showed that 34-56% of the variance in the ADLs condition was explained by HGS and executive functioning. Furthermore, cognitively healthy participants exhibited better ADLs skills, whereas cognitively impaired individuals, both males and females, exhibited poorer HGS efficiency. In conclusion, in clinical settings, the concurrent evaluation of ADLs skills, motor, and higher-order cognitive processes should be encouraged to detect individuals needing a person-tailored intervention to boost their quality of life.
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Affiliation(s)
- Maria Chiara Fastame
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Ilaria Mulas
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Valeria Putzu
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Gesuina Asoni
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Daniela Viale
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Irene Mameli
- Center for Cognitive Disorders and Dementia, ASSL Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
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Abdelkhalek H, Elliott K, Whitfield T, Pazvantova K, Zabihi S, Wenborn J, Walker Z. Effectiveness of a 14-week protocol for cognitive stimulation therapy for mild dementia: results from a pragmatic study using routinely collected clinical data. Aging Ment Health 2024:1-9. [PMID: 39364856 DOI: 10.1080/13607863.2024.2410256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 09/22/2024] [Indexed: 10/05/2024]
Abstract
OBJECTIVES To explore the effectiveness of an adapted 14-week cognitive stimulation therapy (CST) protocol on psychoaffective symptoms and quality of life (QOL) for people living with mild dementia. METHOD The sample for this pragmatic study were people with dementia who underwent CST between May 2016 and September 2022 during routine healthcare. Measures of participants' psychoaffective symptoms and QOL were administered before CST ('baseline') and following CST ('post-intervention'). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety symptoms, depression symptoms, and their sum score (referred to as HADS-total). The Quality of Life-Alzheimer's Disease (QOL-AD) scale was used to measure participants' quality of life (both patient and carer ratings were available). Change in these outcomes was assessed using linear mixed models. RESULTS Two hundred and twenty-five participants attended ≥1 session of adapted CST (84% attended at least 9/14 sessions, considered 'high' adherence). The mean change [95% confidence interval] in HADS-total scores indicated improvement (-0.9; [-1.9, -0.0]). Mean scores on the other outcomes showed neither improvement nor worsening. CONCLUSION Overall, this pragmatic study shows that an adapted 14-week face-to-face CST protocol is effective in improving mental health in people with mild dementia and has the potential to be widely implemented within routine healthcare.
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Affiliation(s)
| | - Karen Elliott
- Essex Partnership University NHS Foundation Trust, Essex, UK
| | - Tim Whitfield
- Division of Psychiatry, University College London, London, UK
| | | | - Sedigheh Zabihi
- Division of Psychiatry, University College London, London, UK
- Preventive Neurology Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Jennifer Wenborn
- Essex Partnership University NHS Foundation Trust, Essex, UK
- Division of Psychiatry, University College London, London, UK
| | - Zuzana Walker
- Essex Partnership University NHS Foundation Trust, Essex, UK
- Division of Psychiatry, University College London, London, UK
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Yong K, Petzold A, Foster P, Young A, Bell S, Bai Y, Leff AP, Crutch S, Greenwood JA. The Graded Incomplete Letters Test (GILT): a rapid test to detect cortical visual loss, with UK Biobank implementation. Behav Res Methods 2024; 56:7748-7760. [PMID: 38890263 PMCID: PMC11362218 DOI: 10.3758/s13428-024-02448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/20/2024]
Abstract
Impairments of object recognition are core features of neurodegenerative syndromes, in particular posterior cortical atrophy (PCA; the 'visual-variant Alzheimer's disease'). These impairments arise from damage to higher-level cortical visual regions and are often missed or misattributed to common ophthalmological conditions. Consequently, diagnosis can be delayed for years with considerable implications for patients. We report a new test for the rapid measurement of cortical visual loss - the Graded Incomplete Letters Test (GILT). The GILT is an optimised psychophysical variation of a test used to diagnose cortical visual impairment, which measures thresholds for recognising letters under levels of increasing visual degradation (decreasing "completeness") in a similar fashion to ophthalmic tests. The GILT was administered to UK Biobank participants (total n=2,359) and participants with neurodegenerative conditions characterised by initial cortical visual (PCA, n=18) or memory loss (typical Alzheimer's disease, n=9). UK Biobank participants, including both typical adults and those with ophthalmological conditions, were able to recognise letters under low levels of completeness. In contrast, participants with PCA consistently made errors with only modest decreases in completeness. GILT sensitivity to PCA was 83.3% for participants reaching the 80% accuracy cut-off, increasing to 88.9% using alternative cut-offs (60% or 100% accuracy). Specificity values were consistently over 94% when compared to UK Biobank participants without or with documented visual conditions, regardless of accuracy cut-off. These first-release UK Biobank and clinical verification data suggest the GILT has utility in both rapidly detecting visual perceptual losses following posterior cortical damage and differentiating perceptual losses from common eye-related conditions.
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Affiliation(s)
- Kxx Yong
- Queen Square Institute of Neurology, University College London, London, UK.
| | - A Petzold
- Queen Square Institute of Neurology, University College London, London, UK
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
- Neuro-ophthalmology Expertise Centre, Amsterdam UMC, Amsterdam, NL, The Netherlands
| | - P Foster
- Institute of Ophthalmology, University College London, London, UK
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - A Young
- Big Data Institute, Nuffield, Department of Population Health, University of Oxford, Oxford, UK
| | - S Bell
- UK Biobank, Stockport, UK
| | - Y Bai
- Queen Square Institute of Neurology, University College London, London, UK
| | - A P Leff
- Queen Square Institute of Neurology, University College London, London, UK
| | - S Crutch
- Queen Square Institute of Neurology, University College London, London, UK
| | - J A Greenwood
- Experimental Psychology, University College London, London, UK.
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Geng L, Cao W, Zuo J, Yan H, Wan J, Sun Y, Wang N. Functional activity, functional connectivity and complex network biomarkers of progressive hyposmia Parkinson's disease with no cognitive impairment: evidences from resting-state fMRI study. Front Aging Neurosci 2024; 16:1455020. [PMID: 39385833 PMCID: PMC11461260 DOI: 10.3389/fnagi.2024.1455020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 09/10/2024] [Indexed: 10/12/2024] Open
Abstract
Background Olfactory dysfunction stands as one of the most prevalent non-motor symptoms in the initial stage of Parkinson's disease (PD). Nevertheless, the intricate mechanisms underlying olfactory deficits in Parkinson's disease still remain elusive. Methods This study collected rs-fMRI data from 30 PD patients [15 with severe hyposmia (PD-SH) and 15 with no/mild hyposmia (PD-N/MH)] and 15 healthy controls (HC). To investigate functional segregation, the amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) were utilized. Functional connectivity (FC) analysis was performed to explore the functional integration across diverse brain regions. Additionally, the graph theory-based network analysis was employed to assess functional networks in PD patients. Furthermore, Pearson correlation analysis was conducted to delve deeper into the relationship between the severity of olfactory dysfunction and various functional metrics. Results We discovered pronounced variations in ALFF, ReHo, FC, and topological brain network attributes across the three groups, with several of these disparities exhibiting a correlation with olfactory scores. Conclusion Using fMRI, our study analyzed brain function in PD-SH, PD-N/MH, and HC groups, revealing impaired segregation and integration in PD-SH and PD-N/MH. We hypothesize that changes in temporal, frontal, occipital, and cerebellar activities, along with aberrant cerebellum-insula connectivity and node degree and betweenness disparities, may be linked to olfactory dysfunction in PD patients.
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Affiliation(s)
- Lei Geng
- Department of Medical Imaging, The Second People’s Hospital of Lianyungang, Lianyungang, China
- The Oncology Hospital of Lianyungang, Lianyungang, China
- Lianyungang Clinical College of Jiangsu University, Lianyungang, China
| | - Wenfei Cao
- Department of Neurology, Heze Municipal Hospital, Heze, China
| | - Juan Zuo
- Department of Ultrasound, The Fourth People’s Hospital of Lianyungang, Lianyungang, China
| | - Hongjie Yan
- Department of Neurology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang, China
| | - Jinxin Wan
- Department of Medical Imaging, The Second People’s Hospital of Lianyungang, Lianyungang, China
- The Oncology Hospital of Lianyungang, Lianyungang, China
- Lianyungang Clinical College of Jiangsu University, Lianyungang, China
| | - Yi Sun
- Department of Medical Imaging, The Second People’s Hospital of Lianyungang, Lianyungang, China
- The Oncology Hospital of Lianyungang, Lianyungang, China
| | - Nizhuan Wang
- Department of Chinese and Bilingual Studies, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Shamputi D, Kaputu-Kalala-Malu C, Vivalya BMN, Paddick SM, Kalaria R. Challenges in evaluating cognitive impairment in diabetics in the Democratic Republic of the Congo. Dement Neuropsychol 2024; 18:e20230082. [PMID: 39318381 PMCID: PMC11421554 DOI: 10.1590/1980-5764-dn-2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 05/07/2024] [Accepted: 06/09/2024] [Indexed: 09/26/2024] Open
Abstract
Dementia is a global public health issue, with 57.5 million people living with at least one type of dementia in 2019 worldwide, and projected to rise to 152 million by 2050. Objective We assessed the cognitive function in diabetic patients aged 60 or older in Bukavu city, in the eastern Republic of the Congo (DRC). Methods This case-control study involved 123 patients with established diabetes mellitus (DM) and 123 controls over 60-year-olds also with high rates of illiteracy. Cognitive function was assessed using the Swahili version of the Community Screening Instrument for Dementia (CSI-D). Results Foremost, our study revealed language-related differences between Swahili spoken in other eastern African countries such as Tanzania and Kenya, where the Swahili CSI-D is readily applied, compared to the Swahili spoken in Bukavu (DRC). Our results also showed that cognitive impairment was present in 18.7% of the total 246 participants. Remarkably, the prevalence rate of cognitive impairment was higher in the non-diabetic group (12.2 versus 25.2%; p=0.009). Participants aged 80 or older were more likely to present with cognitive impairment compared to those aged less than 80 (adjusted odds ratio - aOR=70.27; 95% confidence interval - 95%CI 3.94-125.15; p=0.004). We also found that patients living with DM for more than 20 years were three times more likely to be impaired compared to those who were recently diagnosed with DM (aOR=3.63; 95%CI 1.70-18.81; p=0.026). Conclusion This study revealed that cognitive impairment was relatively high in Bukavu city. It emphasizes the lack of effective tools to assess cognitive function. This requires, therefore, that research be adapted to the intellect and cultural experiences of the patients.
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Affiliation(s)
- David Shamputi
- Université Evangélique En Afrique, University Teaching Hospital of Panzi, Department of Internal Medicine, Bukavu Town, Republic Democratic of Congo
| | - Célestin Kaputu-Kalala-Malu
- University of Kinshasa, Kinshasa University Teaching Hospital, Centre Neuropsychopathologique, Department of Neurology, Republic Democratic of Congo
| | | | - Stella-Maria Paddick
- Newcastle University, Translational and Clinical Research Institute, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
- University of Nairobi, Faculty of Health Sciences, Nairobi, Kenya
| | - Raj Kalaria
- Newcastle University, Translational and Clinical Research Institute, Campus for Ageing & Vitality, Newcastle upon Tyne, UK
- University of Nairobi, Faculty of Health Sciences, Nairobi, Kenya
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Perry A, Hughes LE, Adams NE, Naessens M, Kloosterman NA, Rouse MA, Murley AG, Street D, Jones PS, Rowe JB. Frontotemporal lobar degeneration changes neuronal beta-frequency dynamics during the mismatch negativity response. Neuroimage Clin 2024; 44:103671. [PMID: 39305652 PMCID: PMC11439566 DOI: 10.1016/j.nicl.2024.103671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 09/07/2024] [Accepted: 09/07/2024] [Indexed: 10/04/2024]
Abstract
The consequences of frontotemporal lobar degeneration include changes in prefrontal cortical neurophysiology, with abnormalities of neural dynamics reported in the beta frequency range (14-30 Hz) that correlate with functional severity. We examined beta dynamics in two clinical syndromes associated with frontotemporal lobar degeneration: the behavioral variant of frontotemporal dementia (bvFTD) and progressive supranuclear palsy (PSP). Whilst these two syndromes are partially convergent in cognitive effects, they differ in disease mechanisms such as molecular pathologies and prefrontal atrophy. Whether bvFTD and PSP also differ in neurophysiology remains to be fully investigated. We compared magnetoencephalography from 20 controls, 23 people with bvFTD and 21 people with PSP (Richardson's syndrome) during an auditory roving oddball paradigm. We measured changes in low and high total beta power responses (14-22 and 22-30 Hz respectively) over frontotemporal cortex in the period of the mismatch negativity response (100-250 ms post-stimulus). In controls, we found increased 14-22 Hz beta power following unexpected sensory events (i.e. increased deviant versus standard response), from right prefrontal cortex. Relative to controls, PSP reversed the mismatch response in this time-frequency window, reflecting reduced responses to the deviant stimuli (relative to standard stimuli). Abnormal beta at baseline in PSP could account for the reduced task-modulation of beta. Across bvFTD and PSP groups, the beta response to deviant stimuli (relative to standard stimuli) correlated with clinical severity, but not with atrophy of the prefrontal source region. These findings confirm the proposed importance of higher-order cortical regions, and their beta-power generators, in sensory change detection and context-updating during oddball paradigms. The physiological effects are proposed to result from changes in synaptic density, cortical neurotransmitters and subcortical connections, rather than merely atrophy. Beta-power changes may assist clinical stratification and provide intermediate outcomes for experimental medicine studies of novel therapeutic strategies.
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Affiliation(s)
- Alistair Perry
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - Laura E Hughes
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - Natalie E Adams
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - Michelle Naessens
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - Niels A Kloosterman
- Institut für Psychologie I, Universität zu Lübeck, Germany; Max Planck Institute for Human Development, Berlin, Germany
| | - Matthew A Rouse
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | - Alexander G Murley
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - Duncan Street
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - P Simon Jones
- Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom
| | - James B Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom; Department of Clinical Neurosciences and Cambridge University Hospitals NHS Trust, University of Cambridge, United Kingdom.
