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Oh S, Kim S, Lee JE, Park BY, Hye Won J, Park H. Multimodal analysis of disease onset in Alzheimer's disease using Connectome, Molecular, and genetics data. Neuroimage Clin 2024; 43:103660. [PMID: 39197213 DOI: 10.1016/j.nicl.2024.103660] [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: 05/26/2024] [Revised: 08/23/2024] [Accepted: 08/23/2024] [Indexed: 09/01/2024]
Abstract
Alzheimer's disease (AD) and its related age at onset (AAO) are highly heterogeneous, due to the inherent complexity of the disease. They are affected by multiple factors, such as neuroimaging and genetic predisposition. Multimodal integration of various data types is necessary; however, it has been nontrivial due to the high dimensionality of each modality. We aimed to identify multimodal biomarkers of AAO in AD using an extended version of sparse canonical correlation analysis, in which we integrated two imaging modalities, functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), and genetic data in the form of single-nucleotide polymorphisms (SNPs) obtained from the Alzheimer's disease neuroimaging initiative database. These three modalities cover low-to-high-level complementary information and offer multiscale insights into the AAO. We identified multivariate markers of AAO in AD using fMRI, PET, and SNP. Furthermore, the markers identified were largely consistent with those reported in the existing literature. In particular, our serial mediation analysis suggests that genetic variants influence the AAO in AD by indirectly affecting brain connectivity by mediation of amyloid-beta protein accumulation, supporting a plausible path in existing research. Our approach provides comprehensive biomarkers related to AAO in AD and offers novel multimodal insights into AD.
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Affiliation(s)
- Sewook Oh
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea
| | - Sunghun Kim
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea; Department of Artificial Intelligence, Sungkyunkwan University, Suwon, Republic of Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Jong-Eun Lee
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea
| | - Bo-Yong Park
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea; Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Ji Hye Won
- Department of Computer Engineering, Pukyong National University, Busan, Republic of Korea
| | - Hyunjin Park
- Department of Electrical and Computer Engineering, Sungkyunkwan University, Suwon, Republic of Korea; Department of Artificial Intelligence, Sungkyunkwan University, Suwon, Republic of Korea; Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon, Republic of Korea.
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2
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Perez-Cruz C, Rodriguez-Callejas JDD. The common marmoset as a model of neurodegeneration. Trends Neurosci 2023; 46:394-409. [PMID: 36907677 DOI: 10.1016/j.tins.2023.02.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/29/2023] [Accepted: 02/14/2023] [Indexed: 03/12/2023]
Abstract
Human life expectancy has increased over the past few centuries, and the incidence of dementia in the older population is also projected to continue to rise. Neurodegenerative diseases are complex multifactorial conditions for which no effective treatments are currently available. Animal models are necessary to understand the causes and progression of neurodegeneration. Nonhuman primates (NHPs) offer significant advantages for the study of neurodegenerative disease. Among them, the common marmoset, Callithrix jacchus, stands out due to its easy handling, complex brain architecture, and occurrence of spontaneous beta-amyloid (Aβ) and phosphorylated tau aggregates with aging. Furthermore, marmosets present physiological adaptations and metabolic alterations associated with the increased risk of dementia in humans. In this review, we discuss the current literature on the use of marmosets as a model of aging and neurodegeneration. We highlight aspects of marmoset physiology associated with aging, such as metabolic alterations, which may help understand their vulnerability to developing a neurodegenerative phenotype that goes beyond normal aging.
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Affiliation(s)
- Claudia Perez-Cruz
- Department of Pharmacology, Center of Research and Advance Studies (Cinvestav-I.P.N.), Av. Politecnico Nacional 2508, San Pedro Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico.
| | - Juan de Dios Rodriguez-Callejas
- Department of Pharmacology, Center of Research and Advance Studies (Cinvestav-I.P.N.), Av. Politecnico Nacional 2508, San Pedro Zacatenco, Gustavo A. Madero, 07360, Mexico City, Mexico
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3
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Bellanti F, Bukke VN, Moola A, Villani R, Scuderi C, Steardo L, Palombelli G, Canese R, Beggiato S, Altamura M, Vendemiale G, Serviddio G, Cassano T. Effects of Ultramicronized Palmitoylethanolamide on Mitochondrial Bioenergetics, Cerebral Metabolism, and Glutamatergic Transmission: An Integrated Approach in a Triple Transgenic Mouse Model of Alzheimer's Disease. Front Aging Neurosci 2022; 14:890855. [PMID: 35686025 PMCID: PMC9170916 DOI: 10.3389/fnagi.2022.890855] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/19/2022] [Indexed: 01/26/2023] Open
Abstract
The therapeutic potential of ultramicronized palmitoylethanolamide (um-PEA) was investigated in young (6-month-old) and adult (12-month-old) 3 × Tg-AD mice, which received um-PEA for 3 months via a subcutaneous delivery system. Mitochondrial bioenergetics, ATP homeostasis, and magnetic resonance imaging/magnetic resonance spectroscopy were evaluated in the frontal cortex (FC) and hippocampus (HIPP) at the end of um-PEA treatment. Glutamate release was investigated by in vivo microdialysis in the ventral HIPP (vHIPP). We demonstrated that chronic um-PEA treatment ameliorates the decrease in the complex-I respiration rate and the FoF1-ATPase (complex V) activity, as well as ATP content depletion in the cortical mitochondria. Otherwise, the impairment in mitochondrial bioenergetics and the release of glutamate after depolarization was not ameliorated by um-PEA treatment in the HIPP of both young and adult 3 × Tg-AD mice. Moreover, progressive age- and pathology-related changes were observed in the cortical and hippocampal metabolism that closely mimic the alterations observed in the human AD brain; these metabolic alterations were not affected by chronic um-PEA treatment. These findings confirm that the HIPP is the most affected area by AD-like pathology and demonstrate that um-PEA counteracts mitochondrial dysfunctions and helps rescue brain energy metabolism in the FC, but not in the HIPP.
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Affiliation(s)
- Francesco Bellanti
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | | | - Archana Moola
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rosanna Villani
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Caterina Scuderi
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | - Luca Steardo
- Department of Physiology and Pharmacology “V. Erspamer”, Sapienza University of Rome, Rome, Italy
| | | | - Rossella Canese
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Sarah Beggiato
- Department of Life Sciences and Biotechnology, University of Ferrara, Ferrara, Italy
| | - Mario Altamura
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Gianluigi Vendemiale
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Gaetano Serviddio
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Tommaso Cassano
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- *Correspondence: Tommaso Cassano
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Hsu CCH, Huang CC, Tsai SJ, Chen LK, Li HC, Lo CYZ, Lin CP. Differential Age Trajectories of White Matter Changes Between Sexes Correlate with Cognitive Performances. Brain Connect 2021; 11:759-771. [PMID: 33858197 DOI: 10.1089/brain.2020.0961] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Aging is accompanied by a gradual deterioration in multiple cognitive abilities and brain structures. Both cognitive function and white matter (WM) structure are found to be associated with neurodegeneration diseases and correlated with sex during aging. However, it is still unclear whether the brain structural change could be attributable to sex, and how sex would affect cognitive performances during aging. Materials and Methods: Diffusion magnetic resonance imaging (MRI) scans were performed on 1127 healthy participants (age range: 21-89) at a single site. The age trajectories of the WM tract microstructure were delineated to estimate the turning age and changing rate between sexes. The canonical correlation analysis and moderated mediation analysis were used to examine the relationship between sex-linked WM tracts and cognitive performances. Results: The axon intactness and demyelination of sex-linked tracts during aging were multifaceted. Sex-linked tracts in females peak around 5 years later than those in males but change significantly faster after the turning age. Projection and association tracts (e.g., corticospinal tracts and parahippocampal cingulum) contributed to a significant decrease in visuospatial functions (VS) and executive functions (E). We discovered that there is a stronger indirect effect of sex-linked tracts on cognitive functions in females than in males. Conclusion: Our findings suggest that the vulnerable projection and association tracts in females may induce negative impacts on integrating multiple functions, which results in a faster decrease in VS and E.
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Affiliation(s)
- Chih-Chin Heather Hsu
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Center of Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chu-Chung Huang
- Key Laboratory of Brain Functional Genomics (MOE & STCSM), Affiliated Mental Health Center (ECNU), Institute of Cognitive Neuroscience, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.,Shanghai Changning Mental Health Center, Shanghai, China
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Liang-Kung Chen
- Center of Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Hui-Chun Li
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Yi Zac Lo
- Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, Shanghai, China
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.,Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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5
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Kaskikallio A, Karrasch M, Koikkalainen J, Lötjönen J, Rinne JO, Tuokkola T, Parkkola R, Grönholm-Nyman P. Effects of White Matter Hyperintensities on Verbal Fluency in Healthy Older Adults and MCI/AD. Front Aging Neurosci 2021; 13:614809. [PMID: 34025385 PMCID: PMC8134546 DOI: 10.3389/fnagi.2021.614809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/25/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND White matter hyperintensities (WMHs) are markers for cerebrovascular pathology, which are frequently seen in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Verbal fluency is often impaired especially in AD, but little research has been conducted concerning the specific effects of WMH on verbal fluency in MCI and AD. OBJECTIVE Our aim was to examine the relationship between WMH and verbal fluency in healthy old age and pathological aging (MCI/AD) using quantified MRI data. METHODS Measures for semantic and phonemic fluency as well as quantified MRI imaging data from a sample of 42 cognitively healthy older adults and 44 patients with MCI/AD (total n = 86) were utilized. Analyses were performed both using the total sample that contained seven left-handed/ambidextrous participants, as well with a sample containing only right-handed participants (n = 79) in order to guard against possible confounding effects regarding language lateralization. RESULTS After controlling for age and education and adjusting for multiple correction, WMH in the bilateral frontal and parieto-occipital areas as well as the right temporal area were associated with semantic fluency in cognitively healthy and MCI/AD patients but only in the models containing solely right-handed participants. CONCLUSION The results indicate that white matter pathology in both frontal and parieto-occipital cerebral areas may have associations with impaired semantic fluency in right-handed older adults. However, elevated levels of WMH do not seem to be associated with cumulative effects on verbal fluency impairment in patients with MCI or AD. Further studies on the subject are needed.
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Affiliation(s)
- Alar Kaskikallio
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | - Mira Karrasch
- Department of Psychology, Åbo Akademi University, Turku, Finland
| | | | | | - Juha O. Rinne
- Turku PET-Centre, University of Turku, Turku, Finland
- Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland
| | | | - Riitta Parkkola
- Department of Radiology, University Hospital of Turku, Turku, Finland
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Yang Z, Rong Y, Cao Z, Wu Y, Zhao X, Xie Q, Luo M, Liu Y. Microstructural and Cerebral Blood Flow Abnormalities in Subjective Cognitive Decline Plus: Diffusional Kurtosis Imaging and Three-Dimensional Arterial Spin Labeling Study. Front Aging Neurosci 2021; 13:625843. [PMID: 33597860 PMCID: PMC7882515 DOI: 10.3389/fnagi.2021.625843] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
Objective: To explore microstructural and cerebral blood flow (CBF) abnormalities in individuals with subjective cognitive decline plus (SCD plus) using diffusional kurtosis imaging (DKI) and three-dimensional (3D) arterial spin labeling (ASL). Methods: Twenty-seven patients with SCD plus, 31 patients with amnestic mild cognitive impairment (aMCI), and 33 elderly controls (ECs) were recruited and underwent DKI and 3D ASL using a GE 3.0-T MRI. Mean kurtosis (MK), fractional anisotropy (FA), mean diffusivity (MD), and CBF values were acquired from 24 regions of interest (ROIs) in the brain, including the bilateral hippocampal (Hip) subregions (head, body, and tail), posterior cingulate cortex (PCC), precuneus, dorsal thalamus subregions (anterior nucleus, ventrolateral nucleus, and medial nucleus), lenticular nucleus, caput nuclei caudati, white matter (WM) of the frontal lobe, and WM of the occipital lobe. Pearson's correlation analysis was performed to assess the relationships among the DKI-derived parameters, CBF values, and key neuropsychological tests for SCD plus. Results: Compared with ECs, participants with SCD plus showed a significant decline in MK and CBF values, mainly in the Hip head and PCC, and participants with aMCI exhibited more significant abnormalities in the MK and CBF values than individuals with ECs and SCD plus in multiple regions. Combined MK values showed better discrimination between patients with SCD plus and ECs than that obtained using CBF levels, with areas under the receiver operating characteristic (ROC) curve (AUC) of 0.874 and 0.837, respectively. Similarly, the AUC in discriminating SCD plus from aMCI patients obtained using combined MK values was 0.823, which was also higher than the combined AUC of 0.779 obtained using CBF values. Moreover, MK levels in the left Hip (h) and left PCC positively correlated with the auditory verbal learning test-delayed recall (AVLT-DR) score in participants with SCD plus. By contrast, only the CBF value in the left Hip head positively correlated with the AVLT-DR score. Conclusions: Our results provide new evidence of microstructural and CBF changes in patients with SCD plus. MK may be used as an early potential neuroimaging biomarker and may be a more sensitive DKI parameter than CBF at the very early stage of Alzheimer's disease (AD).
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Affiliation(s)
- Zhongxian Yang
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China.,Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yu Rong
- Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China.,Department of Neurology, The People's Hospital of Gaozhou City, Maoming, China
| | - Zhen Cao
- Medical Imaging Center, The Second Affiliated Hospital, Medical College of Shantou University, Shantou, China
| | - Yi Wu
- Department of Neurology, Shantou Central Hospital and Affiliated Shantou Hospital of Sun Yat-sen University, Shantou, China
| | - Xinzhu Zhao
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Qiuxia Xie
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Min Luo
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
| | - Yubao Liu
- Medical Imaging Center, Shenzhen Hospital, Southern Medical University, Shenzhen, China
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7
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White matter pathways underlying Chinese semantic and phonological fluency in mild cognitive impairment. Neuropsychologia 2020; 149:107671. [PMID: 33189733 DOI: 10.1016/j.neuropsychologia.2020.107671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022]
Abstract
Neuroimaging evidence has suggested that Chinese-language processing differs from that of its alphabetic-language counterparts. However, the underlying white matter pathway correlations between semantic and phonological fluency in Chinese-language processing remain unknown. Thus, we investigated the differences between two verbal fluency tests on 50 participants with amnestic mild cognitive impairment (aMCI) and 36 healthy controls (HC) with respect to five groups (ventral and dorsal stream fibers, frontal-striatal fibers, hippocampal-related fibers, and the corpus callosum) of white matter microstructural integrity. Diffusion spectrum imaging was used. The results revealed a progressive reduction in advantage in semantic fluency relative to phonological fluency from HC to single-domain aMCI to multidomain aMCI. Common and dissociative white matter correlations between tests of the two types of fluency were identified. Both types of fluency relied on the corpus callosum and ventral stream fibers, semantic fluency relied on the hippocampal-related fibers, and phonological fluency relied on the dorsal stream and frontal-striatal fibers. The involvement of bilateral tracts of interest as well as the association with the corpus callosum indicate the uniqueness of Chinese-language fluency processing. Dynamic associations were noted between white matter tract involvement and performance on the two fluency tests in four time blocks. Overall, our findings suggest the clinical utility of verbal fluency tests in geriatric populations, and they elucidate both task-specific and language-specific brain-behavior associations.
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8
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Foran AM, Mathias JL, Bowden SC. Effectiveness of sorting tests for detecting cognitive decline in older adults with dementia and other common neurodegenerative disorders: A meta-analysis. Neurosci Biobehav Rev 2020; 120:442-454. [PMID: 33091417 DOI: 10.1016/j.neubiorev.2020.10.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 12/13/2022]
Abstract
The demand for simple, accurate and time-efficient screens to detect cognitive decline at point-of-care is increasing. Sorting tests are often used to detect the 'executive' deficits that are commonly associated with behavioural-variant frontotemporal dementia (bvFTD), but their potential for use as a cognitive screen with older adults is unclear. A comprehensive search of four databases identified 142 studies that compared the sorting test performance (e.g. WCST, DKEFS-ST) of adults with a common neurodegenerative disorder (e.g. Alzheimer's disease, vascular dementia, bvFTD, Parkinson's disease) and cognitively-healthy controls. Hedges' g effect sizes were used to compare the groups on five common test scores (Category, Total, Perseveration, Error, Description). The neurodegenerative disorders (combined) showed large deficits on all scores (g -1.0 to -1.3), with dementia (combined subtypes) performing more poorly (g -1.2 to -2.1), although bvFTD was not disproportionately worse than the other dementias. Overall, sorting tests detected the cognitive impairments caused by common neurodegenerative disorders, especially dementia, highlighting their potential suitability as a cognitive screen for older adults.
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Affiliation(s)
- A M Foran
- School of Psychology, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - J L Mathias
- School of Psychology, University of Adelaide, Adelaide, South Australia, 5005, Australia.
| | - S C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, 3010, Australia
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Pisano F, Caltagirone C, Satriano F, Perri R, Fadda L, Marangolo P. Can Alzheimer's Disease Be Prevented? First Evidence from Spinal Stimulation Efficacy on Executive Functions. J Alzheimers Dis 2020; 77:1755-1764. [PMID: 32925066 DOI: 10.3233/jad-200695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Recently, a growing body of evidence has shown that, from the early stage of impairment, Alzheimer's patients (AD) present difficulties on a variety of tasks mostly relying on executive functions. These strongly impact their daily life activities causing a severe loss of independency and autonomy. OBJECTIVE To evaluate the efficacy of transpinal direct current stimulation (tsDCS) combined with cognitive trainings for improving attentional and executive function abilities in a group of AD patients. METHODS In a randomized-double blind design, sixteen AD patients underwent different cognitive trainings combined with tsDCS. During the treatment, each subject received tsDCS (20 min, 2 mA) over the thoracic vertebrae (IX-X vertebrae) in two different conditions: 1) anodal, and 2) sham while performing three computerized tasks: alertness, selective attention, and executive functions. Each experimental condition was run in ten consecutive daily sessions over two weeks. RESULTS After anodal tsDCS, a greater improvement in executive functions compared to sham condition was found. More importantly, the follow-up testing revealed that these effects lasted over 1 month after the intervention and generalized to the different neuropsychological tests administered before, after the treatment and at one month after the end of the intervention. This generalization was present also in the attentional domain. CONCLUSION This evidence emphasizes, for the first time, that tsDCS combined with cognitive training results efficacious for AD patients. We hypothesize that enhancing activity into the spinal sensorimotor pathways through stimulation improved cognitive abilities which rely on premotor activity, such as attention and executive functions.
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Affiliation(s)
- Francesca Pisano
- Department of Humanities studies - University Federico II, Naples, Italy
| | | | | | | | | | - Paola Marangolo
- Department of Humanities studies - University Federico II, Naples, Italy.,IRCCS Santa Lucia Foundation, Rome, Italy
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10
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Guarino A, Forte G, Giovannoli J, Casagrande M. Executive functions in the elderly with mild cognitive impairment: a systematic review on motor and cognitive inhibition, conflict control and cognitive flexibility. Aging Ment Health 2020; 24:1028-1045. [PMID: 30938193 DOI: 10.1080/13607863.2019.1584785] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Background: Mild Cognitive Impairment (MCI) is a syndrome characterised by mild cognitive decline, on one or more domains, but which does not compromise daily functions. Several studies have investigated the relationship between MCI and deficit in executive functions (EFs) but, unlike robust evidence in the mnestic domain, the nature of executive deficits in the MCI population remains uncertain.Objectives: This systematic review aims to evaluate EFs in patients with MCI, considering inhibition (motor and cognitive), conflict control and cognitive flexibility.Method: The databases used for the search were PUBMED, PsycINFO, PsycARTICLES and MEDLINE. Eligibility criteria: use of specific paradigms for EFs assessment ('Wisconsin Card Sorting Test', 'Stroop Task', 'Go/No-Go Task', 'Flanker Task'); age over 65, studies published in English. Exclusion criteria: presence of dementia; psychiatric disorders; stroke; cranial trauma; inclusion of participants with MCI in groups with healthy elderly or those with dementia.Results: Fifty-five studies were selected, namely: Stroop Task (N = 30), WCST (N = 14), Go/No-Go (N = 9), Flanker Task (N = 2). Results have shown in people with MCI deficits in all the EFs considered.Conclusions: The results of this review support the applicability of the four experimental tasks examined for the study of EFs in people with MCI. These paradigms are useful in research, diagnosis and therapeutic purposes, allowing obtaining an articulated EFs profile that can compromise the daily life in elderly. These EFs are not generally evaluated by standard assessment of MCI, but their evaluation can lead to a better knowledge of MCI and help in the diagnosis and treatment.