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Chantanachai T, Sturnieks DL, Lord SR, Close JCT, Kurrle SE, Delbaere K, Payne N, Savage R, Taylor ME. Effect of cognitive training on cognitive function in community-dwelling older people with mild-to-moderate dementia: A single-blind randomised controlled trial. Australas J Ageing 2024; 43:491-502. [PMID: 38343201 DOI: 10.1111/ajag.13283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/22/2023] [Accepted: 01/05/2024] [Indexed: 10/01/2024]
Abstract
OBJECTIVES The purpose of this assessor-blinded, randomised controlled trial was to determine the effect of computerised cognitive training (CT) on executive function, processing speed and working memory in 61 people with mild-to-moderate dementia. METHODS The primary outcomes were forward Digit Span and Trail Making Tests (TMT) at the completion of the 6-month intervention. Secondary outcomes included cognitive and physical performance, rate of falls, participant and caregiver's quality of life and usability and adherence to the CT program. The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12617000364370). RESULTS Intervention group (n = 31) participants averaged 81 min of CT per week, and system usability scores were acceptable (participants: 68.8 ± 22.1; caregivers: 79.4 ± 23.5). There were no statistically significant differences in cognitive or physical performance outcomes between the intervention and control groups at 6- or 12-months (between-group differences [95% CI] for primary outcomes at 6-months: Forward Digit Span -0.3 [-0.8, 0.3]; TMT-A 2.7 s [-14.1, 19.5]; TMT-B -17.1 s [-79.3, 45.2]). At the 12-month follow-up reassessment, the intervention group reported significantly more depressive symptoms and had lower caregiver-rated participant quality of life and higher caregiver quality of life compared to control. CONCLUSIONS This study showed no benefit of the CT program on working memory, processing speed and executive function. Future studies are required to better understand how CT can be used to improve cognitive and physical functioning in older people with mild-moderate dementia.
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Affiliation(s)
- Thanwarat Chantanachai
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- UNSW Ageing Futures Research Institute, Sydney, New South Wales, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Research Institute, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacqueline C T Close
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Susan E Kurrle
- Department of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Research Institute, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Narelle Payne
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Roslyn Savage
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia
- UNSW Ageing Futures Research Institute, Sydney, New South Wales, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Say MJ, O'Driscoll C. Inter-rater variability in scoring of Addenbrooke's Cognitive Examination-Third Edition (ACE-III) protocols. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:874-878. [PMID: 35705310 DOI: 10.1080/23279095.2022.2083964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite its wide use in dementia diagnosis on the basis of cut-off points, the inter-rater variability of the Addenbrooke's Cognitive Examination-Third Edition (ACE-III) has been poorly studied. METHODS Thirty-one healthcare professionals from an older adults' mental health team scored two ACE-III protocols based on mock patients in a computerised form. Scoring accuracy, as well as total and domain-specific scoring variability, were calculated; factors relevant to participants were obtained, including their level of experience and self-rated confidence administering the ACE-III. RESULTS There was considerable inter-rater variability (up to 18 points for one of the cases), and one case's mean score was significantly higher (by nearly four points) than the true score. The Fluency, Visuospatial and Attention domains had greater levels of variability than Language and Memory. Higher scoring accuracy was not associated with either greater levels of experience or higher self-confidence in administering the ACE-III. CONCLUSIONS The results suggest that the ACE-III is susceptible to scoring error and considerable inter-rater variability, which highlights the critical importance of initial, and continued, administration and scoring training.
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Affiliation(s)
- Miranda J Say
- Barts Health NHS Trust, London, UK
- Psychology Department, Concord Repatriation General Hospital, Sydney, Australia
| | - Ciarán O'Driscoll
- Research Department of Clinical, Educational, and Health Psychology, Centre for Outcomes Research and Effectiveness (CORE), University College London, London, UK
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Tomić A, Ječmenica Lukić M, Petrović I, Korkut V, Kresojević N, Marković V, Dragašević Mišković N, Svetel M, Kostić VS. Motor imagery ability in patients with functional dystonia. J Psychosom Res 2024; 187:111911. [PMID: 39244967 DOI: 10.1016/j.jpsychores.2024.111911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 08/06/2024] [Accepted: 08/31/2024] [Indexed: 09/10/2024]
Abstract
INTRODUCTION Motor imagery (MI) involves recreating a movement mentally without physically performing the movement itself. MI has a positive impact on motor performance, motor learning and neural plasticity. We analysed the connection between motor imagination and altered movement execution in individuals with dystonia, a complex sensorimotor disorder. The aim of our study was to examine MI ability in patients with functional dystonia (FD) in comparison to organic dystonia (OD). METHODS Our case-control study involved 46 patients, 22 with FD and 24 with OD. The assessment consisted of specific questionnaire and standardized motor, cognitive and psychiatric scales. The KVIQ-20 was used to test MI in each patient. RESULTS Patients with FD scored lower on both global visual and kinaesthetic scales of the KVIQ-20 exam compared to patients with OD (63.1 ± 18.5 vs. 73.7 ± 13.2, and 54.9 ± 21.9 vs. 68.8 ± 18.2, respectively). Patients with FD also exhibited visual and/or kinaesthetic MI impairment in different body segments. The internal perspective when imagining movements was preferred in both patients with FD and OD. CONCLUSION FD patients showed global dysfunction of visual and kinaesthetic MI abilities. Techniques for MI improvements might have a potential role in dystonia rehabilitation.
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Affiliation(s)
- Aleksandra Tomić
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Milica Ječmenica Lukić
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Igor Petrović
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Vladimir Korkut
- Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Nikola Kresojević
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Vladana Marković
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Nataša Dragašević Mišković
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Marina Svetel
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia
| | - Vladimir S Kostić
- Movement Disorders Department, Clinic for Neurology, University Clinical Center of Serbia, Dr Subotića starijeg 6, 11000 Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Dr Subotića starijeg 8, 11000 Belgrade, Serbia; Serbian Academy of Sciences and Arts, Kneza Mihaila 35, 11000 Belgrade, Serbia.
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McIntyre M, Cullen J, Turner C, Bohanna I, Lakhini A, Rixon K. The development of a cognitive screening protocol for Aboriginal and/or Torres Strait Islander peoples: the Guddi Way screen. BRAIN IMPAIR 2024; 25:IB23058. [PMID: 39222469 DOI: 10.1071/ib23058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/30/2024] [Indexed: 09/04/2024]
Abstract
Background Many Aboriginal and/or Torres Strait Islander peoples are exposed to risk factors for cognitive impairment. However, culturally appropriate methods for identifying potential cognitive impairment are lacking. This paper reports on the development of a screen and interview protocol designed to flag possible cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults over the age of 16years. Methods The Guddi Way screen includes items relating to cognition and mental functions across multiple cognitive domains. The screen is straightforward, brief, and able to be administered by non-clinicians with training. Results Early results suggest the Guddi Way screen is reliable and culturally acceptable, and correctly flags cognitive dysfunction among Aboriginal and/or Torres Strait Islander adults. Conclusions The screen shows promise as a culturally appropriate and culturally developed method to identify the possibility of cognitive impairments and psychosocial disability in Aboriginal and/or Torres Strait Islander adults. A flag on the Guddi Way screen indicates the need for referral to an experienced neuropsychologist or neuropsychiatrist for further assessment and can also assist in guiding support services.
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Affiliation(s)
- Michelle McIntyre
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | - Jennifer Cullen
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | | | - India Bohanna
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
| | - Ali Lakhini
- La Trobe University, Melbourne, Vic 3086, Australia
| | - Kylie Rixon
- Synapse Australia, Impact & Evaluation, West End, Qld 4101, Australia
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11
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Rojas-Pescio H, Beishon L, Panerai R, Chacón M. Statistical Complexity Analysis of Neurovascular Coupling with Cognitive Stimulation in Healthy Participants. J Cogn Neurosci 2024; 36:1995-2010. [PMID: 38820561 DOI: 10.1162/jocn_a_02200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Neurovascular coupling (NVC) is the tight relationship between changes in cerebral blood flow and neural activation. NVC can be evaluated non-invasively using transcranial Doppler ultrasound (TCD)-measured changes in brain activation (cerebral blood velocity [CBv]) using different cognitive tasks and stimuli. This study used a novel approach to analyzing CBv changes occurring in response to 20 tasks from the Addenbrooke's Cognitive Examination III in 40 healthy individuals. The novel approach compared various information entropy families (permutation, Tsallis, and Rényi entropy) and statistical complexity measures based on disequilibrium. Using this approach, we found the majority of the attention, visuospatial, and memory tasks from the Addenbrooke's Cognitive Examination III that showed lower statistical complexity values when compared with the resting state. On the entropy-complexity (HC) plane, a receiver operating characteristic curve was used to distinguish between baseline and cognitive tasks using the area under the curve. Best area under the curve values were 0.91 ± 0.04, p = .001, to distinguish between resting and cognitively active states. Our findings show that brain hemodynamic signals captured with TCD can be used to distinguish between resting state (baseline) and cognitive effort (stimulation paradigms) using entropy and statistical complexity as an alternative method to traditional techniques such as coherent averaging of CBv signals. Further work should directly compare these analysis methods to identify the optimal method for analyzing TCD-measured changes in NVC.
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12
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Tsiakiri A, Koutzmpi V, Megagianni S, Toumaian M, Geronikola N, Despoti A, Kanellopoulou S, Arampatzi X, Margioti E, Davila A, Zoi P, Kalligerou F, Liozidou A, Tsapanou A, Sakka P. Remote neuropsychological evaluation of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:796-803. [PMID: 35595233 DOI: 10.1080/23279095.2022.2074850] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
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Affiliation(s)
- A Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
- Hellenic Neuropsychological Society, Athens, Greece
| | - V Koutzmpi
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - S Megagianni
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - M Toumaian
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis," Athens, Greece
| | - N Geronikola
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Despoti
- Hellenic Neuropsychological Society, Athens, Greece
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - X Arampatzi
- Athens Alzheimer's Association, Athens, Greece
| | - E Margioti
- Athens Alzheimer's Association, Athens, Greece
| | - A Davila
- Athens Alzheimer's Association, Athens, Greece
| | - P Zoi
- Athens Alzheimer's Association, Athens, Greece
| | - F Kalligerou
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Liozidou
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, The Scientific College of Greece. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens
| | - A Tsapanou
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, USA
| | - P Sakka
- Athens Alzheimer's Association, Athens, Greece
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13
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Aizawa K, Jordan AN, Gooding KM, Llewellyn DJ, Mawson DM, Casanova F, Gates PE, Adingupu DD, Elyas S, Hope SV, Gilchrist M, Strain WD, Clark CE, Bellenger NG, Sharp ASP, Parker KH, Hughes AD, Shore AC. Aortic reservoir-excess pressure parameters are associated with worse cognitive function in people with untreated stage II/III hypertension. J Hypertens 2024:00004872-990000000-00533. [PMID: 39248140 DOI: 10.1097/hjh.0000000000003853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024]
Abstract
OBJECTIVE Hypertension is a recognized risk factor for the development of cognitive impairment and dementia in older adults. Aortic stiffness and altered haemodynamics could promote the transmission of detrimental high pressure pulsatility into the cerebral circulation, potentially damaging brain microvasculature and leading to cognitive impairment. We determined whether reservoir-excess pressure parameters were associated with cognitive function in people with hypertension (HT) and normotension (NT). METHODS We studied 35 middle-aged and older treatment-naïve stage II/III HT (office systolic BP 176 ± 17 mmHg) and 35 age-, sex- and body mass index-matched NT (office systolic BP 127 ± 8 mmHg). Parameters derived from reservoir-excess pressure analysis including reservoir pressure integral (INTPR), excess pressure integral (INTXSP), systolic rate constant (SRC), diastolic rate constant (DRC) and pulse wave velocity (PWV) were calculated from an ensemble-averaged aortic pressure waveform derived from radial artery tonometry. Cognitive function was assessed using the Addenbrooke's Cognitive Examination Revised (ACE-R), Trail Making Test Part A (TMT-A) and Part B (TMT-B). RESULTS All reservoir-excess pressure parameters were greater in HT than NT (all P < 0.05). Greater INTXSP was associated with lower ACE-R score (rs = -0.31), longer TMT-A (r = 0.31) and TMT-B (r = 0.38). Likewise, greater DRC and PWV were also associated with lower ACE-R score (rs = -0.27 and rs = -0.33), longer TMT-A (r = 0.51 and r = 0.40) and TMT-B (r = 0.38 and r = 0.32). Greater INTXSP, DRC and PWV are consistently associated with worse cognitive function in this study. CONCLUSIONS These observations support a potential mechanistic link between adverse haemodynamics and a heightened risk of cognitive impairment in older adults with hypertension.
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Affiliation(s)
- Kunihiko Aizawa
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - Andrew N Jordan
- Department of Clinical and Biomedical Sciences
- University Hospitals Dorset, Poole
- NIHR Exeter Clinical Research Facility, Exeter
| | - Kim M Gooding
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - David J Llewellyn
- Department of Health and Community Sciences, University of Exeter Medical School, Exeter
- Alan Turing Institute, London
| | - David M Mawson
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - Francesco Casanova
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - Phillip E Gates
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - Damilola D Adingupu
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - Salim Elyas
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
- Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust
| | - Suzy V Hope
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
- Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust
| | - Mark Gilchrist
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
| | - W David Strain
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
- Department of Healthcare for Older People, Royal Devon University Healthcare NHS Foundation Trust
| | - Christopher E Clark
- Department of Health and Community Sciences, University of Exeter Medical School, Exeter
| | - Nicholas G Bellenger
- Department of Cardiology, Royal Devon University Healthcare NHS Foundation Trust, Exeter
| | | | | | - Alun D Hughes
- MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, UK
| | - Angela C Shore
- Department of Clinical and Biomedical Sciences
- NIHR Exeter Clinical Research Facility, Exeter
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14
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Didcote L, Vitoratou S, Al-Chalabi A, Goldstein LH. What is the extent of reliability and validity evidence for screening tools for cognitive and behavioral change in people with ALS? A systematic review. Amyotroph Lateral Scler Frontotemporal Degener 2024; 25:437-451. [PMID: 38415696 PMCID: PMC10972547 DOI: 10.1080/21678421.2024.2314063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/12/2024] [Accepted: 01/28/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVE This systematic review provides an updated summary of the existing literature on the validity of screening tools for cognitive and behavioral impairment in people with Amyotrophic Lateral Sclerosis (pwALS), and also focuses on their reliability. METHOD The following cognitive and behavioral screening tools were assessed in this review: the Edinburgh Cognitive and Behavioral ALS Screen (ECAS); the ALS Cognitive Behavioral Screen (ALS-CBS), the Mini Addenbrooke's Cognitive Examination (Mini-ACE), the Beaumont Behavioral Interview (BBI); the MND Behavior Scale (MiND-B); and the ALS-FTD Questionnaire (ALS-FTD-Q). A search, using Medline, PsychINFO and Embase (21/09/2023), generated 37 results after exclusion criteria were applied. Evidence of internal consistency, item-total correlations, inter-rater reliability, clinical validity, convergent validity, and structural validity were extracted and assessed and risk of bias was evaluated. RESULTS The cognitive component of the ECAS was the tool with most evidence of reliability and validity for the assessment of cognitive impairment in ALS. It is well-suited to accommodate physical symptoms of ALS. For behavioral assessment, the BBI or ALS-FTD-Q had the most evidence of reliability and validity. The BBI is more thorough, but the ALS-FTD-Q is briefer. CONCLUSIONS There is good but limited evidence for the reliability and validity of cognitive and behavioral screens. Further evidence of clinical and convergent validity would increase confidence in their clinical and research use.