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Affiliation(s)
- Angela Guarino
- Dipartimento di Psicologia, Università di Roma Sapienza, Rome, Italy
| | - Giuseppe Forte
- Dipartimento di Psicologia, Università di Roma Sapienza, Rome, Italy
| | | | - Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma Sapienza, Rome, Italy
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11
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El Haj M, Boutoleau-Bretonnière C, Allain P. Memory of decisions: Relationship between decline of autobiographical memory and temporal discounting in Alzheimer's disease. J Clin Exp Neuropsychol 2020; 42:415-424. [PMID: 32223584 DOI: 10.1080/13803395.2020.1744527] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Temporal discounting refers to the tendency to attribute higher value to a reward received early than to one received later. We evaluated this tendency in patients with Alzheimer's Disease. We also evaluated whether temporal discounting is associated with decline in autobiographical memory (i.e., the ability to remember past personal experiences), with executive dysfunction, and/or with general cognitive decline. We invited patients with AD and control participants to answer binary questions involving the choice between receiving a smaller amount of money earlier or a larger one later (e.g., "Which do you prefer, 10 euros in cash right now or 50 euros in a month?"). Results demonstrated higher temporal discounting in patients with AD than in control participants. Temporal discounting was significantly correlated with decline in AM and general cognitive decline but not with executive dysfunction in patients with AD. The tendency to decide based on immediate rewards (i.e., temporal discounting) in AD is related with difficulty in remembering information about experiences of previous decisions, and/or their consequences (i.e., decline in autobiographical memory).
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Affiliation(s)
- Mohamad El Haj
- Nantes Université, Univ Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes, France.,Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France.,Institut Universitaire de France, Paris, France
| | | | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, Nantes Université, Maison de la Recherche Germaine Tillion, Angers, France
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12
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Inhibitory Control Deficits in Individuals with Amnestic Mild Cognitive Impairment: a Meta-Analysis. Neuropsychol Rev 2020; 30:97-125. [DOI: 10.1007/s11065-020-09428-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 02/05/2020] [Indexed: 01/07/2023]
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13
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Cui Y, Tang TY, Lu CQ, Cai Y, Lu T, Wang YC, Teng GJ, Ju S. Abnormal Cingulum Bundle Induced by Type 2 Diabetes Mellitus: A Diffusion Tensor Tractography Study. Front Aging Neurosci 2020; 12:594198. [PMID: 33384593 PMCID: PMC7771529 DOI: 10.3389/fnagi.2020.594198] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 11/16/2020] [Indexed: 01/29/2023] Open
Abstract
Purpose: In Type 2 diabetes (T2DM), white matter (WM) pathology has been suggested to play an important role in the etiology of T2DM-related cognitive impairment. This study aims to investigate the integrity of the cingulum bundle (CB), a major WM tract, in T2DM patients using diffusion tensor tractography. Methods: Thirty-seven T2DM patients and 34 age-, sex- and education matched healthy controls were included and underwent diffusion tensor imaging. Tractography of bilateral CB tracts was performed and diffusion measurements were compared between the two groups. Next, brain regions with significant group differences on fractional anisotropy (FA) values were set as the region of interest (ROI), and the CB fibers that passed through were identified. Diffusion measures were extracted from these fibers to investigate their correlations with the cognitive performances and endocrine parameters. Results: T2DM patients exhibited decreased FA in bilateral CB, increased mean diffusion (MD) in the right CB, and decreased length in the left CB. Through voxel-wise comparison, the most prominent FA difference was identified in the posterior segment of the CB and the reconstructed tract was part of the retrosplenial component. Importantly, the diffusion measurements of the tract were significantly correlated with the impaired performance in executive functioning and elevated insulin resistance (IR) in the T2DM group, instead of the control group. Conclusions: The diffusion measurements in bilateral CB were altered in T2DM patients, which might reflect important neuropathologic changes in the fibers. Our study adds to knowledge about how the cingulum changes structurally along its entire length in T2DM and highlights the relationship between WM and cognitive performance. Besides, IR might be an important risk factor that warrants further exploration.
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Affiliation(s)
- Ying Cui
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yu Cai
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tong Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuan-Cheng Wang
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Gao-Jun Teng
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
- *Correspondence: Shenghong Ju
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14
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Menardi A, Pascual-Leone A, Fried PJ, Santarnecchi E. The Role of Cognitive Reserve in Alzheimer's Disease and Aging: A Multi-Modal Imaging Review. J Alzheimers Dis 2019; 66:1341-1362. [PMID: 30507572 DOI: 10.3233/jad-180549] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Comforts in modern society have generally been associated with longer survival rates, enabling individuals to reach advanced age as never before in history. With the increase in longevity, however, the incidence of neurodegenerative diseases, especially Alzheimer's disease, has also doubled. Nevertheless, most of the observed variance, in terms of time of clinical diagnosis and progression, often remains striking. Only recently, differences in the social, educational and occupational background of the individual, as proxies of cognitive reserve (CR), have been hypothesized to play a role in accounting for such discrepancies. CR is a well-established concept in literature; lots of studies have been conducted in trying to better understand its underlying neural substrates and associated biomarkers, resulting in an incredible amount of data being produced. Here, we aimed to summarize recent relevant published work addressing the issue, gathering evidence for the existence of a common path across research efforts that might ease future investigations by providing a general perspective on the actual state of the arts. An innovative model is hereby proposed, addressing the role of CR across structural and functional evidences, as well as the potential implementation of non-invasive brain stimulation techniques in the causal validation of such theoretical frame.
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Affiliation(s)
- Arianna Menardi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emiliano Santarnecchi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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15
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Levit A, Regis AM, Gibson A, Hough OH, Maheshwari S, Agca Y, Agca C, Hachinski V, Allman BL, Whitehead SN. Impaired behavioural flexibility related to white matter microgliosis in the TgAPP21 rat model of Alzheimer disease. Brain Behav Immun 2019; 80:25-34. [PMID: 30776475 DOI: 10.1016/j.bbi.2019.02.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 02/11/2019] [Accepted: 02/14/2019] [Indexed: 01/04/2023] Open
Abstract
Executive dysfunction and white matter inflammation continue to be relatively understudied in rodent models of Alzheimer's disease (AD). Behavioural inflexibility is an important component of executive dysfunction that can be further categorized as perseverative or regressive, which respectively specify whether maladaptive persistence occurs early or late during a behavioural change. Previous studies of the TgAPP21 rat model of AD (expressing pathogenic hAPP) suggested a potentially spontaneous increase of regressive behavioral inflexibility. In this study, 7-8-month-old male TgAPP21 rats were tested for behavioral flexibility, learning, and memory using an operant conditioning chamber and the Morris Water Maze (MWM). TgAPP21 rats demonstrated a regressive behavioral inflexibility during set shifting in an operant conditioning chamber (regressive errors η2 = 0.32 and number of errors after criterion η2 = 0.33). Regressive behavior was also demonstrated in the MWM probe test, wherein TgAPP21 rats significantly increased their swim time in the target quadrant during the last third of the probe test (43% vs 33% in the first 2 thirds of the probe test or the Wt rats' 29%-32%); this behavioral phenotype has not been previously described in the MWM. TgAPP21 demonstrated further impairment of behavioural inflexibility as they committed a greater number of reversal errors in the operant conditioning chamber (η2 = 0.30). Diffuse microglia activation was increased in the white matter tracts of TgAPP21 (corpus callosum, cingulum, and internal capsule; η2 = 0.59-0.62), which was found to correlate with the number of reversal errors in the operant conditioning chamber (R2 = 0.42). As TgAPP21 rats do not spontaneously develop amyloid plaques but have been shown in previous studies to be vulnerable to the development of plaques, these rats demonstrate an important onset of cognitive change and inflammation in the pre-plaque phase of AD. TgAPP21 rats are also an instrumental model for studying the role and mechanism of white matter microglial activation in executive functioning. This is pertinent to clinical research of prodromal AD which has suggested that white matter inflammation may underlie impairment of executive functions such as behavioral flexibility.
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Affiliation(s)
- Alexander Levit
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Aaron M Regis
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Andrew Gibson
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Olivia H Hough
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Shikhar Maheshwari
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Yuksel Agca
- Department of Veterinary Pathobiology, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
| | - Cansu Agca
- Department of Veterinary Pathobiology, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, University Hospital, Western University, London, ON, Canada
| | - Brian L Allman
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Shawn N Whitehead
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada; Department of Clinical Neurological Sciences, University Hospital, Western University, London, ON, Canada.
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16
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Müller S, Herde L, Preische O, Zeller A, Heymann P, Robens S, Elbing U, Laske C. Diagnostic value of digital clock drawing test in comparison with CERAD neuropsychological battery total score for discrimination of patients in the early course of Alzheimer's disease from healthy individuals. Sci Rep 2019; 9:3543. [PMID: 30837580 PMCID: PMC6400894 DOI: 10.1038/s41598-019-40010-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/06/2019] [Indexed: 11/17/2022] Open
Abstract
The early detection of cognitive impairment or dementia is in the focus of current research as the amount of cognitively impaired individuals will rise intensely in the next decades due to aging population worldwide. Currently available diagnostic tools to detect mild cognitive impairment (MCI) or dementia are time-consuming, invasive or expensive and not suitable for wide application as required by the high number of people at risk. Thus, a fast, simple and sensitive test is urgently needed to enable an accurate detection of people with cognitive dysfunction and dementia in the earlier stages to initiate specific diagnostic and therapeutic interventions. We examined digital Clock Drawing Test (dCDT) kinematics for their clinical utility in differentiating patients with amnestic MCI (aMCI) or mild Alzheimer’s dementia (mAD) from healthy controls (HCs) and compared it with the diagnostic value of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) neuropsychological battery total score. Data of 381 participants (138 patients with aMCI, 106 patients with mAD and 137 HCs) was analyzed in the present study. All participants performed the clock drawing test (CDT) on a tablet computer and underwent the CERAD test battery and depression screening. CERAD total scores were calculated by subtest summation, excluding MMSE scores. All tablet variables (i.e. time in air, time on surface, total time, velocity, pressure, pressure/velocity relation, strokes per minute, time not painting, pen-up stroke length, pen-up/pen-down relation, and CDT score) during dCDT performance were entered in a forward stepwise logistic regression model to assess, which parameters best discriminated between aMCI or mAD and HC. Receiver operating characteristics (ROC) curves were constructed to visualize the specificity in relation to the sensitivity of dCDT variables against CERAD total scores in categorizing the diagnostic groups. dCDT variables provided a slightly better diagnostic accuracy of 81.5% for discrimination of aMCI from HCs than using CERAD total score (accuracy 77.5%). In aMCI patients with normal CDT scores, both dCDT (accuracy 78.0%) and CERAD total scores (accuracy 76.0%) were equally accurate in discriminating against HCs. Finally, in differentiating patients with mAD from healthy individuals, accuracy of both dCDT (93.0%) and CERAD total scores (92.3%) was excellent. Our findings suggest that dCDT is a suitable screening tool to identify early cognitive dysfunction. Its performance is comparable with the time-consuming established psychometric measure (CERAD test battery).
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Affiliation(s)
- Stephan Müller
- Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany. .,Geriatric Center at the University Hospital, Eberhard Karls University, Tübingen, Germany.
| | - Laura Herde
- Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany.,Geriatric Center at the University Hospital, Eberhard Karls University, Tübingen, Germany
| | - Oliver Preische
- Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
| | - Anja Zeller
- Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany.,Geriatric Center at the University Hospital, Eberhard Karls University, Tübingen, Germany
| | - Petra Heymann
- Nuertingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nuertingen, Germany
| | - Sibylle Robens
- University Witten/Herdecke, Department of Psychology and Psychotherapy, Witten, Germany
| | - Ulrich Elbing
- Nuertingen-Geislingen University (HfWU), Institute of Research and Development in Art Therapies, Nuertingen, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, Eberhard Karls University, Tübingen, Germany
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17
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Guarino A, Favieri F, Boncompagni I, Agostini F, Cantone M, Casagrande M. Executive Functions in Alzheimer Disease: A Systematic Review. Front Aging Neurosci 2019; 10:437. [PMID: 30697157 PMCID: PMC6341024 DOI: 10.3389/fnagi.2018.00437] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/20/2018] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease is a severe irreversible syndrome, characterized by a slow and progressive cognitive decline that interferes with the standard instrumental and essential functions of daily life. Promptly identifying the impairment of particular cognitive functions could be a fundamental condition to limit, through preventive or therapeutic interventions, the functional damages found in this degenerative dementia. This study aims to analyse, through a systematic review of the studies, the sensitivity of four experimental paradigms (Wisconsin Card Sorting Test, Stroop Task, Go/No-Go Task, and Flanker Task) considered as golden standard instruments for executive functions assessment in elderly subjects affected by Alzheimer dementia. This review was carried out according to the PRISMA method. Forty-five studies comparing the executive performance of patients with Alzheimer's dementia (diagnosed according to different classification criteria for dementia) and healthy elderly patients both over the age of sixty, were selected. For the research, PubMed, PsycINFO, PsycArticles databases were used. The study highlighted the importance of using standard protocols to evaluate executive dysfunction in Alzheimer's disease. The Stroop task allows discriminating better between healthy and pathological aging.
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Affiliation(s)
- Angela Guarino
- Dipartimento di Psicologia, Università di Roma "Sapienza", Rome, Italy
| | - Francesca Favieri
- Dipartimento di Psicologia, Università di Roma "Sapienza", Rome, Italy
| | | | | | - Micaela Cantone
- Dipartimento di Psicologia, Università di Roma "Sapienza", Rome, Italy
| | - Maria Casagrande
- Dipartimento di Psicologia Dinamica e Clinica, Università di Roma "Sapienza", Rome, Italy
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18
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Yu F, Vock DM, Barclay TR. Executive function: Responses to aerobic exercise in Alzheimer's disease. Geriatr Nurs 2018; 39:219-224. [PMID: 29031520 PMCID: PMC5897173 DOI: 10.1016/j.gerinurse.2017.09.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/07/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Abstract
Executive dysfunction occurs early and is prevalent in Alzheimer's disease (AD). This study tested the ability of different measures for identifying changes in executive function and the effect of 6-months of aerobic exercise on executive function in older adults with mild to moderate AD, using a single-group, repeated-measures design (n = 28, age 78.1 ± 8.37). Factor analysis and linear mixed-effects model analyses showed that individually the Exit Interview-25 (EXIT-25), Behavioral Dyscontrol Scale (BDS), and Golden Stroop test were the preferred instruments for measuring changes in executive function in the sample. The COWAT and TMT had substantial floor effects limiting their ability to identify changes in executive function. A single latent factor was sufficient to describe the heterogeneity of executive function. Over 6 months, aerobic exercise maintained executive function (effect size = -0.11, -0.24, -0.27, and -0.21 for the EXIT-25, BDS, Stroop, and latent factor, respectively). Decline in the latent factor (effect size = -0.21, p = 0.06) was minimal and comparable to that in global cognition (effect size = -0.20, p = 0.34). Aerobic exercise may be effective on maintaining executive function in AD.
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Affiliation(s)
- Fang Yu
- University of Minnesota School of Nursing, Minneapolis, MN, USA.
| | - David M Vock
- University of Minnesota School of Public Health Division of Biostatistics, Minneapolis, MN, USA.
| | - Terry R Barclay
- University of Minnesota Department of Neurology, Minneapolis, MN, USA.
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19
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Su L, Hayes L, Soteriades S, Williams G, Brain SAE, Firbank MJ, Longoni G, Arnold RJ, Rowe JB, O'Brien JT. Hippocampal Stratum Radiatum, Lacunosum, and Moleculare Sparing in Mild Cognitive Impairment. J Alzheimers Dis 2018; 61:415-424. [PMID: 29171994 PMCID: PMC5819729 DOI: 10.3233/jad-170344] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is associated with atrophy in entorhinal cortex (ERC), the hippocampus, and its subfields Cornu Ammonis 1 (CA1) and subiculum, which predict conversion from mild cognitive impairment (MCI) to clinical AD. The stratum radiatum, lacunosum, and moleculare (SRLM) are also important gateways involving ERC and CA1, which are affected by early AD pathology. OBJECTIVE To assess whether the SRLM is affected in MCI and AD. METHODS In this proof-of-concept study, 27 controls, 13 subjects with AD, and 22 with MCI underwent 3T MRI. T1 maps were used for whole-hippocampal volumetry, T2 maps were segmented for hippocampal subfield areas, entorhinal cortex and subiculum thickness, and evaluated for SRLM integrity. RESULTS Significant CA1 atrophy and subiculum thinning were found in both AD and MCI compared to similarly aged controls. However, SRLM integrity was only significantly reduced in AD but not in MCI compared to controls. There were no significant differences in other hippocampal subfields (CA2, CA3/dentate gyrus) or ERC thickness between the groups. Finally, CA1 and CA3/DG areas and SRLM clarity were correlated with clinical and cognitive measurements of disease severity. CONCLUSION Although this study was cross sectional, it suggests a progression of specific subfield changes from MCI to established AD that is associated with the reduced integrity of SRLM, which may reflect more widespread hippocampal involvement as the disease progresses and the relative preservation of SRLM in MCI. These results provide new MRI biomarkers for disease staging and understanding of the neurobiology in AD.
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Affiliation(s)
- Li Su
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
- China-UK Centre for Cognition and Ageing Research, Faculty of Psychology, Southwest University, Chongqing, China
| | - Lawrence Hayes
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Soteris Soteriades
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Guy Williams
- Wolfson Brain Imaging Centre, University of Cambridge, School of Clinical Medicine, Cambridge Biomedical Campus, Cambridge CB2 0QQ
| | - Susannah AE Brain
- Oxford University Hospitals NHS Trust, Windmill Road, Oxford OX3 7LD
| | - Michael J Firbank
- Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL
| | - Giulia Longoni
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - Robert J Arnold
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
| | - James B Rowe
- Department of Clinical Neurosciences, Cambridge University, CB2 0SZ
- MRC Cognition and Brain Sciences Unit, Cambridge, CB2 7EF
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SP
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20
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Yu J, Lam CLM, Lee TMC. White matter microstructural abnormalities in amnestic mild cognitive impairment: A meta-analysis of whole-brain and ROI-based studies. Neurosci Biobehav Rev 2017; 83:405-416. [PMID: 29092777 DOI: 10.1016/j.neubiorev.2017.10.026] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 10/24/2017] [Accepted: 10/27/2017] [Indexed: 12/29/2022]
Abstract
Studies that examined white matter (WM) alterations in amnestic mild cognitive impairment (aMCI) abound. This timely meta-analysis aims to synthesize the results of these studies. Seventy-seven studies (totalNaMCI=1844) were included. Fourteen region-of-interest-based (ROI-based) (k≥8;NaMCI≥284 per ROI) and two activation likelihood estimation (ALE) meta-analyses (fractional anisotropy [FA]: k=15;NaMCI=463; mean diffusivity [MD]: k=8;NaMCI=193) were carried out. Among the many significant ROI-related findings, reliable FA and MD alterations in the fornix, uncinate fasciculus, and parahippocampal cingulum were observed in aMCI. Larger effects were observed in MD relative to FA. The ALE meta-analysis revealed a significant FA decrease among aMCI subjects in the posterior corona radiata. These results provide robust evidence of the presence of WM abnormalities in aMCI. Our findings also highlight the importance of carrying out both ROI-based and whole-brain-based research to obtain a complete picture of WM microstructural alterations associated with the condition..
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Affiliation(s)
- Junhong Yu
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong
| | - Charlene L M Lam
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong
| | - Tatia M C Lee
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong; Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong.
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21
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Levit A, Regis AM, Garabon JR, Oh SH, Desai SJ, Rajakumar N, Hachinski V, Agca Y, Agca C, Whitehead SN, Allman BL. Behavioural inflexibility in a comorbid rat model of striatal ischemic injury and mutant hAPP overexpression. Behav Brain Res 2017; 333:267-275. [PMID: 28693862 DOI: 10.1016/j.bbr.2017.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 06/22/2017] [Accepted: 07/06/2017] [Indexed: 01/04/2023]
Abstract
Alzheimer disease (AD) and stroke coexist and interact; yet how they interact is not sufficiently understood. Both AD and basal ganglia stroke can impair behavioural flexibility, which can be reliably modeled in rats using an established operant based set-shifting test. Transgenic Fischer 344-APP21 rats (TgF344) overexpress pathogenic human amyloid precursor protein (hAPP) but do not spontaneously develop overt pathology, hence TgF344 rats can be used to model the effect of vascular injury in the prodromal stages of Alzheimer disease. We demonstrate that the injection of endothelin-1 (ET1) into the dorsal striatum of TgF344 rats (Tg-ET1) produced an exacerbation of behavioural inflexibility with a behavioural phenotype that was distinct from saline-injected wildtype & TgF344 rats as well as ET1-injected wildtype rats (Wt-ET1). In addition to profiling the types of errors made, interpolative modeling using logistic exposure-response regression provided an informative analysis of the timing and efficiency of behavioural flexibility. During set-shifting, Tg-ET1 committed fewer perseverative errors than Wt-ET1. However, Tg-ET1 committed significantly more regressive errors and had a less efficient strategy change than all other groups. Thus, behavioural flexibility was more vulnerable to striatal ischemic injury in TgF344 rats.