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Affiliation(s)
- Lyndsay Didcote
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Silia Vitoratou
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Ammar Al-Chalabi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, King’s College London, London, UK, and
- Department of Neurology, King’s College Hospital NHS Foundation Trust, London, UK
| | - Laura H. Goldstein
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Rouse MA, Ramanan S, Halai AD, Volfart A, Garrard P, Patterson K, Rowe JB, Lambon Ralph MA. The impact of bilateral versus unilateral anterior temporal lobe damage on face recognition, person knowledge and semantic memory. Cereb Cortex 2024; 34:bhae336. [PMID: 39123309 PMCID: PMC11315654 DOI: 10.1093/cercor/bhae336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
The functional importance of the anterior temporal lobes (ATLs) has come to prominence in two active, albeit unconnected literatures-(i) face recognition and (ii) semantic memory. To generate a unified account of the ATLs, we tested the predictions from each literature and examined the effects of bilateral versus unilateral ATL damage on face recognition, person knowledge, and semantic memory. Sixteen people with bilateral ATL atrophy from semantic dementia (SD), 17 people with unilateral ATL resection for temporal lobe epilepsy (TLE; left = 10, right = 7), and 14 controls completed tasks assessing perceptual face matching, person knowledge and general semantic memory. People with SD were impaired across all semantic tasks, including person knowledge. Despite commensurate total ATL damage, unilateral resection generated mild impairments, with minimal differences between left- and right-ATL resection. Face matching performance was largely preserved but slightly reduced in SD and right TLE. All groups displayed the familiarity effect in face matching; however, it was reduced in SD and right TLE and was aligned with the level of item-specific semantic knowledge in all participants. We propose a neurocognitive framework whereby the ATLs underpin a resilient bilateral representation system that supports semantic memory, person knowledge and face recognition.
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Affiliation(s)
- Matthew A Rouse
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Siddharth Ramanan
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Ajay D Halai
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
| | - Angélique Volfart
- Université de Lorraine, CNRS, 2 avenue de la Forêt de Haye, Nancy F-54000, France
- Psychological Sciences Research Institute, University of Louvain, Place du Cardinal Mercier, 10, Louvain-la-Neuve B-1348, Belgium
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Victoria Park Road, Brisbane 4059, Australia
| | - Peter Garrard
- Molecular and Clinical Sciences Research Institute, St George’s, University of London, Cranmer Terrace, London SW17 0RE, UK
| | - Karalyn Patterson
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Hills Road, Cambridge CB2 0SZ, United Kingdom
| | - James B Rowe
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
- Department of Clinical Neurosciences, University of Cambridge, Hills Road, Cambridge CB2 0SZ, United Kingdom
- Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0SZ, United Kingdom
| | - Matthew A Lambon Ralph
- MRC Cognition and Brain Sciences Unit, University of Cambridge, 15 Chaucer Road, Cambridge CB2 7EF, UK
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Manser P, de Bruin ED. Diagnostic accuracy, reliability, and construct validity of the German quick mild cognitive impairment screen. BMC Geriatr 2024; 24:613. [PMID: 39026157 PMCID: PMC11256646 DOI: 10.1186/s12877-024-05219-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Early detection of cognitive impairment is among the top research priorities aimed at reducing the global burden of dementia. Currently used screening tools have high sensitivity but lack specificity at their original cut-off, while decreasing the cut-off was repeatedly shown to improve specificity, but at the cost of lower sensitivity. In 2012, a new screening tool was introduced that aims to overcome these limitations - the Quick mild cognitive impairment screen (Qmci). The original English Qmci has been rigorously validated and demonstrated high diagnostic accuracy with both good sensitivity and specificity. We aimed to determine the optimal cut-off value for the German Qmci, and evaluate its diagnostic accuracy, reliability (internal consistency) and construct validity. METHODS We retrospectively analyzed data from healthy older adults (HOA; n = 43) and individuals who have a clinical diagnosis of 'mild neurocognitive disorder' (mNCD; n = 37) with a biomarker supported characterization of the etiology of mNCD of three studies of the 'Brain-IT' project. Using Youden's Index, we calculated the optimal cut-off score to distinguish between HOA and mNCD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic accuracy based on the area under the curve (AUC). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Reliability (internal consistency) was analyzed by calculating Cronbach's α. Construct validity was assessed by analyzing convergent validity between Qmci-G subdomain scores and reference assessments measuring the same neurocognitive domain. RESULTS The optimal cut-off score for the Qmci-G was ≤ 67 (AUC = 0.96). This provided a sensitivity of 91.9% and a specificity of 90.7%. The PPV and NPV were 89.5% and 92.9%, respectively. Cronbach's α of the Qmci-G was 0.71 (CI95% [0.65 to 0.78]). The Qmci-G demonstrated good construct validity for subtests measuring learning and memory. Subtests that measure executive functioning and/or visuo-spatial skills showed mixed findings and/or did not correlate as strongly as expected with reference assessments. CONCLUSION Our findings corroborate the existing evidence of the Qmci's good diagnostic accuracy, reliability, and construct validity. Additionally, the Qmci shows potential in resolving the limitations of commonly used screening tools, such as the Montreal Cognitive Assessment. To verify these findings for the Qmci-G, testing in clinical environments and/or primary health care and direct comparisons with standard screening tools utilized in these settings are warranted.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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17
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Papamichail P, Sagredaki ML, Bouzineki C, Kanellopoulou S, Lyros E, Christakou A. The Effectiveness of an Exercise Program on Muscle Strength and Range of Motion on Upper Limbs, Functional Ability and Depression at Early Stage of Dementia. J Clin Med 2024; 13:4136. [PMID: 39064174 PMCID: PMC11278101 DOI: 10.3390/jcm13144136] [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: 06/15/2024] [Revised: 07/10/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Dementia involves the loss of cognitive abilities and represents a decline from the prior level of function, which impairs functional abilities in day-to-day life. The purpose of the present study is to examine the effectiveness of an exercise program on the muscle strength and range of motion of the upper limbs, the functional status, and the depression of elderly people with early stage dementia. Methods: The sample consisted of 60 elderly people with early stage dementia who were randomly divided into a control and an experimental group of 30 participants each. The experimental group received a 12-week Otago exercise program with 45 min duration of each session. The control group received usual care without doing exercise. The outcome measures of muscle strength and range of motion of the upper limbs, the functional status, and the depression were assessed by valid instruments and tests at the beginning and at the end of the intervention program. Repeated measures one-way ANOVA and Mann-Whitney tests examined the differences between the two groups at the end of the 12-week exercise program. Results: Statistically significant differences were found between the experimental and control groups in the entire outcome measures (functional ability F = 9.35 p < 0.05; muscle strength right hand F = 32.33, p < 0.05 left hand U = 95.50 p < 0.01; e.g., range of motion shoulder extension U = 104.00 p < 0.01), except depression. Conclusions: Both muscle strength and range of motion of the upper limbs, as well as the functional ability, were improved by the exercise program. Further research is needed to investigate the present results, in particular to explore the long-term cognitive, behavioral, and functional status outcomes of exercise in the early stages of dementia.
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Affiliation(s)
- Panagiotis Papamichail
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (P.P.); (M.-L.S.); (E.L.)
- Intensive Care Unit, Bioclinic Athens, 11525 Athens, Greece
| | - Maria-Louiza Sagredaki
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (P.P.); (M.-L.S.); (E.L.)
| | | | | | - Epameinondas Lyros
- Department of Physiotherapy, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece; (P.P.); (M.-L.S.); (E.L.)
| | - Anna Christakou
- Department of Physiotherapy, Lab Biomechanics, School of Health Sciences, University of Peloponnese, 23100 Sparta, Greece
- Department of Physiotherapy, University of West Attica, 12243 Athens, Greece
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18
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Siva K, Ponnusamy P, Ramanathan M. Disrupted Brain Network Measures in Parkinson's Disease Patients with Severe Hyposmia and Cognitively Normal Ability. Brain Sci 2024; 14:685. [PMID: 39061425 PMCID: PMC11274763 DOI: 10.3390/brainsci14070685] [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: 06/12/2024] [Revised: 06/30/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024] Open
Abstract
Neuroscience has revolved around brain structural changes, functional activity, and connectivity alteration in Parkinson's Disease (PD); however, how the network topology organization becomes altered is still unclear, specifically in Parkinson's patients with severe hyposmia. In this study, we have examined the functional network topological alteration in patients affected by Parkinson's Disease with normal cognitive ability (ODN), Parkinson's Disease with severe hyposmia (ODP), and healthy controls (HCs) using resting-state functional magnetic resonance imaging (rsfMRI) data. We have analyzed brain topological organization using popular graph measures such as network segregation (clustering coefficient, modularity), network integration (participation coefficient, path length), small-worldness, efficiency, centrality, and assortativity. Then, we used a feature ranking approach based on the diagonal adaptation of neighborhood component analysis, aiming to determine a graph measure that is sensitive enough to distinguish between these three different groups. We noted significantly lower segregation and local efficiency and small-worldness in ODP compared to ODN and HCs. On the contrary, we did not find differences in network integration in ODP compared to ODN and HCs, which indicates that the brain network becomes fragmented in ODP. At the brain network level, a progressive increase in the DMN (Default Mode Network) was observed from healthy controls to ODN to ODP, and a continuous decrease in the cingulo-opercular network was observed from healthy controls to ODN to ODP. Further, the feature ranking approach has shown that the whole-brain clustering coefficient and small-worldness are sensitive measures to classify ODP vs. ODN, as well as HCs. Looking at the brain regional network segregation, we have found that the cerebellum and limbic, fronto-parietal, and occipital lobes have higher ODP reductions than ODN and HCs. Our results suggest network topological measures, specifically whole-brain segregation and small-worldness decreases. At the network level, an increase in DMN and a decrease in the cingulo-opercular network could be used as biomarkers to characterize ODN and ODP.
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Affiliation(s)
| | | | - Malmathanraj Ramanathan
- Department of Electronics and Communication Engineering, National Institute of Technology, Tiruchirappalli 620015, India; (K.S.); (P.P.)
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19
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Khan AS, Peterson KA, Vittay OI, McLean MA, Kaggie JD, O’Brien JT, Rowe JB, Gallagher FA, Matys T, Wolfe S. Deuterium Metabolic Imaging of Alzheimer Disease at 3-T Magnetic Field Strength: A Pilot Case-Control Study. Radiology 2024; 312:e232407. [PMID: 39012255 PMCID: PMC11294762 DOI: 10.1148/radiol.232407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 04/05/2024] [Accepted: 04/15/2024] [Indexed: 07/17/2024]
Abstract
Background Impaired glucose metabolism is characteristic of several types of dementia, preceding cognitive symptoms and structural brain changes. Reduced glucose uptake in specific brain regions, detected using fluorine 18 (18F) fluorodeoxyglucose (FDG) PET, is a valuable diagnostic marker in Alzheimer disease (AD). However, the use of 18F-FDG PET in clinical practice may be limited by equipment availability and high cost. Purpose To test the feasibility of using MRI-based deuterium (2H) metabolic imaging (DMI) at a clinical magnetic field strength (3 T) to detect and localize changes in the concentration of glucose and its metabolites in the brains of patients with a clinical diagnosis of AD. Materials and Methods Participants were recruited for this prospective case-control pilot study between March 2021 and February 2023. DMI was performed at 3 T using a custom birdcage head coil following oral administration of deuterium-labeled glucose (0.75 g/kg). Unlocalized whole-brain MR spectroscopy (MRS) and three-dimensional MR spectroscopic imaging (MRSI) (voxel size, 3.2 cm cubic) were performed. Ratios of 2H-glucose, 2H-glutamate and 2H-glutamine (2H-Glx), and 2H-lactate spectroscopic peak signals to 2H-water peak signal were calculated for the whole-brain MR spectra and for individual MRSI voxels. Results A total of 19 participants, including 10 participants with AD (mean age, 68 years ± 5 [SD]; eight males) and nine cognitively healthy control participants (mean age, 70 years ± 6; six males) were evaluated. Whole-brain spectra demonstrated a reduced ratio of 2H-Glx to 2H-glucose peak signals in participants with AD compared with control participants (0.41 ± 0.09 vs 0.58 ± 0.20, respectively; P = .04), suggesting an impairment of oxidative glucose metabolism in AD. However, there was no evidence of localization of these changes to the expected regions of metabolic impairment at MRSI, presumably due to insufficient spatial resolution. Conclusion DMI at 3 T demonstrated impairment of oxidative glucose metabolism in the brains of patients with AD but no evidence of regional signal differences. © RSNA, 2024 Supplemental material is available for this article.
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Affiliation(s)
- Alixander S. Khan
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Katie A. Peterson
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Orsolya I. Vittay
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Mary A. McLean
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Joshua D. Kaggie
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - John T. O’Brien
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - James B. Rowe
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Ferdia A. Gallagher
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Tomasz Matys
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
| | - Shannyn Wolfe
- From the Departments of Radiology (A.S.K., K.A.P., M.A.M., J.D.K.,
F.A.G., T.M.), Psychiatry (J.T.O.), and Clinical Neurosciences (J.B.R.),
University of Cambridge, Hills Road, Cambridge CB2 0QQ, England; and
Departments of Radiology (O.I.V., F.A.G., T.M.) and Neurology (J.B.R.),
Cambridge University Hospitals NHS Foundation Trust, Cambridge, England
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20
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Ladthavorlaphatt K, Surti FBS, Beishon LC, Robinson TG, Panerai RB. Depression of dynamic cerebral autoregulation during neural activation: The role of responders and non-responders. J Cereb Blood Flow Metab 2024; 44:1231-1245. [PMID: 38301726 PMCID: PMC11179612 DOI: 10.1177/0271678x241229908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/15/2023] [Accepted: 12/28/2023] [Indexed: 02/03/2024]
Abstract
Neurovascular coupling (NVC) interaction with dynamic cerebral autoregulation (dCA) remains unclear. We investigated the effect of task complexity and duration on the interaction with dCA. Sixteen healthy participants (31.6 ± 11.6 years) performed verbal fluency (naming-words (NW)) and serial subtraction (SS) paradigms, of varying complexity, at durations of 05, 30 and 60 s. The autoregulation index (ARI), was estimated from the bilateral middle cerebral artery blood velocity (MCAv) step response, calculated by transfer function analysis (TFA), for each paradigm during unstimulated (2 min) and neuroactivated (1 min) segments. Intraclass correlation (ICC) and coefficient of variation (CV) determined reproducibility for two visits and objective criteria were applied to classify responders (R) and non-responders (NoR) to task-induced MCAv increase. ICC values demonstrated fair reproducibility in all tasks. ARI decreased in right (RH) and left (LH) hemispheres, irrespective of paradigm complexity and duration (p < 0.0001). Bilateral ARI estimates were significantly decreased during NW for the R group only (p < 0.0001) but were reduced in both R (p < 0.0001) and NoR (p = 0.03) groups for SS tasks compared with baseline. The reproducible attenuation of dCA efficiency due to paradigm-induced NVC response, its interaction, and different behaviour in R and NoR, warrant further research in different physiological and clinical conditions.
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Affiliation(s)
- Kannaphob Ladthavorlaphatt
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- Medical Diagnostics Unit, Thammasat University Hospital, Thammasat University, Pathum Thani, Thailand
- Thammasat University Centre of Excellence in Computational Mechanics and Medical Engineering, Thammasat University, Pathum Thani, Thailand
| | - Farhaana BS Surti
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - Lucy C Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Thompson G Robinson
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
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21
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Brikou D, Dimopoulou MA, Drouka A, Ntanasi E, Mamalaki E, Gu Y, Scarmeas N, Yannakoulia M. Eating Frequency, Timing, and Duration in Relation to Cognitive Performance and Alzheimer Disease Biomarkers in Adults. J Nutr 2024; 154:2167-2175. [PMID: 38797480 DOI: 10.1016/j.tjnut.2024.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/18/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND The potential association between temporal dimensions of eating and cognition/cognitive declines has been poorly investigated so far. OBJECTIVES The aim of this study was to examine relationships among eating frequency, timing and time window, and cognitive performance and novel Alzheimer disease (AD) biomarkers in cognitively healthy and mildly cognitively impaired middle-aged and older adults. METHODS Cross-sectional data were derived from the Aiginition Longitudinal Biomarker Investigation of Neurodegeneration (ALBION) cohort study, including people aged 40 y or older who have a positive family history of cognitive disorder or cognition-related concerns. Cognitive performance was assessed by a battery of neuropsychological tests. Amyloid β (Αβ42), a biomarker of AD-related pathology, was measured in cerebrospinal fluid. Eating frequency, timing, and the eating time window between the first and the last meal were estimated using time-related information recorded in four 24-h recalls. RESULTS Study participants had, on average, 5.3 ± 1.2 eating episodes per day, consumed at 8:20 ± 1.3 and 21:14 ± 1.3 h their first and their last eating episode, respectively, while their eating time window was 12.9 ± 1.6 h. Eating frequency, but not eating time window, was positively associated with global cognition, executive and language performance even after controlling for age, sex, education, BMI, and Mediterranean diet. Increasing eating frequency by 1 eating episode per day was associated with 0.169 higher global z-score. Furthermore, compared with ≤4, having 5-6 or >6 eating episodes per day was associated with better global and memory z-scores. Time of last eating episode was also positively associated with language performance. No associations were detected among eating frequency, timing and window, and AD pathology. CONCLUSIONS An eating pattern characterized by less frequent eating and/or by earlier times is present in individuals with worse cognitive performance. Our results shed light on the relevance of temporal eating patterns as potential early markers of behavioral or metabolic changes related to AD pathology.
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Affiliation(s)
- Dora Brikou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Archontoula Drouka
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Yian Gu
- The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Department of Neurology, Department of Epidemiology, Columbia University, NY, United States
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Department of Neurology, Department of Epidemiology, Columbia University, NY, United States
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
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22
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Readman MR, Polden M, Gibbs MC, Donohue A, Chhetri SK, Crawford TJ. Oculomotor atypicalities in motor neurone disease: a systematic review. Front Neurosci 2024; 18:1399923. [PMID: 38988765 PMCID: PMC11233471 DOI: 10.3389/fnins.2024.1399923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 06/13/2024] [Indexed: 07/12/2024] Open
Abstract
Introduction Cognitive dysfunction is commonplace in Motor Neurone Disease (MND). However, due to the prominent motor symptoms in MND, assessing patients' cognitive function through traditional cognitive assessments, which oftentimes require motoric responses, may become increasingly challenging as the disease progresses. Oculomotor pathways are apparently resistant to pathological degeneration in MND. As such, abnormalities in oculomotor functions, largely driven by cognitive processes such as saccades and smooth pursuit eye movement, may be reflective of frontotemporal cognitive deficits in MND. Thus, saccadic and smooth pursuit eye movements may prove to be ideal mechanistic markers of cognitive function in MND. Methods To ascertain the utility of saccadic and smooth pursuit eye movements as markers of cognitive function in MND, this review summarizes the literature concerning saccadic and smooth pursuit eye movement task performance in people with MND. Results and discussion Of the 22 studies identified, noticeable patterns suggest that people with MND can be differentiated from controls based on antisaccade and smooth pursuit task performance, and thus the antisaccade task and smooth pursuit task may be potential candidates for markers of cognition in MND. However, further studies which ascertain the concordance between eye tracking measures and traditional measures of cognition are required before this assumption is extrapolated, and clinical recommendations are made. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=376620, identifier CRD42023376620.
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Affiliation(s)
- Megan Rose Readman
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
- Department of Primary Care and Mental Health, The University of Liverpool, Liverpool, United Kingdom
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
| | - Megan Polden
- Department of Primary Care and Mental Health, The University of Liverpool, Liverpool, United Kingdom
- National Institute of Health Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Melissa C Gibbs
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Aisling Donohue
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, United Kingdom
| | - Suresh K Chhetri
- Lancashire and South Cumbria Motor Neurone Disease Care and Research Centre, Neurology Department, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Preston, United Kingdom
| | - Trevor J Crawford
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
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23
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Gezegen H, Ay U, Samancı B, Kurt E, Yörük SS, Medetalibeyoğlu A, Şen C, Şahin E, Barbüroğlu M, Doğan FU, Bilgiç B, Hanağası H, Gürvit H. Cognitive deficits and cortical volume loss in COVID-19-related hyposmia. Eur J Neurol 2024:e16378. [PMID: 38850121 DOI: 10.1111/ene.16378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND AND PURPOSE Studies have found that up to 73% of COVID-19 patients experience hyposmia. It is unclear if the loss of smell in COVID-19 is due to damage to the peripheral or central mechanisms. This study aimed to explore the impacts of COVID-19-induced hyposmia on brain structure and cognitive functions. METHODS The study included 36 hyposmic (h-COV) and 21 normosmic (n-COV) participants who had recovered from mild COVID-19 infection, as well as 25 healthy controls (HCs). All participants underwent neurological examination, neuropsychiatric assessment and Sniffin' Sticks tests. High-resolution anatomical images were collected; olfactory bulb (OB) volume and cortical thickness were measured. RESULTS Addenbrooke's Cognitive Examination-Revised total and language sub-scores were slightly but significantly lower in the h-COV group compared to the HC group (p = 0.04 and p = 0.037). The h-COV group exhibited poorer performance in the Sniffin' Sticks test terms of discrimination score, identification score and the composite score compared to the n-COV and HC groups (p < 0.001, p = 0.001 and p = 0.002 respectively). A decrease in left and right OB volumes was observed in the h-COV group compared to the n-COV and HC groups (p = 0.003 and p = 0.006 respectively). The cortical thickness analysis revealed atrophy in the left lateral orbitofrontal cortex in the h-COV group compared to HCs. A significant low positive correlation of varying degrees was detected between discrimination and identification scores and both OB and left orbital sulci. CONCLUSION Temporary or permanent hyposmia after COVID-19 infection leads to atrophy in the OB and olfactory-related cortical structures and subtle cognitive problems in the long term.
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Affiliation(s)
- Haşim Gezegen
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ulaş Ay
- Neuroimaging Unit, Istanbul University Hulusi Behçet Life Sciences Research Laboratory, Istanbul, Turkey
- Department of Neuroscience, Istanbul University Aziz Sancar Institute of Experimental Medicine, Istanbul, Turkey
| | - Bedia Samancı
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Elif Kurt
- Department of Neuroscience, Istanbul University Aziz Sancar Institute of Experimental Medicine, Istanbul, Turkey
| | - Sanem Sultan Yörük
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Alpay Medetalibeyoğlu
- Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Cömert Şen
- Department of Otolaryngology, Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdi Şahin
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Barbüroğlu
- Department of Radiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Faruk Uğur Doğan
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Başar Bilgiç
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Haşmet Hanağası
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hakan Gürvit
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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24
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Barker MS, Ceslis A, Argall R, McCombe P, Henderson RD, Robinson GA. Verbal and nonverbal fluency in amyotrophic lateral sclerosis. J Neuropsychol 2024; 18:265-285. [PMID: 37997256 DOI: 10.1111/jnp.12354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Amyotrophic lateral sclerosis (ALS) is a multi-system disorder that commonly affects cognition and behaviour. Verbal fluency impairments are consistently reported in ALS patients, and we aimed to investigate whether this deficit extends beyond the verbal domain. We further aimed to determine whether deficits are underpinned by a primary intrinsic response generation impairment (i.e., a global reduction across tasks), potentially related to apathy, or an inability to maintain responding over time (i.e., a 'drop off' pattern). Twenty-two ALS patients and 21 demographically-matched controls completed verbal and nonverbal fluency tasks (phonemic/semantic word fluency, design fluency, gesture fluency and ideational fluency), requiring the generation of responses over a specified time period. Fluency performance was analysed in terms of the overall number of novel items produced, as well as the number of items produced in the first 'initiation' and the remaining 'maintenance' time periods. ALS patients' overall performance was not globally reduced across tasks. Patients were impaired only on meaningful gesture fluency, which requires the generation of gestures that communicate meaning (e.g., waving). On phonemic fluency, ALS patients showed a 'drop off' pattern of performance, where they had difficulty maintaining responding over time, but this pattern was not evident on the other fluency tasks. Apathy did not appear to be related to fluency performance. The selective meaningful gesture fluency deficit, in the context of preserved meaningless gesture fluency, highlights that the retrieval of action knowledge may be weakened in early ALS.
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Affiliation(s)
- Megan S Barker
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Amelia Ceslis
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Rosemary Argall
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Pamela McCombe
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Robert D Henderson
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
- Wesley Medical Research, The Wesley Hospital, Brisbane, Queensland, Australia
| | - Gail A Robinson
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Neuropsychology and Neurology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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25
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Laurell AAS, Venkataraman AV, Schmidt T, Montagnese M, Mueller C, Stewart R, Lewis J, Mundell C, Isaacs JD, Krishnan MS, Barber R, Rittman T, Underwood BR. Estimating demand for potential disease-modifying therapies for Alzheimer's disease in the UK. Br J Psychiatry 2024; 224:198-204. [PMID: 38235531 DOI: 10.1192/bjp.2023.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
BACKGROUND Phase three trials of the monoclonal antibodies lecanemab and donanemab, which target brain amyloid, have reported statistically significant differences in clinical end-points in early Alzheimer's disease. These drugs are already in use in some countries and are going through the regulatory approval process for use in the UK. Concerns have been raised about the ability of healthcare systems, including those in the UK, to deliver these treatments, considering the resources required for their administration and monitoring. AIMS To estimate the scale of real-world demand for monoclonal antibodies for Alzheimer's disease in the UK. METHOD We used anonymised patient record databases from two National Health Service trusts for the year 2019 to collect clinical, demographic, cognitive and neuroimaging data for these cohorts. Eligibility for treatment was assessed using the inclusion criteria from the clinical trials of donanemab and lecanemab, with consideration given to diagnosis, cognitive performance, cerebrovascular disease and willingness to receive treatment. RESULTS We examined the records of 82 386 people referred to services covering around 2.2 million people. After applying the trial criteria, we estimate that a maximum of 906 people per year would start treatment with monoclonal antibodies in the two services, equating to 30 200 people if extrapolated nationally. CONCLUSIONS Monoclonal antibody treatments for Alzheimer's disease are likely to present a significant challenge for healthcare services to deliver in terms of the neuroimaging and treatment delivery. The data provided here allows health services to understand the potential demand and plan accordingly.
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Affiliation(s)
- Axel A S Laurell
- Department of Psychiatry, University of Cambridge, UK; and Older People and Adult Community Directorate, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Ashwin V Venkataraman
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Tatjana Schmidt
- Department of Clinical Neurosciences, University of Cambridge, UK
| | | | - Christoph Mueller
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Robert Stewart
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and South London and Maudsley NHS Foundation Trust, London, UK
| | - Jonathan Lewis
- Informatics Department, Cambridgeshire and Peterborough NHS Foundation Trust, UK
| | - Clare Mundell
- Pharmacy Department, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Jeremy D Isaacs
- Department of Neurology, Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, UK; and Molecular and Clinical Sciences Research Institute, St George's, University of London, UK
| | - Mani S Krishnan
- Department of Old Age Psychiatry, Tees, Esk and Wear Valleys NHS Foundation Trust, Darlington, UK
| | - Robert Barber
- Department of Old Age Psychiatry, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
| | - Timothy Rittman
- Department of Clinical Neurosciences, University of Cambridge, UK
| | - Benjamin R Underwood
- Department of Psychiatry, University of Cambridge, UK; and Older People and Adult Community Directorate, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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26
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Fieldhouse JLP, van Paassen DN, van Engelen MPE, De Boer SCM, Hartog WL, Braak S, Schoonmade LJ, Schouws SNTM, Krudop WA, Oudega ML, Mutsaerts HJMM, Teunissen CE, Vijverberg EGB, Pijnenburg YAL. The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials. Front Aging Neurosci 2024; 16:1382593. [PMID: 38784446 PMCID: PMC11112081 DOI: 10.3389/fnagi.2024.1382593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/16/2024] [Indexed: 05/25/2024] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disorder characterized by diverse and prominent changes in behavior and personality. One of the greatest challenges in bvFTD is to capture, measure and predict its disease progression, due to clinical, pathological and genetic heterogeneity. Availability of reliable outcome measures is pivotal for future clinical trials and disease monitoring. Detection of change should be objective, clinically meaningful and easily assessed, preferably associated with a biological process. The purpose of this scoping review is to examine the status of longitudinal studies in bvFTD, evaluate current assessment tools and propose potential progression markers. A systematic literature search (in PubMed and Embase.com) was performed. Literature on disease trajectories and longitudinal validity of frequently-used measures was organized in five domains: global functioning, behavior, (social) cognition, neuroimaging and fluid biomarkers. Evaluating current longitudinal data, we propose an adaptive battery, combining a set of sensitive clinical, neuroimaging and fluid markers, adjusted for genetic and sporadic variants, for adequate detection of disease progression in bvFTD.