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Affiliation(s)
- Alexander Levit
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Aaron M Regis
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Jessica R Garabon
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Seung-Hun Oh
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Sagar J Desai
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Nagalingam Rajakumar
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada
| | - Vladimir Hachinski
- Department of Clinical Neurological Sciences, University Hospital, Western University, London, ON, Canada
| | - Yuksel Agca
- Department of Veterinary Pathobiology, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
| | - Cansu Agca
- Department of Veterinary Pathobiology, University of Missouri College of Veterinary Medicine, Columbia, MO, USA
| | - Shawn N Whitehead
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada; Department of Clinical Neurological Sciences, University Hospital, Western University, London, ON, Canada.
| | - Brian L Allman
- Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London ON, Canada.
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22
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Müller S, Preische O, Heymann P, Elbing U, Laske C. Increased Diagnostic Accuracy of Digital vs. Conventional Clock Drawing Test for Discrimination of Patients in the Early Course of Alzheimer's Disease from Cognitively Healthy Individuals. Front Aging Neurosci 2017; 9:101. [PMID: 28443019 PMCID: PMC5386968 DOI: 10.3389/fnagi.2017.00101] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 03/29/2017] [Indexed: 11/13/2022] Open
Abstract
The conventional Clock Drawing Test (cCDT) is a rapid and inexpensive screening tool for detection of moderate and severe dementia. However, its usage is limited due to poor diagnostic accuracy especially in patients with mild cognitive impairment (MCI). The diagnostic value of a newly developed digital Clock Drawing Test (dCDT) was evaluated and compared with the cCDT in 20 patients with early dementia due to AD (eDAT), 30 patients with amnestic MCI (aMCI) and 20 cognitively healthy controls (HCs). Parameters assessed by dCDT were time while transitioning the stylus from one stroke to the next above the surface (i.e., time-in-air), time the stylus produced a visible stroke (i.e., time-on-surface) and total-time during clock drawing. Receiver-operating characteristic (ROC) curves were calculated and logistic regression analyses have been conducted for statistical analysis. Using dCDT, time-in-air was significantly increased in eDAT (70965.8 ms) compared to aMCI (54073.7 ms; p = 0.027) and HC (32315.6 ms; p < 0.001). In addition, time-in-air was significantly longer in patients with aMCI compared to HC (p = 0.003), even in the aMCI group with normal cCDT score (54141.8 ms; p < 0.001). Time-in-air using dCDT allowed discrimination of patients with aMCI from HCs with a sensitivity of 81.3% and a specificity of 72.2% while cCDT scoring revealed a sensitivity of 62.5% and a specificity of 83.3%. Most interestingly, time-in-air allowed even discrimination of aMCI patients with normal cCDT scores (80% from all aMCI patients) from HCs with a clinically relevant sensitivity of 80.8% and a specificity of 77.8%. A combination of dCDT variables and cCDT scores did not improve the discrimination of patients with aMCI from HC. In conclusion, assessment of time-in-air using dCDT yielded a higher diagnostic accuracy for discrimination of aMCI patients from HCs than the use of cCDT even in those aMCI patients with normal cCDT scores. Modern digitizing devices offer the opportunity to measure subtle changes of visuo-constructive demands and executive functions that may be used as a fast and easy to perform screening instrument for the early detection of cognitive impairment in primary care.
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Affiliation(s)
- Stephan Müller
- Department of Psychiatry and Psychotherapy, Eberhard Karls UniversityTübingen, Germany.,Geriatric Center at the University Hospital, Eberhard Karls UniversityTübingen, Germany
| | - Oliver Preische
- German Center for Neurodegenerative Diseases (DZNE)Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, Eberhard Karls UniversityTübingen, Germany
| | - Petra Heymann
- Art Therapy Research Institute, Nürtingen-Geislingen UniversityNürtingen, Germany
| | - Ulrich Elbing
- Art Therapy Research Institute, Nürtingen-Geislingen UniversityNürtingen, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE)Tübingen, Germany.,Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, Eberhard Karls UniversityTübingen, Germany
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23
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Lee E, Park JE, Iida M, Fujie T, Kaji T, Ichihara G, Weon YC, Kim Y. Magnetic resonance imaging of leukoencephalopathy in amnestic workers exposed to organotin. Neurotoxicology 2016; 57:128-135. [DOI: 10.1016/j.neuro.2016.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 09/08/2016] [Accepted: 09/10/2016] [Indexed: 10/21/2022]
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24
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Oosterman JM, Heringa SM, Kessels RPC, Biessels GJ, Koek HL, Maes JHR, van den Berg E. Rule induction performance in amnestic mild cognitive impairment and Alzheimer's dementia: examining the role of simple and biconditional rule learning processes. J Clin Exp Neuropsychol 2016; 39:231-241. [PMID: 27618141 DOI: 10.1080/13803395.2016.1218444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus-response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer's dementia (AD). METHOD Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition-inducing an increase in complexity and, hence, executive control load (Condition 3). RESULTS Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. CONCLUSIONS These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.
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Affiliation(s)
- Joukje M Oosterman
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Sophie M Heringa
- b Department of Psychiatry, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Roy P C Kessels
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands.,c Department of Medical Psychology & Radboudumc Alzheimer Center , Radboud University Medical Center , Nijmegen , the Netherlands
| | - Geert Jan Biessels
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands
| | - Huiberdina L Koek
- e Department of Geriatrics , University Medical Center Utrecht , Utrecht , the Netherlands
| | - Joseph H R Maes
- a Donders Institute for Brain, Cognition and Behaviour , Radboud University , Nijmegen , The Netherlands
| | - Esther van den Berg
- d Department of Neurology, Brain Center Rudolf Magnus , University Medical Center , Utrecht , the Netherlands.,f Experimental Psychology , Utrecht University , Utrecht , The Netherlands.,g Department of Neurology , Erasmus Medical Center , Rotterdam , The Netherlands
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25
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Mistridis P, Krumm S, Monsch AU, Berres M, Taylor KI. The 12 Years Preceding Mild Cognitive Impairment Due to Alzheimer's Disease: The Temporal Emergence of Cognitive Decline. J Alzheimers Dis 2016; 48:1095-107. [PMID: 26402083 PMCID: PMC4927842 DOI: 10.3233/jad-150137] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: The identification of the type and sequence of cognitive decline in preclinical mild cognitive impairment (MCI) prior to Alzheimer’s disease (AD) is crucial for understanding AD pathogenesis and implementing therapeutic interventions. Objective: To model the longitudinal courses of different neuropsychological functions in MCI due to AD. Methods: We investigated the prodromal phase of MCI over a 12-year period in 27 initially healthy participants with subsequent MCI preceding AD (NC-MCI) and 60 demographically matched healthy individuals (NC-NC). The longitudinal courses of cognitive performance (verbal and visual episodic memory, semantic memory, executive functioning, constructional praxis, psychomotor speed, language, and informant-based reports) were analyzed with linear mixed effects models. Results: The sequence with which different cognitive functions declined in the NC-MCI relative to the NC-NC group began with verbal memory and savings performance approximately eight years, and verbal episodic learning, visual memory, and semantic memory (animal fluency) circa four years prior to the MCI diagnosis. Executive functioning, psychomotor speed, and informant-based reports of the NC-MCI group declined approximately two years preceding the MCI diagnosis. Conclusions: Measurable neuropsychological deterioration occurs up to approximately eight years preceding MCI due to AD.
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Affiliation(s)
- Panagiota Mistridis
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Sabine Krumm
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Andreas U Monsch
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Manfred Berres
- Department of Mathematics and Technology, University of Applied Sciences Koblenz, Koblenz, Germany
| | - Kirsten I Taylor
- Memory Clinic, University Center for Medicine of Aging Basel, Felix Platter Hospital, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Centre for Speech, Language and the Brain, Department of Experimental Psychology, University of Cambridge, Cambridge, UK
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26
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Borsa VM, Della Rosa PA, Catricalà E, Canini M, Iadanza A, Falini A, Abutalebi J, Iannaccone S. Interference and conflict monitoring in individuals with amnestic mild cognitive impairment: A structural study of the anterior cingulate cortex. J Neuropsychol 2016; 12:23-40. [PMID: 27147117 DOI: 10.1111/jnp.12105] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 03/30/2016] [Indexed: 12/25/2022]
Abstract
Amnestic mild cognitive impairment (aMCI) is a clinical condition characterized by memory impairment in the absence of any other cognitive impairment and is commonly associated with high conversion to Alzheimer's disease. Recent evidence shows that executive functions and selective attention mechanisms could also be impaired in aMCI. In this study, we investigated performance differences (i.e., reaction times [RTs] and accuracy) between a group of aMCI participants and a group of age-matched healthy individuals on the attentional network task (ANT) focusing on situations with increased interference. In particular, we assessed the relationship between interference and conflict effects and grey matter volumes (GMVs) of the anterior cingulate cortex (ACC)/pre-supplementary motor area in the entire sample because of its crucial role in conflict monitoring. When compared with controls, aMCI participants were less accurate on the ANT, showing increased interference and conflict effects, but no differences in RTs. In addition, aMCI participants exhibited lower GMV in the ACC than controls. While better accuracy for interference and conflict effects was associated with an increase of GMV in the ACC for both groups, RTs from the interference effect were negatively correlated with GMV of the ACC only in aMCI participants. In other words, lower GMV values of the ACC were paralleled with significantly impaired performance in terms of interference resolution. In conclusion, our study suggests the presence of a selective impairment in interference and conflict monitoring in aMCI, which in turn is associated with decreased GMVs in the ACC.