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Affiliation(s)
- Jay L. P. Fieldhouse
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Dirk N. van Paassen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Marie-Paule E. van Engelen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Sterre C. M. De Boer
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Willem L. Hartog
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Simon Braak
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, Netherlands
| | | | - Sigfried N. T. M. Schouws
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Welmoed A. Krudop
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Mardien L. Oudega
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, Netherlands
- GGZ inGeest Mental Health Care, Amsterdam, Netherlands
| | - Henk J. M. M. Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Charlotte E. Teunissen
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
- Neurochemistry Laboratory, Department of Laboratory Medicine, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
| | - Everard G. B. Vijverberg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
| | - Yolande A. L. Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC Location VUmc, Amsterdam, Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, Netherlands
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Abo Foul Y, Arkadir D, Demikhovskaya A, Noyman Y, Linetsky E, Abu Snineh M, Aviezer H, Eitan R. Perception of emotionally incongruent cues: evidence for overreliance on body vs. face expressions in Parkinson's disease. Front Psychol 2024; 15:1287952. [PMID: 38770252 PMCID: PMC11103677 DOI: 10.3389/fpsyg.2024.1287952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
Individuals with Parkinson's disease (PD) may exhibit impaired emotion perception. However, research demonstrating this decline has been based almost entirely on the recognition of isolated emotional cues. In real life, emotional cues such as expressive faces are typically encountered alongside expressive bodies. The current study investigated emotion perception in individuals with PD (n = 37) using emotionally incongruent composite displays of facial and body expressions, as well as isolated face and body expressions, and congruent composite displays as a baseline. In addition to a group of healthy controls (HC) (n = 50), we also included control individuals with schizophrenia (SZ) (n = 30), who display, as in PD, similar motor symptomology and decreased emotion perception abilities. The results show that individuals with PD showed an increased tendency to categorize incongruent face-body combinations in line with the body emotion, whereas those with HC showed a tendency to classify them in line with the facial emotion. No consistent pattern for prioritizing the face or body was found in individuals with SZ. These results were not explained by the emotional recognition of the isolated cues, cognitive status, depression, or motor symptoms of individuals with PD and SZ. As real-life expressions may include inconsistent cues in the body and face, these findings may have implications for the way individuals with PD and SZ interpret the emotions of others.
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Affiliation(s)
- Yasmin Abo Foul
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - David Arkadir
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anastasia Demikhovskaya
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Noyman
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eduard Linetsky
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Muneer Abu Snineh
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hillel Aviezer
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Renana Eitan
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Medical Neurobiology (Physiology), Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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28
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Huang M, Landin-Romero R, Matis S, Dalton MA, Piguet O. Longitudinal volumetric changes in amygdala subregions in frontotemporal dementia. J Neurol 2024; 271:2509-2520. [PMID: 38265470 PMCID: PMC11055736 DOI: 10.1007/s00415-023-12172-5] [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: 12/07/2023] [Revised: 12/20/2023] [Accepted: 12/23/2023] [Indexed: 01/25/2024]
Abstract
Amygdala atrophy has been found in frontotemporal dementia (FTD), yet the specific changes of its subregions across different FTD phenotypes remain unclear. The aim of this study was to investigate the volumetric alterations of the amygdala subregions in FTD phenotypes and how they evolve with disease progression. Patients clinically diagnosed with behavioral variant FTD (bvFTD) (n = 20), semantic dementia (SD) (n = 20), primary nonfluent aphasia (PNFA) (n = 20), Alzheimer's disease (AD) (n = 20), and 20 matched healthy controls underwent whole brain structural MRI. The patient groups were followed up annually for up to 3.5 years. Amygdala nuclei were segmented using FreeSurfer, corrected by total intracranial volumes, and grouped into the basolateral, superficial, and centromedial subregions. Linear mixed effects models were applied to identify changes in amygdala subregional volumes over time. At baseline, bvFTD, SD, and AD displayed global amygdala volume reduction, whereas amygdala volume appeared to be preserved in PNFA. Asymmetrical amygdala atrophy (left > right) was most pronounced in SD. Longitudinally, SD and PNFA showed greater rates of annual decline in the right basolateral and superficial subregions compared to bvFTD and AD. The findings provide comprehensive insights into the differential impact of FTD pathology on amygdala subregions, revealing distinct atrophy patterns that evolve over disease progression. The characterization of amygdala subregional involvement in FTD and their potential role as biomarkers carry substantial clinical implications.
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Affiliation(s)
- Mengjie Huang
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Ramon Landin-Romero
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- School of Health Sciences, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Sophie Matis
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
- School of Health Sciences, The University of Sydney, Camperdown, NSW, 2050, Australia
| | - Marshall A Dalton
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia
| | - Olivier Piguet
- School of Psychology, The University of Sydney, Camperdown, NSW, 2050, Australia.
- Brain and Mind Centre, The University of Sydney, 94 Mallett Street, Camperdown, NSW, 2050, Australia.
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29
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Heikkinen AL, Tikkanen V, Hänninen T, Hublin C, Koivisto AM, Saari TT, Remes AM, Paajanen TI, Krüger J. Utility of the INECO Frontal Screening and the Frontal Assessment Battery in detecting executive dysfunction in early-onset cognitive impairment and dementia. J Int Neuropsychol Soc 2024; 30:339-349. [PMID: 37800312 DOI: 10.1017/s1355617723000619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
OBJECTIVE The INECO Frontal Screening (IFS) and the Frontal Assessment Battery (FAB) are executive dysfunction (ED) screening tools that can distinguish patients with neurodegenerative disorders from healthy controls and, to some extent, between dementia subtypes. This paper aims to examine the suitability of these tests in assessing early-onset cognitive impairment and dementia patients. METHOD In a memory clinic patient cohort (age mean = 57.4 years) with symptom onset at ≤65 years, we analyzed the IFS and the FAB results of four groups: early-onset dementia (EOD, n = 49), mild cognitive impairment due to neurological causes (MCI-n, n = 34), MCI due to other causes such as depression (MCI-o, n = 99) and subjective cognitive decline (SCD, n = 14). Data were gathered at baseline and at 6 and 12 months. We also studied the tests' accuracy in distinguishing EOD from SCD patients and ED patients from those with intact executive functioning. Correlations with neuropsychological measures were also studied. RESULTS The EOD group had significantly (p < .05) lower IFS and FAB total scores than the MCI-o and SCD groups. Compared with the FAB, the IFS showed more statistically significant (p < .05) differences between diagnostic groups, greater accuracy (IFS AUC = .80, FAB AUC = .75, p = .036) in detecting ED and marginally stronger correlations with neuropsychological measures. We found no statistically significant differences in the EOD group scores from baseline up to 6- or 12-months follow-up. CONCLUSIONS While both tests can detect EOD among memory clinic patients, the IFS may be more reliable in detecting ED than the FAB.
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Affiliation(s)
- Anna-Leena Heikkinen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Veera Tikkanen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Tuomo Hänninen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Christer Hublin
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Anne M Koivisto
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Toni T Saari
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anne M Remes
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
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Sharma S, Kumari V, Phougat J, Sarin J. Cognitive Rehabilitation Programme (CRP): An Effective Tool Against Mild Cognitive Impairment Among Elderly. Neurol India 2024; 72:561-566. [PMID: 39041973 DOI: 10.4103/neuroindia.ni_1436_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 10/25/2021] [Indexed: 07/24/2024]
Abstract
BACKGROUND With a steady increase in life expectancy seen worldwide, age-associated cognitive decline and mild cognitive impairment in old age are major public health challenges. OBJECTIVE To determine the effectiveness of the Cognitive Rehabilitation Program on cognition parameters in old age people with mild cognitive impairment. MATERIALS AND METHODS DESIGN This study was a quasi-experimental design using a non-equivalent control group pretest post-test design. SETTING/LOCATION Mullana and Adhoya villages of Ambala, Haryana. SUBJECTS Eighty old age people with mild cognitive impairment. INTERVENTION The pre- and post-interventional cognition parameters were assessed using Addenbrooke's cognitive examination on Day 1 and Day 29. The cognitive Rehabilitation Program was administered in the experimental group once a day for 28 days. OUTCOME MEASURES Dependent variables were cognition parameters. RESULTS AND CONCLUSION In the experimental group, a significant increase in cognition parameters score was observed from Day 1 (62.28 ± 6.23) to Day 29 (63.25 ± 5.10) after administration of the Cognitive Rehabilitation Program. In the comparison group, there was a non-significant decrease in cognition parameters score from Day 1 (56.73 ± 8.24) to Day 29 (55.85 ± 8.90). The post-implementation cognition parameters score of old age people in the experimental group (mean = 63.25) was significantly higher than in the comparison group (mean = 55.85). The mean gain in cognition scores was significantly higher in the experimental group than in the comparison group with a moderate effect size. It is concluded that the cognitive rehabilitation program is an effective tool in improving cognition parameters score among old age people with mild cognitive impairment.
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Affiliation(s)
- Shabnam Sharma
- M.M College of Nursing, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
| | - Vinay Kumari
- Chitkara School of Health Sciences, Chitkara University, Punjab, India
| | - Jyoti Phougat
- M.M Institute of Nursing, Maharishi Markandeshwar (Deemed to be University), Ambala, Haryana, India
| | - Jyoti Sarin
- M.M College of Nursing, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala, Haryana, India
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31
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Kolanko MA, Huber H, David MCB, Montoliu-Gaya L, Simrén J, Blennow K, Zetterberg H, Nilforooshan R, Malhotra P, Sharp DJ, Ashton NJ, Graham NSN. Quantification of neurofilament light and glial fibrillary acidic protein in finger-prick blood. Brain Commun 2024; 6:fcae151. [PMID: 38903933 PMCID: PMC11189302 DOI: 10.1093/braincomms/fcae151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/05/2024] [Accepted: 04/25/2024] [Indexed: 06/22/2024] Open
Abstract
An accurate diagnosis of neurodegenerative disease and traumatic brain injury is important for prognostication and treatment. Neurofilament light and glial fibrillary acidic protein (GFAP) are leading biomarkers for neurodegeneration and glial activation that are detectable in blood. Yet, current recommendations require rapid centrifugation and ultra-low temperature storage post-venepuncture. Here, we investigated if these markers can be accurately measured in finger-prick blood using dried plasma spot cards. Fifty patients (46 with dementia; 4 with traumatic brain injury) and 19 healthy volunteers underwent finger-prick and venous sampling using dried plasma spot cards and aligned plasma sampling. Neurofilament light and GFAP were quantified using a Single molecule array assay and correlations between plasma and dried plasma spot cards assessed. Biomarker concentrations in plasma and finger-prick dried plasma spot samples were significantly positively correlated (neurofilament light ρ = 0.57; GFAP ρ = 0.58, P < 0.001). Finger-prick neurofilament light and GFAP were significantly elevated after acute traumatic brain injury with non-significant group-level increases in dementia (91% having Alzheimer's disease dementia). In conclusion, we present preliminary evidence that quantifying GFAP and neurofilament light using finger-prick blood collection is viable, with samples stored at room temperature using dried plasma spot cards. This has potential to expand and promote equitable testing access, including in settings where trained personnel are unavailable to perform venepuncture.
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Affiliation(s)
- Magdalena A Kolanko
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Department of Brain Sciences, Imperial College London, W12 0BZ London, UK
| | - Hanna Huber
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
| | - Michael C B David
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Department of Brain Sciences, Imperial College London, W12 0BZ London, UK
| | - Laia Montoliu-Gaya
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
| | - Joel Simrén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 43180, Sweden
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 43180, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal 43180, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, WC1N 3BG London, UK
- UK Dementia Research Institute at UCL, WC1N 3BG London,UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, 53792 WI, USA
| | - Ramin Nilforooshan
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, KT22 7AD Surrey, UK
- University of Surrey, GU2 7XH Guildford, UK
| | - Paresh Malhotra
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Department of Brain Sciences, Imperial College London, W12 0BZ London, UK
| | - David J Sharp
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Department of Brain Sciences, Imperial College London, W12 0BZ London, UK
- Centre for Injury Studies, Imperial College London, W12 0BZ London, UK
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, 43141 Mölndal, Sweden
- Institute of Psychiatry, Psychology and Neuroscience Maurice Wohl Institute Clinical Neuroscience Institute, King's College London, SE5 9RT London,UK
- NIHR Biomedical Research Centre for Mental Health and Biomedical Research Unit for Dementia at South London and Maudsley NHS Foundation, SE5 8AF London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, 4011 Stavanger, Norway
| | - Neil S N Graham
- UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, 9SMUB, White City Campus, W12 0BZ London, UK
- Department of Brain Sciences, Imperial College London, W12 0BZ London, UK
- Centre for Injury Studies, Imperial College London, W12 0BZ London, UK
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Pelegrini LNDC, da Silva VA, Grigoli MM, Vatanabe IP, Manzine PR, Cominetti MR. Plasma ADAM10 Levels and Their Association with Alzheimer's Disease Diagnosis in Older Adults with Fewer Years of Formal Education. Dement Geriatr Cogn Disord 2024; 53:153-161. [PMID: 38583419 DOI: 10.1159/000538630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION Low educational attainment is a potential risk factor for Alzheimer's disease (AD) development. Alpha-secretase ADAM10 plays a central role in AD pathology, attenuating the formation of beta-amyloid peptides and, therefore, their aggregation into senile plaques. This study seeks to investigate ADAM10 as a blood-based biomarker in mild cognitive impairment (MCI) and AD in a diverse group of community-dwelling older adults, focusing on those with limited educational attainment. METHODS Participants were recruited from public health services. Cognition was evaluated using Mini-Mental State Examination (MMSE) and Addenbrooke's Cognitive Examination - Revised (ACE-R) batteries. Blood samples were collected to analyze plasma ADAM10 levels. A logistic regression was conducted to verify the influence of plasma ADAM10 on the AD diagnosis. RESULTS Significant differences in age, years of education, prescribed medications, and cognitive test scores were found between the MCI and AD groups. Regarding cognitive performance, both ACE-R and MMSE scores displayed significant differences between groups, with post hoc analyses highlighting these distinctions, particularly between AD and cognitively unimpaired individuals. Elevated plasma ADAM10 levels were associated with a 4.5-fold increase in the likelihood of a diagnosis of MCI and a 5.9-fold increase in the likelihood of a diagnosis of AD. These findings suggest ADAM10 levels in plasma as a valuable biomarker for assessing cognitive status in older individuals with low education attainment. CONCLUSION This study underscores the potential utility of plasma ADAM10 levels as a blood-based biomarker for cognitive status, especially in individuals with low educational backgrounds, shedding light on their relevance in AD development and diagnosis.
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Affiliation(s)
| | | | | | - Izabela Pereira Vatanabe
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil
- Pharmaceutical Sciences Faculty, University of São Paulo, São Paulo, Brazil
| | | | - Marcia Regina Cominetti
- Department of Gerontology, Federal University of São Carlos, São Carlos, Brazil,
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland,
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Landin-Romero R, Kumfor F, Ys Lee A, Leyton C, Piguet O. Clinical and cortical trajectories in non-fluent primary progressive aphasia and Alzheimer's disease: A role for emotion processing. Brain Res 2024; 1829:148777. [PMID: 38286395 DOI: 10.1016/j.brainres.2024.148777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 01/12/2024] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To examine the clinical trajectories and neural correlates of cognitive and emotion processing changes in the non-fluent/agrammatic (nfvPPA) and the logopenic (lvPPA) variants of primary progressive aphasia (PPA). DESIGN Observational case-control longitudinal cohort study. SETTING Research clinic of frontotemporal dementia. PARTICIPANTS This study recruited 29 non-semantic PPA patients (15 nfvPPA and 14 lvPPA) and compared them with 15 Alzheimer's disease (AD) patients and 14 healthy controls. MEASUREMENTS Participants completed an annual assessment (median = 2 years; range = 1-5 years) of general cognition, emotion processing and structural MRI. Linear mixed effects models investigated clinical and imaging trajectories between groups. RESULTS Over time, lvPPA showed the greatest cognitive deterioration. In contrast, nfvPPA showed significant decline in emotion recognition, whereas AD showed preserved emotion recognition, even with disease progression. Importantly, lvPPA also developed emotion processing impairments, with disease progression. Both nfvPPA and lvPPA showed continuing cortical atrophy in hallmark language-processing regions associated with these syndromes, together with progressive involvement of the right hemisphere regions, mirroring left hemisphere atrophy patterns at presentation. Decline in emotion processing was associated with bilateral frontal atrophy in nfvPPA and right temporal atrophy in lvPPA. CONCLUSIONS Our results show divergent clinical courses in nfvPPA and lvPPA, with rapid cognitive and neural deterioration in lvPPA and emotion processing decline in both groups and support the concurrent assessment of cognition and emotion processing in the clinic to inform diagnosis and monitoring in the non-semantic variants of PPA.
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Affiliation(s)
- Ramon Landin-Romero
- Sydney School of Health Sciences & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia.
| | - Fiona Kumfor
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Austin Ys Lee
- ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Cristian Leyton
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
| | - Olivier Piguet
- School of Psychology & Brain and Mind Centre, The University of Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Australia
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Davies SJ, Gullo HL, Doig E. The Priority Goals and Underlying Impairments Contributing to Goal-Related Problems of People with Parkinson's Disease Receiving a Community-Based Rehabilitation Program. PARKINSON'S DISEASE 2024; 2024:9465326. [PMID: 38716035 PMCID: PMC11074914 DOI: 10.1155/2024/9465326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
Background Goal setting is a core rehabilitation practice in Parkinson's disease (PD). Targeting therapy towards specific goals leads to greater improvements in performance and psychosocial outcomes. Goal setting in PD is feasible, and although the nature of goals has been described in previous studies, the underlying impairments related to goals have not been described. Understanding the nature of goals ensures that interventions for people with PD are aligned with their needs and priorities. Understanding the underlying impairments highlights which symptoms have the biggest impact on daily life and is necessary for planning appropriate interventions to target them. Aim To describe the nature of the goals of people with PD; the underlying impairments related to goals; and to compare differences between high and low priority goals. Method Deductive content analysis was used to map goal statements to the international classification of function (ICF) activity and participation category and to map therapist field notes detailing the primary underlying impairment to the ICF Body Functions category. These results were then compared across goal priority rankings. Results 88 goals of 22 people with PD were analysed. We found that people with PD set diverse goals across all chapters of the ICF Activity and Participation category, with "self-care" goals making up the highest proportion of goals. The primary underlying impairment related to the goals was predominantly related to impairments in "mental functions" under the Body Functions category. Regardless of goal priority, most goal-related underlying impairments were found to be in the "mental functions" category. Conclusion The goals of this sample of community-dwelling people with PD highlight their diverse needs and priorities. These findings indicate that nonmotor symptoms, namely, executive dysfunction and amotivation most commonly impact the performance of and participation in activities of greatest importance to people with PD. This trial is registered with ACTRN12621001483842.
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Affiliation(s)
- Sarah J. Davies
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- School of Health, University of the Sunshine Coast, Sunshine Coast, Queensland 4556, Australia
| | - Hannah L. Gullo
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Allied Health Research Collaborative, The Prince Charles Hospital, Chermside, QLD 4032, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
| | - Emmah Doig
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Brisbane, Australia
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Fay A, Synott E, McDaid E, Barrett E. A comparison of the immediate effects of the Andago over ground body weight support trainer versus over ground walking on selected gait parameters in a post-acute rehabilitation population. Physiother Theory Pract 2024; 40:767-777. [PMID: 36593733 DOI: 10.1080/09593985.2022.2162834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 12/20/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Andago is an electromechanical gait trainer providing dynamic body weight support while simultaneously enabling over ground walking. The aim of this study was to compare the effects of the Andago with over ground walking on selected gait parameters, during a single gait reeducation session in a post-acute rehabilitation population. METHODS Twenty-seven participants (mean age 78 yrs. (SD = 9.2), female 55.6% (n = 15)) undergoing rehabilitation for neurological (51.8%, n = 14), orthopedic (33.3%, n = 9), and medical conditions (14.8%, n = 4) completed the study. This was a single group, cross sectional, repeated measures study. Participants completed a 10-meter walk test (10MWT) and a 20-minute gait reeducation session under two conditions: i) harnessed in the Andago with body weight support or ii) using their normal walking pattern. Walking speed, steps taken, distance walked, rest breaks, Borg ratings of perceived exertion, and fear of falling were compared over both conditions. RESULTS Walking speed was significantly slower with the Andago (10MWT mean difference 0.12 (95% CI 0.03-0.20), eta squared 0.24, p = .008; 20-min gait mean difference 0.04 (95% CI 0.00-0.09), eta squared 0.15, p = .049). During the 20-minute gait reeducation session, step count, distance walked, and duration of walking was similar over both conditions, however participants recorded less rest breaks and fear of falling at minutes 10 and 20 in favor of the Andago. CONCLUSION Gait parameters measured during a single gait reeducation session in the Andago, in a mixed cohort of predominately older rehabilitation patients, appear comparable to conventional over ground training, other than walking speed which was reduced.
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Affiliation(s)
- Amy Fay
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, College Green, Dublin, Ireland
| | - Eoin Synott
- Physiotherapy Department, Royal Hospital Donnybrook, Morehampton Road, Dublin, Ireland
| | - Edel McDaid
- Physiotherapy Department, Royal Hospital Donnybrook, Morehampton Road, Dublin, Ireland
| | - Emer Barrett
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, University of Dublin, College Green, Dublin, Ireland
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Bagarinao E, Maesawa S, Kato S, Mutoh M, Ito Y, Ishizaki T, Tanei T, Tsuboi T, Suzuki M, Watanabe H, Hoshiyama M, Isoda H, Katsuno M, Sobue G, Saito R. Cerebellar and thalamic connector hubs facilitate the involvement of visual and cognitive networks in essential tremor. Parkinsonism Relat Disord 2024; 121:106034. [PMID: 38382401 DOI: 10.1016/j.parkreldis.2024.106034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 02/05/2024] [Accepted: 02/09/2024] [Indexed: 02/23/2024]
Abstract
INTRODUCTION Connector hubs are specialized brain regions that connect multiple brain networks and therefore have the potential to affect the functions of multiple systems. This study aims to examine the involvement of connector hub regions in essential tremor. METHODS We examined whole-brain functional connectivity alterations across multiple brain networks in 27 patients with essential tremor and 27 age- and sex-matched healthy controls to identify affected hub regions using a network metric called functional connectivity overlap ratio estimated from resting-state functional MRI. We also evaluated the relationships of affected hubs with cognitive and tremor scores in all patients and with motor function improvement scores in 15 patients who underwent postoperative follow-up evaluations after focused ultrasound thalamotomy. RESULTS We have identified affected connector hubs in the cerebellum and thalamus. Specifically, the dentate nucleus in the cerebellum and the dorsomedial thalamus exhibited more extensive connections with the sensorimotor network in patients. Moreover, the connections of the thalamic pulvinar with the visual network were also significantly widespread in the patient group. The connections of these connector hub regions with cognitive networks were negatively associated (FDR q < 0.05) with cognitive, tremor, and motor function improvement scores. CONCLUSION In patients with essential tremor, connector hub regions within the cerebellum and thalamus exhibited widespread functional connections with sensorimotor and visual networks, leading to alternative pathways outside the classical tremor axis. Their connections with cognitive networks also affect patients' cognitive function.
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Affiliation(s)
- Epifanio Bagarinao
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan.
| | - Satoshi Maesawa
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Sachiko Kato
- Focused Ultrasound Therapy Center, Nagoya Kyoritsu Hospital, Nagoya, Aichi, Japan
| | - Manabu Mutoh
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoshiki Ito
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Tomotaka Ishizaki
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takafumi Tanei
- Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Tsuboi
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Masashi Suzuki
- Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hirohisa Watanabe
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan; Department of Neurology, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Minoru Hoshiyama
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan
| | - Haruo Isoda
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan
| | - Masahisa Katsuno
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan; Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan; Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Gen Sobue
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan; Aichi Medical University, Nagakute, Aichi, Japan
| | - Ryuta Saito
- Brain and Mind Research Center, Nagoya University, Nagoya, Aichi, Japan; Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Tamaš O, Mijajlović M, Švabić T, Kostić M, Marić G, Milovanović A, Jeremić M, Dragašević-Mišković N. Transcranial Sonography Characteristics of Cerebellar Neurodegenerative Ataxias. Brain Sci 2024; 14:340. [PMID: 38671992 PMCID: PMC11048096 DOI: 10.3390/brainsci14040340] [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: 03/18/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Cerebellar neurodegenerative ataxias are a group of disorders affecting the cerebellum and its pathways with different neurological structures. Transcranial sonography (TCS) has been used for the evaluation of brain parenchymal structures in various diseases because of its fast and safe utilization, especially in neuropsychiatric and neurodegenerative diseases. The aim of our study was to investigate TCS characteristics of patients with neurodegenerative cerebellar ataxias. In our study, we included 74 patients with cerebellar degenerative ataxia; 36.5% had autosomal dominant onset, while 33.8% had sporadic onset. Standardized ultrasonographic planes were used for the identification of brain structures of interest. The SARA, INAS, neuropsychological and psychiatric scales were used for the further clinical evaluation of our study participants. The brainstem raphe was discontinued in 33.8% of the patients. The substantia nigra (SN) hyperechogenicity was identified in 79.7%. The third and fourth ventricle enlargement had 79.7% and 45.9% of patients, respectively. A positive and statistically significant correlation was found between SN hyperechogenicity with dystonia (p < 0.01), rigidity and dyskinesia (p < 0.05). The higher SARA total score is statistically significantly correlated with the larger diameter of the III (r = 0.373; p = 0.001) and IV ventricles (r = 0.324; p = 0.005). In such patients, the echogenicity of substantia nigra has been linked to extrapyramidal signs, and raphe discontinuity to depression. Furthermore, ataxia and its clinical subtypes have positively correlated with the IV ventricle diameter, indicating brain atrophy and brain mass reduction.
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Affiliation(s)
- Olivera Tamaš
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Milija Mijajlović
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Tamara Švabić
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Milutin Kostić
- Institute of Mental Health, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Gorica Marić
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
| | - Andona Milovanović
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Marta Jeremić
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
| | - Nataša Dragašević-Mišković
- Neurology Clinic, University Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (M.M.); (T.Š.); (A.M.); (M.J.); (N.D.-M.)
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Lan F, Roquet D, Dalton MA, El-Omar H, Ahmed RM, Piguet O, Irish M. Exploring graded profiles of hippocampal atrophy along the anterior-posterior axis in semantic dementia and Alzheimer's disease. Neurobiol Aging 2024; 135:70-78. [PMID: 38232501 DOI: 10.1016/j.neurobiolaging.2024.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
Mounting evidence indicates marked hippocampal degeneration in semantic dementia (SD) however, the spatial distribution of hippocampal atrophy profiles in this syndrome remains unclear. Using a recently developed parcellation approach, we extracted hippocampal volumes from four distinct subregions running from anterior to posterior along the longitudinal axis (anterior, intermediate rostral, intermediate caudal, and posterior). Volumetric differences in hippocampal subregions were compared between 21 SD, 24 matched Alzheimer's disease (AD), and 27 healthy older Control participants. Despite comparable overall hippocampal volume loss, SD and AD groups diverged in terms of the magnitude of atrophy along the anterior-posterior axis of the hippocampus. Global hippocampal atrophy was observed in AD, with no discernible gradation or lateralisation. In contrast, SD patients displayed graded bilateral hippocampal atrophy, most pronounced on the left-hand side, and concentrated in anterior relative to posterior subregions. Finally, we found preliminary evidence that disease-specific vulnerability along the anterior-posterior axis of the hippocampus was associated with canonical clinical features of these syndromes.
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Affiliation(s)
- Fang Lan
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, School of Psychology, Sydney, New South Wales, Australia
| | - Daniel Roquet
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, School of Psychology, Sydney, New South Wales, Australia
| | - Marshall A Dalton
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, School of Psychology, Sydney, New South Wales, Australia
| | - Hashim El-Omar
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia
| | - Rebekah M Ahmed
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Olivier Piguet
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, School of Psychology, Sydney, New South Wales, Australia
| | - Muireann Irish
- The University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia; The University of Sydney, School of Psychology, Sydney, New South Wales, Australia.
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O'Connor S, Hevey D, Burke T, Rafee S, Pender N, O'Keeffe F. A Systematic Review of Cognition in Cervical Dystonia. Neuropsychol Rev 2024; 34:134-154. [PMID: 36696021 PMCID: PMC10920436 DOI: 10.1007/s11065-022-09558-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 04/17/2022] [Accepted: 06/10/2022] [Indexed: 01/26/2023]
Abstract
Growing evidence points to a spectrum of non-motor symptoms, including cognitive difficulties that have a greater impact on functional outcomes and quality of life than motor symptoms in cervical dystonia (CD). Some cognitive impairments have been reported; however, findings are inconsistent, and described across mixed groups of dystonia. The current review aimed to examine the evidence for cognitive impairments in CD. MEDLINE, EMBASE, PsychINFO and Web of Science databases were searched. Studies were included if they met the following criteria (i) cross-sectional or longitudinal studies of adults with CD, (ii) where the results of standardised measures of cognitive or neuropsychological function in any form were assessed and reported, (iii) results compared to a control group or normative data, and (iv) were published in English. Results are presented in a narrative synthesis. Twenty studies were included. Subtle difficulties with general intellectual functioning, processing speed, verbal memory, visual memory, visuospatial function, executive function, and social cognition were identified while language, and attention and working memory appear to be relatively spared. Several methodological limitations were identified that should be considered when interpreting the evidence to describe a specific profile of cognitive impairment in CD. Clinical and research implications are discussed.