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Affiliation(s)
- Virginia M Borsa
- Department of Clinical Neurosciences, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
| | - Pasquale A Della Rosa
- Department of Clinical Neurosciences, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy.,Free University of Bolzan, Bolzano, Italy
| | | | - Matteo Canini
- Department of Clinical Neurosciences, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
| | - Antonella Iadanza
- Department of Neuroscience, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
| | - Andrea Falini
- Department of Neuroscience, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
| | - Jubin Abutalebi
- Department of Clinical Neurosciences, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
| | - Sandro Iannaccone
- Department of Clinical Neurosciences, University San Raffaele and Scientific Institute San Raffaele, Milano, Italy
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27
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Rodríguez-Aranda C, Waterloo K, Johnsen SH, Eldevik P, Sparr S, Wikran GC, Herder M, Vangberg TR. Neuroanatomical correlates of verbal fluency in early Alzheimer's disease and normal aging. BRAIN AND LANGUAGE 2016; 155-156:24-35. [PMID: 27062691 DOI: 10.1016/j.bandl.2016.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 01/22/2016] [Accepted: 03/12/2016] [Indexed: 06/05/2023]
Abstract
Verbal fluency (VF) impairments occur early in Alzheimer's disease (AD) and to a lesser extent also in normal aging. However, the neural underpinnings of these impairments are not fully understood. The present study evaluated whether VF impairments in early AD and normal aging rely upon common or different neuroanatomical correlates. We examined the association between VF performance and brain structure in 18 mild AD patients and 24 healthy elderly. Linear regressions were performed between accuracy and time intervals in VF scores and structural measurements of cerebral gray matter (GM) and white matter (WM) using MRI. Results showed that semantic VF correlated exclusively with GM in cerebellum, left temporal fusiform cortex, and WM in uncinate fasciculus, inferior fronto-occipital fasciculus and corpus callosum. Phonemic VF showed unique associations between intervals and WM in left-hemisphere tracts. The association between GM in hippocampus, subcortical structures and semantic accuracy differentiated patients from controls. Results showed that VF impairments are primarily associated with same structural brain changes in AD as in healthy elderly but at exaggerated levels. However, specific VF deficiencies and their underlying neural correlates exist and these clearly differentiate the initial stages of AD.
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Affiliation(s)
| | - Knut Waterloo
- Department of Psychology, UiT The Artic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital North Norway, Tromsø, Norway
| | - Stein Harald Johnsen
- Department of Neurology, University Hospital North Norway, Tromsø, Norway; Brain and Circulation Research Group, Department of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
| | - Petter Eldevik
- Department of Radiology, University Hospital North Norway, Tromsø, Norway
| | - Sigurd Sparr
- Department of Geriatrics, University Hospital North Norway, Tromsø, Norway
| | - Gry C Wikran
- Department of Radiology, University Hospital North Norway, Tromsø, Norway
| | - Marit Herder
- Department of Radiology, University Hospital North Norway, Tromsø, Norway
| | - Torgil Riise Vangberg
- Department of Radiology, University Hospital North Norway, Tromsø, Norway; Medical Imaging Research Group, Department of Clinical Medicine, UiT The Artic University of Norway, Tromsø, Norway
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Measuring Cortical Connectivity in Alzheimer's Disease as a Brain Neural Network Pathology: Toward Clinical Applications. J Int Neuropsychol Soc 2016; 22:138-63. [PMID: 26888613 DOI: 10.1017/s1355617715000995] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The objective was to review the literature on diffusion tensor imaging as well as resting-state functional magnetic resonance imaging and electroencephalography (EEG) to unveil neuroanatomical and neurophysiological substrates of Alzheimer's disease (AD) as a brain neural network pathology affecting structural and functional cortical connectivity underlying human cognition. METHODS We reviewed papers registered in PubMed and other scientific repositories on the use of these techniques in amnesic mild cognitive impairment (MCI) and clinically mild AD dementia patients compared to cognitively intact elderly individuals (Controls). RESULTS Hundreds of peer-reviewed (cross-sectional and longitudinal) papers have shown in patients with MCI and mild AD compared to Controls (1) impairment of callosal (splenium), thalamic, and anterior-posterior white matter bundles; (2) reduced correlation of resting state blood oxygen level-dependent activity across several intrinsic brain circuits including default mode and attention-related networks; and (3) abnormal power and functional coupling of resting state cortical EEG rhythms. Clinical applications of these measures are still limited. CONCLUSIONS Structural and functional (in vivo) cortical connectivity measures represent a reliable marker of cerebral reserve capacity and should be used to predict and monitor the evolution of AD and its relative impact on cognitive domains in pre-clinical, prodromal, and dementia stages of AD.
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29
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Promteangtrong C, Kolber M, Ramchandra P, Moghbel M, Houshmand S, Schöll M, Bai H, Werner TJ, Alavi A, Buchpiguel C. Multimodality Imaging Approach in Alzheimer disease. Part I: Structural MRI, Functional MRI, Diffusion Tensor Imaging and Magnetization Transfer Imaging. Dement Neuropsychol 2015; 9:318-329. [PMID: 29213981 PMCID: PMC5619314 DOI: 10.1590/1980-57642015dn94000318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The authors make a complete review of the potential clinical applications of
traditional and novel magnetic resonance imaging (MRI) techniques in the
evaluation of patients with Alzheimer's disease, including structural MRI,
functional MRI, diffusion tension imaging and magnetization transfer
imaging.
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Affiliation(s)
| | - Marcus Kolber
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Priya Ramchandra
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Mateen Moghbel
- Stanford University School of Medicine, Stanford, California
| | - Sina Houshmand
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Michael Schöll
- Karolinska Institutet, Alzheimer Neurobiology Center, Stockholm, Sweden
| | - Halbert Bai
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Thomas J Werner
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Abass Alavi
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Carlos Buchpiguel
- Nuclear Medicine Service, Instituto do Cancer do Estado de São Paulo, University of São Paulo, São Paulo, Brazil.,Nuclear Medicine Center, Radiology Institute, University of São Paulo General Hospital , São Paulo, Brazil
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30
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Nowrangi MA, Okonkwo O, Lyketsos C, Oishi K, Mori S, Albert M, Mielke MM. Atlas-based diffusion tensor imaging correlates of executive function. J Alzheimers Dis 2015; 44:585-98. [PMID: 25318544 DOI: 10.3233/jad-141937] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Impairment in executive function (EF) is commonly found in Alzheimer's disease (AD) and mild cognitive impairment (MCI). Atlas-based diffusion tensor imaging (DTI) methods may be useful in relating regional integrity to EF measures in MCI and AD. Sixty-six participants (25 normal controls, 22 MCI, and 19 AD) received DTI scans and clinical evaluation. DTI scans were applied to a pre-segmented atlas and fractional anisotropy (FA) and mean diffusivity (MD) were calculated. ANOVA was used to assess group differences in frontal, parietal, and cerebellar regions. For regions differing between groups (p < 0.01), linear regression examined the relationship between EF scores and regional FA and MD. Anisotropy and diffusivity in frontal and parietal lobe white matter structures were associated with EF scores in MCI and only frontal lobe structures in AD. EF was more strongly associated with FA than MD. The relationship between EF and anisotropy and diffusivity was strongest in MCI. These results suggest that regional white matter integrity is compromised in MCI and AD and that FA may be a better correlate of EF than MD.
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Affiliation(s)
- Milap A Nowrangi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Ozioma Okonkwo
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Constantine Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Kenichi Oishi
- Department of Radiology Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Susumu Mori
- Department of Radiology Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Marilyn Albert
- Department of Neurology, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
| | - Michelle M Mielke
- Department of Health Sciences Research, Division of Epidemiology and Department of Neurology, Mayo Clinic, Rochester, MN, USA
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31
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Hammers D, Ramirez G, Persad C, Heidebrink J, Barbas N, Giordani B. Diagnostic Profiles of Patients Differentially Failing Executive Functioning Measures. Am J Alzheimers Dis Other Demen 2015; 31:214-22. [PMID: 26340963 DOI: 10.1177/1533317515603114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Limited research exists to explain differential executive functioning impairment in clinical populations, particularly between the Wisconsin Card Sorting Task (WCST) and the Trail Making Test (TMT). METHODS The distribution of clinical diagnoses was examined in patients failing none, one, or both tasks, and executive task performance was compared among dementia-related diagnoses. Two hundred and sixty-six participants received evaluations through an Alzheimer's Disease Research Center, which included executive tasks. Dementia-related diagnoses were established through consensus. RESULTS Chi-square analyses indicated that TMT failure, with or without WCST failure, possessed higher associations with dementia diagnoses. Repeated measures analysis of variance similarly indicated that participants with dementia, especially mild and moderate severity, performed worse on TMT. CONCLUSIONS Executive dysfunction was observed in dementia-related diagnoses, and TMT failure was implicated in dementia in higher proportions than WCST impairment. Trail Making Test appears more sensitive than WCST for assessing executive impairment across diagnoses, especially when time and resources are limited in screening and clinical settings.
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Affiliation(s)
- Dustin Hammers
- Department of Neurology, Center for Alzheimer's Care, Imaging, and Research, University of Utah, Salt Lake City, UT, USA
| | - Gabriela Ramirez
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Carol Persad
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Judith Heidebrink
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA Neurology Service, VAAAHS, Ann Arbor, MI, USA
| | - Nancy Barbas
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA Neurology Service, VAAAHS, Ann Arbor, MI, USA
| | - Bruno Giordani
- Neuropsychology Section, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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Lindbergh CA, Puente AN, Gray JC, Mackillop J, Miller LS. Delay and probability discounting as candidate markers for dementia: an initial investigation. Arch Clin Neuropsychol 2014; 29:651-62. [PMID: 25236720 PMCID: PMC4263925 DOI: 10.1093/arclin/acu043] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2014] [Indexed: 11/12/2022] Open
Abstract
The present study investigated delay discounting and probability discounting-behavioral economic indices of impulsivity and risk proneness, respectively-in 39 healthy older adults and 25 older adults with mild cognitive impairment (MCI). Relative to the healthy group, it was hypothesized that older adults with MCI would display greater levels of impulsivity, risk proneness, and response inconsistency. The MCI group was found to display a unique delay discounting profile characterized by increasing impulsivity with decreasing reward magnitude, such that cognitively impaired older adults were significantly more impulsive than healthy controls at the small reward magnitude. The two groups exhibited similar levels of probability discounting, though older adults with MCI were significantly less consistent in their risk preferences. The present findings shed light onto decision-making in pre-dementia disease stages and suggest that discounting performance holds potential to complement early diagnostic instruments, likely due to pathophysiological processes in relevant brain regions.
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Affiliation(s)
| | - Antonio N Puente
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - Joshua C Gray
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - James Mackillop
- Department of Psychology, University of Georgia, Athens, GA 30602, USA
| | - L Stephen Miller
- Department of Psychology, University of Georgia, Athens, GA 30602, USA Bio-Imaging Research Center, Paul D. Coverdell Center, University of Georgia, Athens, GA 30602, USA
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33
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Seiler S, Pirpamer L, Hofer E, Duering M, Jouvent E, Fazekas F, Mangin JF, Chabriat H, Dichgans M, Ropele S, Schmidt R. Magnetization transfer ratio relates to cognitive impairment in normal elderly. Front Aging Neurosci 2014; 6:263. [PMID: 25309438 PMCID: PMC4174770 DOI: 10.3389/fnagi.2014.00263] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Accepted: 09/11/2014] [Indexed: 01/15/2023] Open
Abstract
Magnetization transfer imaging (MTI) can detect microstructural brain tissue changes and may be helpful in determining age-related cerebral damage. We investigated the association between the magnetization transfer ratio (MTR) in gray and white matter (WM) and cognitive functioning in 355 participants of the Austrian stroke prevention family study (ASPS-Fam) aged 38-86 years. MTR maps were generated for the neocortex, deep gray matter structures, WM hyperintensities, and normal appearing WM (NAWM). Adjusted mixed models determined whole brain and lobar cortical MTR to be directly and significantly related to performance on tests of memory, executive function, and motor skills. There existed an almost linear dose-effect relationship. MTR of deep gray matter structures and NAWM correlated to executive functioning. All associations were independent of demographics, vascular risk factors, focal brain lesions, and cortex volume. Further research is needed to understand the basis of this association at the tissue level, and to determine the role of MTR in predicting cognitive decline and dementia.