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Affiliation(s)
- Sarah O'Connor
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland.
| | - David Hevey
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
| | - Tom Burke
- Department of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Shameer Rafee
- Department of Neurology, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine & Health Science, University College Dublin, Dublin, Ireland
| | - Niall Pender
- Academic Unit of Neurology, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fiadhnait O'Keeffe
- Department of Clinical Psychology, School of Psychology, Aras an Phiarsaigh, Trinity College Dublin, Dublin 2, Dublin, Ireland
- Department of Psychology, St Vincent's University Hospital, Dublin, Ireland
- School of Psychology, University College Dublin, Dublin, Ireland
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40
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Ysseldyk R, Morton TA, Haslam C, Haslam SA, Boger J, Giau E, Macdonald EP, Matharu A, McCoy M. You've Got E-Mail: A Pilot Study Examining the Feasibility and Impact of a Group-Based Technology-Training Intervention Among Older Adults Living in Residential Care. Can J Aging 2024; 43:45-56. [PMID: 37501571 DOI: 10.1017/s0714980823000375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
Older adults living in residential care often experience challenges in sustaining meaningful social relationships, which can result in compromised health and well-being. Online social networking has the potential to mitigate this problem, but few studies have investigated its implementation and its effectiveness in maintaining or enhancing well-being. This pilot study used a cluster-randomized pre-post design to examine the feasibility of implementing a 12-week group-based technology-training intervention for older adults (n = 48) living in residential care by exploring how cognitive health, mental health, and confidence in technology were impacted. Analysis of variance revealed significant increases in life satisfaction, positive attitudes toward computer use, and self-perceived competence among participants who received the intervention, but increased depressive symptoms for the control group. These findings suggest that, despite challenges in implementing the intervention in residential care, group-based technology training may enhance confidence among older adults while maintaining or enhancing mental health.
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Affiliation(s)
- Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | | | - Catherine Haslam
- School of Psychology, The University of Queensland, Brisbane, QL, Australia
| | - S Alexander Haslam
- School of Psychology, The University of Queensland, Brisbane, QL, Australia
| | - Jennifer Boger
- Systems Design Engineering, University of Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON, Canada
| | - Emily Giau
- Systems Design Engineering, University of Waterloo, ON, Canada
| | - Erin P Macdonald
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
| | - Amy Matharu
- Research Institute for Aging, Waterloo, ON, Canada
| | - Madeline McCoy
- Department of Health Sciences, Carleton University, Ottawa, ON, Canada
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Deb P, Basu A. The Role of Verbal Fluency as a Variable in Reading and Comprehension Skills in Bengali. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2024; 53:11. [PMID: 38319444 DOI: 10.1007/s10936-024-10037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 02/07/2024]
Abstract
The study explored the role of verbal fluency in determining reading and comprehension skills in Bengali among 10-year old typically developing Bengali children. Robust correlations were found between semantic fluency and word reading (0.63) as well as semantic fluency and comprehension (0.70). Good correlation was found between letter fluency and comprehension (0.49), and, word reading and comprehension (0.62). The findings suggest that good word storing capacity and executive functions led to enhanced automaticity of retrieval and verbal fluency, which together with improved orthographic and phonological processing led to good word reading scores, contributing to lesser cognitive load thereby easing out the complex text comprehension task. Transcending narrow empirical base of reading theories derived from Western writing typologies delimited to orthographic depth and psycholinguistic grain size, the study contends that verbal fluency is another interesting variable determining the reading and comprehension skills in Bengali along with visuo-spatial complexity and complex phonology-orthography inconsistencies.
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Affiliation(s)
- Paromita Deb
- Centre for Educational Technology, IIT Kharagpur, Kharagpur, 721302, West Bengal, India.
| | - Anupam Basu
- NIT Durgapur, Durgapur, West Bengal, India
- Computer Science Department, IIT Kharagpur, Kharagpur, 721302, West Bengal, India
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Aldecoa C, Bettelli G, Bilotta F, Sanders RD, Aceto P, Audisio R, Cherubini A, Cunningham C, Dabrowski W, Forookhi A, Gitti N, Immonen K, Kehlet H, Koch S, Kotfis K, Latronico N, MacLullich AMJ, Mevorach L, Mueller A, Neuner B, Piva S, Radtke F, Blaser AR, Renzi S, Romagnoli S, Schubert M, Slooter AJC, Tommasino C, Vasiljewa L, Weiss B, Yuerek F, Spies CD. Update of the European Society of Anaesthesiology and Intensive Care Medicine evidence-based and consensus-based guideline on postoperative delirium in adult patients. Eur J Anaesthesiol 2024; 41:81-108. [PMID: 37599617 PMCID: PMC10763721 DOI: 10.1097/eja.0000000000001876] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Postoperative delirium (POD) remains a common, dangerous and resource-consuming adverse event but is often preventable. The whole peri-operative team can play a key role in its management. This update to the 2017 ESAIC Guideline on the prevention of POD is evidence-based and consensus-based and considers the literature between 01 April 2015, and 28 February 2022. The search terms of the broad literature search were identical to those used in the first version of the guideline published in 2017. POD was defined in accordance with the DSM-5 criteria. POD had to be measured with a validated POD screening tool, at least once per day for at least 3 days starting in the recovery room or postanaesthesia care unit on the day of surgery or, at latest, on postoperative day 1. Recent literature confirmed the pathogenic role of surgery-induced inflammation, and this concept reinforces the positive role of multicomponent strategies aimed to reduce the surgical stress response. Although some putative precipitating risk factors are not modifiable (length of surgery, surgical site), others (such as depth of anaesthesia, appropriate analgesia and haemodynamic stability) are under the control of the anaesthesiologists. Multicomponent preoperative, intra-operative and postoperative preventive measures showed potential to reduce the incidence and duration of POD, confirming the pivotal role of a comprehensive and team-based approach to improve patients' clinical and functional status.
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Affiliation(s)
- César Aldecoa
- From the Department of Anaesthesia and Postoperative Critical Care, Hospital Universitario Rio Hortega, Valladolid, Spain (CA), Department of Biomedical Studies, University of the Republic of San Marino, San Marino (GB), Department of Anesthesiology, Critical Care and Pain Medicine, 'Sapienza' University of Rome, Rome, Italy (FB, AF, LM), Specialty of Anaesthetics & NHMRC Clinical Trials Centre, University of Sydney & Department of Anaesthetics and Institute of Academic Surgery, Royal Prince Alfred Hospital (RDS), Department of Anesthesiology and Intensive Care Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, and Humboldt Universität zu Berlin, Campus Charité Mitte, and Campus Virchow Klinikum (CDS, SK, AM, BN, LV, BW, FY), Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy (PA), Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy (PA), Department of Surgery, Institute of Clinical Sciences, Sahlgrenska University Hospital, Göteborg, Sweden (RA), Geriatria, Accettazione Geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy (AC), School of Biochemistry and Immunology and Trinity College Institute of Neuroscience, Trinity College, Dublin, Ireland (CC), First Department of Anaesthesiology and Intensive Care Medical University of Lublin, Poland (WD), Research Unit of Nursing Science and Health Management, University of Oulu, Oulu, Finland (KI), Section of Surgical Pathophysiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (HK), Department of Anesthesiology, Intensive Therapy and Acute Intoxications, Pomeranian Medical University in Szczecin, Poland (KK), Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia (NG, NL, SP, SR), Department of Anesthesia, Critical Care and Emergency, Spedali Civili University Hospital, Brescia, Italy (NL, SP), Edinburgh Delirium Research Group, Ageing and Health, Usher Institute, University of Edinburgh, Edinburgh, United Kingdom (AMJM), Department of Anaesthesia and Intensive Care, Nykoebing Hospital; University of Southern Denmark, SDU (SK, FR), Department of Anaesthesiology and Intensive Care, University of Tartu, Tartu, Estonia (ARB), Center for Intensive Care Medicine, Luzerner Kantonsspital, Lucerne, Switzerland (ARB), Department of Health Science, Section of Anesthesiology, University of Florence (SR), Department of Anaesthesia and Critical Care, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy (SR), School of Health Sciences, Institute of Nursing, ZHAW Zurich University of Applied Science, Winterthur, Switzerland (MS), Departments of Psychiatry and Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (AJCS), Department of Neurology, UZ Brussel and Vrije Universiteit Brussel, Brussels, Belgium (AJCS) and Dental Anesthesia and Intensive Care Unit, Polo Universitario Ospedale San Paolo, Department of Biomedical, Surgical and Odontoiatric Sciences, University of Milano, Milan, Italy (CT)
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Bhattacharyya B, Paplikar A, Varghese F, Das G, Shukla V, Arshad F, Gupta A, Mekala S, Mukherjee A, Mukherjee R, Venugopal A, Tripathi M, Ghosh A, Biswas A, Alladi S. Illiterate Addenbrooke's Cognitive Examination-III in Three Indian Languages: An Adaptation and Validation Study. Arch Clin Neuropsychol 2024:acad106. [PMID: 38273465 DOI: 10.1093/arclin/acad106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Literacy is an important factor that predicts cognitive performance. Existing cognitive screening tools are validated only in educated populations and are not appropriate for older adults with little or no education leading to poor performance on these tests and eventually leading to misdiagnosis. This challenge for clinicians necessitates a screening tool suitable for illiterate or low-literate older individuals. OBJECTIVES The objective was to adapt and validate Addenbrooke's Cognitive Examination-III (ACE-III) for screening general cognitive functions in illiterate and low-literate older populations in the Indian context in three languages. METHOD The Indian illiterate ACE-III was systematically adapted by modifying the original items of the Indian literate ACE-III to assess the cognitive functions of illiterates and low-literates with the consensus of an expert panel of professionals working in the area of dementia and related disorders. A total of 180 illiterate or low-literate participants (84 healthy-controls, 50 with dementia, and 46 with mild cognitive impairment [MCI]) were recruited from three different centers speaking Bengali, Hindi, and Kannada to validate the adapted version. RESULTS The optimal cut-off score for illiterate ACE-III to distinguish controls from dementia in all 3 languages was 75. The optimal cut-off scores in distinguishing between controls and MCI ranged from 79 to 82, with a sensitivity ranging from 93% to 99% and a specificity ranging from 72% to 99%. CONCLUSION The test is found to have good psychometric properties and is a reliable cognitive screening tool for identifying dementia and MCI in older adults with low educational backgrounds in the Indian context.
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Affiliation(s)
- Bidisha Bhattacharyya
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Avanthi Paplikar
- Department of Speech and Language Studies, Dr. S. R. Chandrasekhar Institute of Speech and Hearing, Bengaluru, India
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Feba Varghese
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Gautam Das
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Vasundhara Shukla
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Faheem Arshad
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Aakansha Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Shailaja Mekala
- Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Adreesh Mukherjee
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Ruchira Mukherjee
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Aparna Venugopal
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
- Department of Speech Language Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Manjari Tripathi
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Amitabha Ghosh
- Department of Neurology, Apollo Multispecialty Hospital, Kolkata, India
| | - Atanu Biswas
- Department of Neurology, Bangur Institute of Neurosciences and Institute of Post Graduate Medical Education & Research, Kolkata, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru, India
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Nous A, Seynaeve L, Feys O, Wens V, De Tiège X, Van Mierlo P, Baroumand AG, Nieboer K, Allemeersch GJ, Mangelschots S, Michiels V, van der Zee J, Van Broeckhoven C, Ribbens A, Houbrechts R, De Witte S, Wittens MMJ, Bjerke M, Vanlersberghe C, Ceyssens S, Nagels G, Smolders I, Engelborghs S. Subclinical epileptiform activity in the Alzheimer continuum: association with disease, cognition and detection method. Alzheimers Res Ther 2024; 16:19. [PMID: 38263073 PMCID: PMC10804650 DOI: 10.1186/s13195-023-01373-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/17/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND Epileptic seizures are an established comorbidity of Alzheimer's disease (AD). Subclinical epileptiform activity (SEA) as detected by 24-h electroencephalography (EEG) or magneto-encephalography (MEG) has been reported in temporal regions of clinically diagnosed AD patients. Although epileptic activity in AD probably arises in the mesial temporal lobe, electrical activity within this region might not propagate to EEG scalp electrodes and could remain undetected by standard EEG. However, SEA might lead to faster cognitive decline in AD. AIMS 1. To estimate the prevalence of SEA and interictal epileptic discharges (IEDs) in a well-defined cohort of participants belonging to the AD continuum, including preclinical AD subjects, as compared with cognitively healthy controls. 2. To evaluate whether long-term-EEG (LTM-EEG), high-density-EEG (hd-EEG) or MEG is superior to detect SEA in AD. 3. To characterise AD patients with SEA based on clinical, neuropsychological and neuroimaging parameters. METHODS Subjects (n = 49) belonging to the AD continuum were diagnosed according to the 2011 NIA-AA research criteria, with a high likelihood of underlying AD pathophysiology. Healthy volunteers (n = 24) scored normal on neuropsychological testing and were amyloid negative. None of the participants experienced a seizure before. Subjects underwent LTM-EEG and/or 50-min MEG and/or 50-min hd-EEG to detect IEDs. RESULTS We found an increased prevalence of SEA in AD subjects (31%) as compared to controls (8%) (p = 0.041; Fisher's exact test), with increasing prevalence over the disease course (50% in dementia, 27% in MCI and 25% in preclinical AD). Although MEG (25%) did not withhold a higher prevalence of SEA in AD as compared to LTM-EEG (19%) and hd-EEG (19%), MEG was significantly superior to detect spikes per 50 min (p = 0.002; Kruskall-Wallis test). AD patients with SEA scored worse on the RBANS visuospatial and attention subset (p = 0.009 and p = 0.05, respectively; Mann-Whitney U test) and had higher left frontal, (left) temporal and (left and right) entorhinal cortex volumes than those without. CONCLUSION We confirmed that SEA is increased in the AD continuum as compared to controls, with increasing prevalence with AD disease stage. In AD patients, SEA is associated with more severe visuospatial and attention deficits and with increased left frontal, (left) temporal and entorhinal cortex volumes. TRIAL REGISTRATION Clinicaltrials.gov, NCT04131491. 12/02/2020.
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Affiliation(s)
- Amber Nous
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Laboratory of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology (EFAR), Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Laura Seynaeve
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
| | - Odile Feys
- Department of Neurology, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
| | - Vincent Wens
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
- Department of Translational Neuroimaging, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
| | - Xavier De Tiège
- Laboratoire de Neuroimagerie Et Neuroanatomie Translationnelles (LN2T), Université Libre de Bruxelles (ULB), ULB Neuroscience Institute (UNI), Brussels, Belgium
- Department of Translational Neuroimaging, Université Libre de Bruxelles (ULB), Hôpital Universitaire de Bruxelles (HUB), Hôpital Erasme, Brussels, Belgium
| | | | | | - Koenraad Nieboer
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Gert-Jan Allemeersch
- Department of Radiology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Shana Mangelschots
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
| | - Veronique Michiels
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Julie van der Zee
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, Antwerp, Belgium
| | - Christine Van Broeckhoven
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Neurodegenerative Brain Diseases, VIB Center for Molecular Neurology, Antwerp, Belgium
| | | | | | - Sara De Witte
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
| | - Mandy Melissa Jane Wittens
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
| | - Maria Bjerke
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium
- Department of Clinical Biology, Laboratory of Clinical Neurochemistry, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Caroline Vanlersberghe
- Department of Anaesthesiology and Perioperative Medicine, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | - Sarah Ceyssens
- Department of Nuclear Medicine, Universitair Ziekenhuis Antwerpen, University of Antwerp, Antwerpen, Belgium
| | - Guy Nagels
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
- Artificial Intelligence Supported Modelling in Clinical Sciences (AIMS) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ilse Smolders
- Laboratory of Pharmaceutical Chemistry, Drug Analysis and Drug Information (FASC), Research Group Experimental Pharmacology (EFAR), Center for Neurosciences, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Sebastiaan Engelborghs
- Department of Neurology, Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium.
- Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels, Belgium.
- Department of Biomedical Sciences, Universiteit Antwerpen, Antwerp, Belgium.
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Bates A, West MA, Jack S, Grocott MPW. Preparing for and Not Waiting for Surgery. Curr Oncol 2024; 31:629-648. [PMID: 38392040 PMCID: PMC10887937 DOI: 10.3390/curroncol31020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Cancer surgery is an essential treatment strategy but can disrupt patients' physical and psychological health. With worldwide demand for surgery expected to increase, this review aims to raise awareness of this global public health concern, present a stepwise framework for preoperative risk evaluation, and propose the adoption of personalised prehabilitation to mitigate risk. Perioperative medicine is a growing speciality that aims to improve clinical outcome by preparing patients for the stress associated with surgery. Preparation should begin at contemplation of surgery, with universal screening for established risk factors, physical fitness, nutritional status, psychological health, and, where applicable, frailty and cognitive function. Patients at risk should undergo a formal assessment with a qualified healthcare professional which informs meaningful shared decision-making discussion and personalised prehabilitation prescription incorporating, where indicated, exercise, nutrition, psychological support, 'surgery schools', and referral to existing local services. The foundational principles of prehabilitation can be adapted to local context, culture, and population. Clinical services should be co-designed with all stakeholders, including patient representatives, and require careful mapping of patient pathways and use of multi-disciplinary professional input. Future research should optimise prehabilitation interventions, adopting standardised outcome measures and robust health economic evaluation.
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Affiliation(s)
- Andrew Bates
- Perioperative and Critical Care Medicine Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton SO16 6YD, UK; (A.B.); (M.A.W.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Malcolm A. West
- Perioperative and Critical Care Medicine Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton SO16 6YD, UK; (A.B.); (M.A.W.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Sandy Jack
- Perioperative and Critical Care Medicine Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton SO16 6YD, UK; (A.B.); (M.A.W.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Michael P. W. Grocott
- Perioperative and Critical Care Medicine Theme, NIHR Southampton Biomedical Research Centre, University Hospital Southampton/University of Southampton, Southampton SO16 6YD, UK; (A.B.); (M.A.W.)
- Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
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Konstantinopoulou E, Irini V, Ioanna F, Valentina P, Electra H, Nikolaos G, Eleni A, Ioannidis P. Screening for Executive Impairment in Patients with Frontotemporal Dementia: Evidence from the Greek Version of the Frontier Executive Screen. Arch Clin Neuropsychol 2024:acad101. [PMID: 38214191 DOI: 10.1093/arclin/acad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 11/15/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVES The aim of the present study was to adjust the frontier executive screen (FES) for the Greek population, to develop normative data, and to investigate its ability to discriminate patients diagnosed with frontotemporal dementia from healthy individuals. METHODS The FES was administered to 142 community-dwelling healthy adults (age: M = 65.9, SD = 8.5; education: M = 10.8, SD = 4.3; sex: 59% female) and 32 patients diagnosed with frontotemporal dementia (age: M = 69.3, SD = 8.6; education: M = 11.7, SD = 4.8; sex: 31% female). Correlation and regression analyses were performed to determine the association between the FES scores, demographic, and clinical characteristics. Cronbach's α coefficient was used to determine internal consistency. Group differences on the FES were examined with independent samples t-test and Mann-Whitney test. Discriminant and ROC analyses were used to determine diagnostic accuracy and to identify the optimal cutoff score for the discrimination between groups. RESULTS Regression analyses indicated associations between demographic characteristics and FES scores (age: R2 = .08; education: R2 = .33). Internal consistency was marginally acceptable (α = .69). Patients scored lower than healthy participants on the total FES score (d = 1.91) and its three subscores (verbal fluency: η2 = .60; inhibition: η2 = .52; working memory: d = 0.90). The results indicated high diagnostic accuracy (94%) and the optimal cutoff score was 7 (91% sensitivity, 78% specificity). CONCLUSIONS The Greek version of the FES is a useful tool for the brief evaluation of executive functions in patients diagnosed with frontotemporal dementia.
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Affiliation(s)
| | - Vilou Irini
- 2nd Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Falega Ioanna
- School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Grigoriadis Nikolaos
- 2nd Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Aretouli Eleni
- Psychology Department, University of Ioannina, Ioannina, Greece
| | - Panagiotis Ioannidis
- 2nd Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Khalilian M, Toba MN, Roussel M, Tasseel-Ponche S, Godefroy O, Aarabi A. Age-related differences in structural and resting-state functional brain network organization across the adult lifespan: A cross-sectional study. AGING BRAIN 2024; 5:100105. [PMID: 38273866 PMCID: PMC10809105 DOI: 10.1016/j.nbas.2023.100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
We investigated age-related trends in the topology and hierarchical organization of brain structural and functional networks using diffusion-weighted imaging and resting-state fMRI data from a large cohort of healthy aging adults. At the cross-modal level, we explored age-related patterns in the RC involvement of different functional subsystems using a high-resolution functional parcellation. We further assessed age-related differences in the structure-function coupling as well as the network vulnerability to damage to rich club connectivity. Regardless of age, the structural and functional brain networks exhibited a rich club organization and small-world topology. In older individuals, we observed reduced integration and segregation within the frontal-occipital regions and the cerebellum along the brain's medial axis. Additionally, functional brain networks displayed decreased integration and increased segregation in the prefrontal, centrotemporal, and occipital regions, and the cerebellum. In older subjects, structural networks also exhibited decreased within-network and increased between-network RC connectivity. Furthermore, both within-network and between-network RC connectivity decreased in functional networks with age. An age-related decline in structure-function coupling was observed within sensory-motor, cognitive, and subcortical networks. The structural network exhibited greater vulnerability to damage to RC connectivity within the language-auditory, visual, and subcortical networks. Similarly, for functional networks, increased vulnerability was observed with damage to RC connectivity in the cerebellum, language-auditory, and sensory-motor networks. Overall, the network vulnerability decreased significantly in subjects older than 70 in both networks. Our findings underscore significant age-related differences in both brain functional and structural RC connectivity, with distinct patterns observed across the adult lifespan.
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Affiliation(s)
- Maedeh Khalilian
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
| | - Monica N. Toba
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
- Faculty of Medicine, University of Picardy Jules Verne, Amiens, France
| | - Martine Roussel
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
| | - Sophie Tasseel-Ponche
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
- Neurological Physical Medicine and Rehabilitation Department, Amiens University Hospital, University of Picardy Jules Verne, Amiens, France
| | - Olivier Godefroy
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
- Faculty of Medicine, University of Picardy Jules Verne, Amiens, France
- Neurology Department, Amiens University Hospital, Amiens, France
| | - Ardalan Aarabi
- Laboratory of Functional Neuroscience and Pathologies (UR UPJV 4559), University Research Center (CURS), University of Picardy Jules Verne, Amiens, France
- Faculty of Medicine, University of Picardy Jules Verne, Amiens, France
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48
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Pan X, Donaghy PC, Roberts G, Chouliaras L, O’Brien JT, Thomas AJ, Heslegrave AJ, Zetterberg H, McGuinness B, Passmore AP, Green BD, Kane JPM. Plasma metabolites distinguish dementia with Lewy bodies from Alzheimer's disease: a cross-sectional metabolomic analysis. Front Aging Neurosci 2024; 15:1326780. [PMID: 38239488 PMCID: PMC10794326 DOI: 10.3389/fnagi.2023.1326780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Background In multifactorial diseases, alterations in the concentration of metabolites can identify novel pathological mechanisms at the intersection between genetic and environmental influences. This study aimed to profile the plasma metabolome of patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD), two neurodegenerative disorders for which our understanding of the pathophysiology is incomplete. In the clinical setting, DLB is often mistaken for AD, highlighting a need for accurate diagnostic biomarkers. We therefore also aimed to determine the overlapping and differentiating metabolite patterns associated with each and establish whether identification of these patterns could be leveraged as biomarkers to support clinical diagnosis. Methods A panel of 630 metabolites (Biocrates MxP Quant 500) and a further 232 metabolism indicators (biologically informative sums and ratios calculated from measured metabolites, each indicative for a specific pathway or synthesis; MetaboINDICATOR) were analyzed in plasma from patients with probable DLB (n = 15; age 77.6 ± 8.2 years), probable AD (n = 15; 76.1 ± 6.4 years), and age-matched cognitively healthy controls (HC; n = 15; 75.2 ± 6.9 years). Metabolites were quantified using a reversed-phase ultra-performance liquid chromatography column and triple-quadrupole mass spectrometer in multiple reaction monitoring (MRM) mode, or by using flow injection analysis in MRM mode. Data underwent multivariate (PCA analysis), univariate and receiving operator characteristic (ROC) analysis. Metabolite data were also correlated (Spearman r) with the collected clinical neuroimaging and protein biomarker data. Results The PCA plot separated DLB, AD and HC groups (R2 = 0.518, Q2 = 0.348). Significant alterations in 17 detected metabolite parameters were identified (q ≤ 0.05), including neurotransmitters, amino acids and glycerophospholipids. Glutamine (Glu; q = 0.045) concentrations and indicators of sphingomyelin hydroxylation (q = 0.039) distinguished AD and DLB, and these significantly correlated with semi-quantitative measurement of cardiac sympathetic denervation. The most promising biomarker differentiating AD from DLB was Glu:lysophosphatidylcholine (lysoPC a 24:0) ratio (AUC = 0.92; 95%CI 0.809-0.996; sensitivity = 0.90; specificity = 0.90). Discussion Several plasma metabolomic aberrations are shared by both DLB and AD, but a rise in plasma glutamine was specific to DLB. When measured against plasma lysoPC a C24:0, glutamine could differentiate DLB from AD, and the reproducibility of this biomarker should be investigated in larger cohorts.
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Affiliation(s)
- Xiaobei Pan
- School of Biological Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Paul C. Donaghy
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gemma Roberts
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - John T. O’Brien
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Alan J. Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Amanda J. Heslegrave
- Department of Neurodegenerative Disease, University College London Queen Square Institute of Neurology, London, United Kingdom
- Dementia Research Institute, UCL, London, United Kingdom
| | - Henrik Zetterberg
- Department of Neurodegenerative Disease, University College London Queen Square Institute of Neurology, London, United Kingdom
- Dementia Research Institute, UCL, London, United Kingdom
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Hong Kong Center for Neurodegenerative Diseases, Kowloon, Hong Kong SAR, China
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | | | - Anthony P. Passmore
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Brian D. Green
- School of Biological Sciences, Queen’s University Belfast, Belfast, United Kingdom
| | - Joseph P. M. Kane
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
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49
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Sturnieks DL, Hicks C, Smith N, Ratanapongleka M, Menant J, Turner J, Lo J, Chaplin C, Garcia J, Valenzuela MJ, Delbaere K, Herbert RD, Sherrington C, Toson B, Lord SR. Exergame and cognitive training for preventing falls in community-dwelling older people: a randomized controlled trial. Nat Med 2024; 30:98-105. [PMID: 38228913 DOI: 10.1038/s41591-023-02739-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024]
Abstract
Exergame training, in which video games are used to promote exercise, can be tailored to address cognitive and physical risk factors for falls and is a promising method for fall prevention in older people. Here, we performed a randomized clinical trial using the smart±step gaming system to examine the effectiveness of two home-based computer game interventions, seated cognitive training and step exergame training, for fall prevention in community-dwelling older people, as compared with a minimal-intervention control group. Participants aged 65 years or older (n = 769, 71% female) living independently in the community were randomized to one of three arms: (1) cognitive training using a computerized touchpad while seated, (2) exergame step training on a computerized mat or (3) control (provided with an education booklet on healthy ageing and fall prevention). The rate of falls reported monthly over 12 months-the primary outcome of the trial-was significantly reduced in the exergame training group compared with the control group (incidence rate ratio = 0.74, 95% confidence interval = 0.56-0.98), but was not statistically different between the cognitive training and control groups (incidence rate ratio = 0.86, 95% confidence interval = 0.65-1.12). No beneficial effects of the interventions were found for secondary outcomes of physical and cognitive function, and no serious intervention-related adverse events were reported. The results of this trial support the use of exergame step training for preventing falls in community-dwelling older people. As this intervention can be conducted at home and requires only minimal equipment, it has the potential for scalability as a public health intervention to address the increasing problem of falls and fall-related injuries. Australian and New Zealand Clinical Trial Registry identifier: ACTRN12616001325493 .
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Affiliation(s)
- Daina L Sturnieks
- Neuroscience Research Australia, Randwick, New South Wales, Australia.
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia.
| | - Cameron Hicks
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Natassia Smith
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | | | - Jasmine Menant
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jessica Turner
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Joanne Lo
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Carly Chaplin
- Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Jaime Garcia
- UTS Games Studio, Faculty of Engineering and IT, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Michael J Valenzuela
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Skin2Neuron Pty Ltd, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert D Herbert
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Catherine Sherrington
- Sydney Musculoskeletal Health, Sydney School of Public Health, Sydney Local Health District, University of Sydney, Sydney, New South Wales, Australia
| | - Barbara Toson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Stephen R Lord
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- UNSW Ageing Futures Institute, Sydney, New South Wales, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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50
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Gilgoff R, Mengelkoch S, Elbers J, Kotz K, Radin A, Pasumarthi I, Murthy R, Sindher S, Harris NB, Slavich GM. The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology. Stress 2024; 27:2327333. [PMID: 38711299 PMCID: PMC11219250 DOI: 10.1080/10253890.2024.2327333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/02/2024] [Indexed: 05/08/2024] Open
Abstract
Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers of toxic stress physiology; no biological, behavioral, or cognitive treatments specifically focused on normalizing toxic stress processes; and no agreed-upon guidelines for treating stress in the clinic or evaluating the efficacy of interventions that seek to reduce toxic stress and improve human functioning. We address these critical issues by (a) systematically describing key systems and mechanisms that are dysregulated by stress; (b) summarizing indicators, biomarkers, and instruments for assessing stress response systems; and (c) highlighting therapeutic approaches that can be used to normalize stress-related biopsychosocial functioning. We also present a novel multidisciplinary Stress Phenotyping Framework that can bring stress researchers and clinicians one step closer to realizing the goal of using precision medicine-based approaches to prevent and treat stress-associated health problems.
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Affiliation(s)
- Rachel Gilgoff
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Summer Mengelkoch
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Jorina Elbers
- Trauma recovery Program, HeartMath Institute, Boulder Creek, CA, USA
| | | | | | - Isha Pasumarthi
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Reanna Murthy
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | - Sayantani Sindher
- Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, CA, USA
| | | | - George M. Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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