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Affiliation(s)
- Stephan Seiler
- Department of Neurology, Medical University of Graz , Graz , Austria
| | - Lukas Pirpamer
- Department of Neurology, Medical University of Graz , Graz , Austria
| | - Edith Hofer
- Department of Neurology, Medical University of Graz , Graz , Austria ; Institute of Medical Informatics, Statistics and Documentation, Medical University of Graz , Graz , Austria
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University , Munich , Germany
| | - Eric Jouvent
- Department of Neurology, CHU Lariboisière , Paris , France
| | - Franz Fazekas
- Department of Neurology, Medical University of Graz , Graz , Austria
| | | | | | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University , Munich , Germany ; German Center for Neurodegenerative Diseases (DZNE) , Munich , Germany ; Munich Cluster for Systems Neurology (SyNergy) , Munich , Germany
| | - Stefan Ropele
- Department of Neurology, Medical University of Graz , Graz , Austria
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz , Graz , Austria
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Zi W, Duan D, Zheng J. Cognitive impairments associated with periventricular white matter hyperintensities are mediated by cortical atrophy. Acta Neurol Scand 2014; 130:178-87. [PMID: 24838230 DOI: 10.1111/ane.12262] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have shown that white matter lesions (WMLs) is an important risk factor for cognitive impairment, but the underlying mechanisms have not been clarified. OBJECTIVE We tested the hypothesis that the cognitive impairments associated with periventricular white matter hyperintensities (PWMHs) on magnetic resonance imaging (MRI) would be mediated by the cortical thinning of corresponding area. METHOD Sixteen stroke- and dementia-free subjects with PWMHs and 16 healthy control subjects were enrolled in this study. All participants underwent an examination of cognition, MRI-based cortical thickness measurement and a MRI-DTI scan. Then, the possible relationships among cognitive impairments, PWMHs and the topography of cortical thinning were analyzed. RESULTS Comparing with the controls, the cognitive tests of the subjects with PWMHs showed significant decline in the domains of verbal fluency and executive function. After accounting for age, gender, years of education, and treatable vascular risk factors related to cognitive performance, cortical thickness had an independent influence on the cognitive impairments, especially in the frontal pole, orbitofrontal cortex, superior and middle frontal gyrus, superior and middle temporal gyrus, insula, and cuneus. CONCLUSIONS Our results suggest that the association between PWMHs and cognitive impairments is mediated by cortical thinning.
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Affiliation(s)
- W. Zi
- Department of Neurology; Xinqiao Hospital; Third Military Medical University; Chongqing China
| | - D. Duan
- Department of Neurology; Xinqiao Hospital; Third Military Medical University; Chongqing China
| | - J. Zheng
- Department of Neurology; Xinqiao Hospital; Third Military Medical University; Chongqing China
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35
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Brown PJ, Sneed JR, Rutherford B, Devanand D, Roose SP. The nuances of cognition and depression in older adults: the need for a comprehensive assessment. Int J Geriatr Psychiatry 2014; 29:506-14. [PMID: 24123357 PMCID: PMC3975802 DOI: 10.1002/gps.4033] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 08/21/2013] [Accepted: 09/06/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study aimed to examine the confluence of depression, cognitive impairment, and vascular risk factors in older individuals. METHODS The study uses baseline data from the National Alzheimer's Coordinating Center. Data were collected across Alzheimer's Disease Centers in the USA. The sample included 12,634 individuals (cognitive intact = 8022; amnestic mild cognitive impairment [aMCI] = 3652; nonamnestic MCI [nonaMCI] = 960). The Geriatric Depression Scale assessed depression; the Trail Making Test assessed executive function. RESULTS The proportion of participants with depression was higher in the aMCI (18%) and nonaMCI group (21%) as compared with that in the cognitively intact group (8%); there was no difference in rates of depression between aMCI and nonaMCI groups. The proportion of participants with executive dysfunction differed between nondepressed and depressed individuals for the cognitively intact (8% vs. 12%) and aMCI groups (28% vs. 35%), but not for the nonaMCI group (37% vs. 41%). Nine percent of the cognitively intact group had executive dysfunction compared with 31% of the aMCI group and 40% of the nonaMCI group. The proportion of participants with hypertension was greater in individuals with executive dysfunction compared with those with no executive deficits; the presence of hypertension was not associated with depression severity. CONCLUSIONS The confluence of vascular risk factors, episodic memory impairment, and depression and executive dysfunction highlights the need for comprehensive assessment of depressed older adults that can aid clinicians in the formulation of treatment planning and inform clinicians and researchers about long-term prognosis.
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Affiliation(s)
- Patrick J. Brown
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA
| | - Joel R. Sneed
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA,Queens College, City University of New York,The Graduate Center, City University of New York
| | - Bret Rutherford
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA
| | - D.P. Devanand
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA
| | - Steven P. Roose
- Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY USA
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Nowrangi MA, Lyketsos C, Rao V, Munro CA. Systematic review of neuroimaging correlates of executive functioning: converging evidence from different clinical populations. J Neuropsychiatry Clin Neurosci 2014; 26:114-25. [PMID: 24763759 PMCID: PMC5171230 DOI: 10.1176/appi.neuropsych.12070176] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Executive functioning (EF) is an important cognitive domain that is negatively affected in a number of neuropsychiatric conditions. Neuroimaging methods have led to insights into the anatomical and functional nature of EF. The authors conducted a systematic review of the recent cognitive and neuroimaging literature to investigate how the neuroimaging correlates of EF compare between different diagnostic groups. The authors found that the frontal, parietal, and cerebellar lobes were most frequently associated with EF when comparing results from different clinical populations; the occipital lobe was not correlated with EF in any group. These findings suggest that individual disease processes affect circuits within an identifiable distributed network rather than isolated regions.
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37
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Simple and complex rule induction performance in young and older adults: contribution of episodic memory and working memory. J Int Neuropsychol Soc 2014; 20:333-41. [PMID: 24559523 DOI: 10.1017/s1355617713001446] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
This study tested the hypothesis that part of the age-related decline in performance on executive function tasks is due to a decline in episodic memory. For this, we developed a rule induction task in which we manipulated the involvement of episodic memory and executive control processes; age effects and neuropsychological predictors of task performance were investigated. Twenty-six younger (mean age, 24.0; range, 19-35 years) and 27 community-dwelling older adults (mean age, 67.5; range, 50-91 years) participated. The neuropsychological predictors consisted of the performance on tests of episodic memory, working memory, switching, inhibition and flexibility. Performance of the older adults was worse for the learning and memorization of simple rules, as well as for the more demanding executive control condition requiring the manipulation of informational content. Episodic memory was the only predictor of performance on the simple learning and memorization task condition whereas an increase in rule induction complexity additionally engaged working memory processes. Together, these findings indicate that part of the age-related decline on rule induction tests may be the result of a decline in episodic memory. Further studies are needed that examine the role of episodic memory in other executive function tasks in aging.
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Lin YC, Shih YC, Tseng WYI, Chu YH, Wu MT, Chen TF, Tang PF, Chiu MJ. Cingulum correlates of cognitive functions in patients with mild cognitive impairment and early Alzheimer's disease: a diffusion spectrum imaging study. Brain Topogr 2014; 27:393-402. [PMID: 24414091 DOI: 10.1007/s10548-013-0346-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 12/14/2013] [Indexed: 01/18/2023]
Abstract
Diffusion spectrum imaging (DSI) of MRI can detect neural fiber tract changes. We investigated integrity of cingulum bundle (CB) in patients with mild cognitive impairment (MCI) and early Alzheimer's disease (EAD) using DSI tractography and explored its relationship with cognitive functions. We recruited 8 patients with MCI, 9 with EAD and 15 healthy controls (HC). All subjects received a battery of neuropsychological tests to access their executive, memory and language functions. We used a 3.0-tesla MRI scanner to obtain T1- and T2-weighted images for anatomy and used a pulsed gradient twice-refocused spin-echo diffusion echo-planar imaging sequence to acquire DSI. Patients with EAD performed significantly poorer than the HC on most tests in executive and memory functions. Significantly smaller general fractional anisotropy (GFA) values were found in the posterior and inferior segments of left CB and of the anterior segment of right CB of the EAD compared with those of the HC. Spearman's correlation on the patient groups showed that GFA values of the posterior segment of the left CB were significantly negatively associated with the time used to complete Color Trails Test Part II and positively correlated with performance of the logical memory and visual reproduction. GFA values of inferior segment of bilateral CB were positively associated with the performance of visual recognition. DSI tractography demonstrates significant preferential degeneration of the CB on the left side in patients with EAD. The location-specific degeneration is associated with corresponding declines in both executive and memory functions.
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Affiliation(s)
- Yi-Cheng Lin
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No. 17, XuZhou Rd, Taipei, 100, Taiwan
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Chiu MJ, Yang SY, Horng HE, Yang CC, Chen TF, Chieh JJ, Chen HH, Chen TC, Ho CS, Chang SF, Liu HC, Hong CY, Yang HC. Combined plasma biomarkers for diagnosing mild cognition impairment and Alzheimer's disease. ACS Chem Neurosci 2013; 4:1530-6. [PMID: 24090201 DOI: 10.1021/cn400129p] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
A highly sensitive immunoassay, the immunomagnetic reduction, is used to measure several biomarkers for plasma that is related to Alzheimer's disease (AD). These biomarkers include Aβ-40, Aβ-42, and tau proteins. The samples are composed of four groups: healthy controls (n=66), mild cognitive impairment (MCI, n=22), very mild dementia (n=23), and mild-to-serve dementia, all due to AD (n=22). It is found that the concentrations of both Aβ-42 and tau protein for the healthy controls are significantly lower than those of all of the other groups. The sensitivity and the specificity of plasma Aβ-42 and tau protein in differentiating MCI from AD are all around 0.9 (0.88-0.97). However, neither plasma Aβ-42 nor tau-protein concentration is an adequate parameter to distinguish MCI from AD. A parameter is proposed, which is the product of plasma Aβ-42 and tau-protein levels, to differentiate MCI from AD. The sensitivity and specificity are found to be 0.80 and 0.82, respectively. It is concluded that the use of combined plasma biomarkers not only allows the differentiation of the healthy controls and patients with AD in both the prodromal phase and the dementia phase, but it also allows AD in the prodromal phase to be distinguished from that in the dementia phase.
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Affiliation(s)
- Ming-Jang Chiu
- Department
of Neurology, National Taiwan University
Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Graduate
Institute of Brain and Mind Sciences, College
of Medicine, National Taiwan University, Taipei 100, Taiwan
- Department
of Psychology, National Taiwan University, Taipei 100, Taiwan
- Graduate
Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei 116, Taiwan
| | - Shieh-Yueh Yang
- Institute
of Electro-optical Science and Technology, National Taiwan Normal University, Taipei 116, Taiwan
- MagQu Co., Ltd., Xindian District, New Taipei
City 231, Taiwan
| | - Herng-Er Horng
- Institute
of Electro-optical Science and Technology, National Taiwan Normal University, Taipei 116, Taiwan
| | - Che-Chuan Yang
- MagQu Co., Ltd., Xindian District, New Taipei
City 231, Taiwan
| | - Ta-Fu Chen
- Department
of Neurology, National Taiwan University
Hospital, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Jen-Je Chieh
- Institute
of Electro-optical Science and Technology, National Taiwan Normal University, Taipei 116, Taiwan
| | - Hsin-Hsien Chen
- Institute
of Electro-optical Science and Technology, National Taiwan Normal University, Taipei 116, Taiwan
| | - Ting-Chi Chen
- MagQu Co., Ltd., Xindian District, New Taipei
City 231, Taiwan
| | - Chia-Shin Ho
- MagQu Co., Ltd., Xindian District, New Taipei
City 231, Taiwan
| | - Shuo-Fen Chang
- MagQu Co., Ltd., Xindian District, New Taipei
City 231, Taiwan
| | - Hao Chun Liu
- Institute
of Electro-optical Science and Technology, National Taiwan Normal University, Taipei 116, Taiwan
| | - Chin-Yih Hong
- Graduate
Institute of Bio-medical Engineering, National Chung Hsing University, Taichung 402, Taiwan
| | - Hong-Chang Yang
- Department
of Electro-optical Engineering, Kun Shan University, Yongkang District, Tainan City 710, Taiwan
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Diffusion tensor imaging (DTI) in the detection of white matter lesions in patients with mild cognitive impairment (MCI). Acta Neurol Belg 2013; 113:441-51. [PMID: 23625776 DOI: 10.1007/s13760-013-0197-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
Mild cognitive impairment (MCI) is recognized as a precursor to dementia. The amnestic MCI progresses usually to Alzheimer disease. Amnestic MCI multiple domain (md-MCI) seems to progress more rapidly than amnestic MCI single domain (a-MCI). In an attempt to identify patients at risk, we examined white matter changes in MCI subtypes using diffusion tensor imaging (DTI). We also tried to correlate DTI findings to neuropsychological tests. Forty-four amnestic single domain (a-MCI) patients, 19 amnestic multi domain (md-MCI), and 25 cognitively normal (NC) controls were included in the present study. All participants were assessed clinically using a battery of cognitive tests. DTI was performed to measure fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Areas studied were corpus callosum, posterior cingulum (PC), anterior cingulum (AC), and superior longitudinal fasciculus (SLF). ADC and FA of the above areas were related to the scores of certain neuropsychological tests that evaluate visual and verbal memory. No difference in DTI measurements was found between the two MCI subtypes. ADC in MCI cases was increased in comparison with NC in the genu, PC, right SLF, and left AC. FA was spared. Verbal memory was related to ADC of the genu, PC, right AC and right SLF, and to FA of the left SLF. Visual memory was related to ADC of the genu, PC, right AC, and SLF. The strongest correlation found was between the visual memory and the ADC of the right PC (Spearman ρ = 0.45, p < 0.001). DTI revealed that ADC was increased in certain brain areas in MCI patients. No difference in DTI measurements was found between the two MCI subtypes. DTI indices correlate with cognitive performance.
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Benitez A, Fieremans E, Jensen JH, Falangola MF, Tabesh A, Ferris SH, Helpern JA. White matter tract integrity metrics reflect the vulnerability of late-myelinating tracts in Alzheimer's disease. NEUROIMAGE-CLINICAL 2013; 4:64-71. [PMID: 24319654 PMCID: PMC3853114 DOI: 10.1016/j.nicl.2013.11.001] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 11/01/2013] [Accepted: 11/03/2013] [Indexed: 12/21/2022]
Abstract
Post-mortem and imaging studies have observed that white matter (WM) degenerates in a pattern inverse to myelin development, suggesting preferential regional vulnerabilities influencing cognitive decline in AD. This study applied novel WM tract integrity (WMTI) metrics derived from diffusional kurtosis imaging (DKI) to examine WM tissue properties in AD within this framework. Using data from amnestic mild cognitive impairment (aMCI, n = 12), AD (n = 14), and normal control (NC; n = 15) subjects, mixed models revealed interaction effects: specific WMTI metrics of axonal density and myelin integrity (i.e. axonal water fraction, radial extra-axonal diffusivity) in late-myelinating tracts (i.e. superior and inferior longitudinal fasciculi) changed in the course of disease, but were stable in the initial stages for early-myelinating tracts (i.e. posterior limb of the internal capsule, cerebral peduncles). WMTI metrics in late-myelinating tracts correlated with semantic verbal fluency, a cognitive function known to decline in AD. These findings corroborate the preferential vulnerability of late-myelinating tracts, and illustrate an application of WMTI metrics to characterizing the regional course of WM changes in AD. We investigated the vulnerability of late-myelinating tracts in AD using WMTI metrics. WMTI metrics are derived from the biophysical modeling of the DKI signal. These metrics indicate pathological features like axonal density and myelin integrity. WMTI metrics were largely stable in early-myelinating tracts through the course of AD. Axonal density loss & myelin breakdown were observed in late-myelinating tracts.
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Key Words
- AD, Alzheimer's disease
- AWF, axonal water fraction
- Alzheimer's disease
- CP, cerebral peduncle
- DKI, diffusional kurtosis imaging
- DTI, diffusion tensor imaging
- Daxon, intrinsic axonal diffusivity
- De,∥, axial extra-axonal diffusivity
- De,⊥, radial extra-axonal diffusivity
- Diffusion MRI
- Diffusional kurtosis imaging
- FA, fractional anisotropy
- ILF, inferior longitudinal fasciculus
- NC, normal control
- PLIC, posterior limb of the internal capsule
- SLF, superior longitudinal fasciculus
- Verbal fluency
- WM, white matter
- WMTI, white matter tract integrity
- White matter
- aMCI, amnestic mild cognitive impairment
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Affiliation(s)
- Andreana Benitez
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29425, USA ; Center for Biomedical Imaging, Medical University of South Carolina, Charleston, SC 29425, USA
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42
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Chiu MJ, Chen YF, Chen TF, Yang SY, Yang FPG, Tseng TW, Chieh JJ, Chen JCR, Tzen KY, Hua MS, Horng HE. Plasma tau as a window to the brain-negative associations with brain volume and memory function in mild cognitive impairment and early Alzheimer's disease. Hum Brain Mapp 2013; 35:3132-42. [PMID: 24129926 DOI: 10.1002/hbm.22390] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 07/26/2013] [Accepted: 07/30/2013] [Indexed: 11/09/2022] Open
Abstract
Neurofibrillary tangles are associated with cognitive dysfunction, and hippocampal atrophy with increased CSF tau markers. However, the plasma tau levels of Alzheimer's disease (AD) have not been well studied. We investigated plasma tau by using an immunomagnetic reduction assay in 20 patients with mild cognitive impairment (MCI) due to AD, 10 early AD dementia, and 30 healthy elders (HE). All received a 3D-brain MRI scan and a set of cognitive function test. We explored their relationships with both brain structure and cognitive functions. Images were analyzed to determine the brain volumes and gray matter densities. Patients with MCI or early AD had significantly increased plasma tau levels compared with HE. Plasma tau levels were negatively associated with the performance of logical memory, visual reproduction, and verbal fluency; also negatively associated with volume of total gray matter, hippocampus, amygdala; and gray matter densities of various regions. Regression analyses indicated that logical memory explained 0.394 and hippocampus volume predicted .608 of the variance of plasma tau levels, both P < 0.001. Education years were negatively associated with the gray matter densities of the supramarginal (r = -0.407), middle temporal gyrus (r = -0.40) and precuneus (r = -0.377; all P < 0.05) in HE; and negatively associated with plasma tau levels in patients (r = -0.626). We propose that plasma tau may serve as a window to both structure and function of the brain. Higher education is a protective factor against AD and is associated with lower plasma tau levels in patients.
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Affiliation(s)
- Ming-Jang Chiu
- Department of Neurology, College of Medicine, National Taiwan University, Taipei, Taiwan; Institute of Brain and Mind Sciences, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Psychology, National Taiwan University, Taipei, Taiwan; Graduate Institute of Biomedical Engineering and Bio-informatics, National Taiwan University, Taipei, Taiwan
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Executive functions in clinical and preclinical Alzheimer's disease. Rev Neurol (Paris) 2013; 169:695-708. [DOI: 10.1016/j.neurol.2013.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 07/23/2013] [Accepted: 07/23/2013] [Indexed: 01/18/2023]
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Rowley J, Fonov V, Wu O, Eskildsen SF, Schoemaker D, Wu L, Mohades S, Shin M, Sziklas V, Cheewakriengkrai L, Shmuel A, Dagher A, Gauthier S, Rosa-Neto P. White matter abnormalities and structural hippocampal disconnections in amnestic mild cognitive impairment and Alzheimer's disease. PLoS One 2013; 8:e74776. [PMID: 24086371 PMCID: PMC3785512 DOI: 10.1371/journal.pone.0074776] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 08/07/2013] [Indexed: 01/18/2023] Open
Abstract
The purpose of this project was to evaluate white matter degeneration and its impact on hippocampal structural connectivity in patients with amnestic mild cognitive impairment, non-amnestic mild cognitive impairment and Alzheimer’s disease. We estimated white matter fractional anisotropy, mean diffusivity and hippocampal structural connectivity in two independent cohorts. The ADNI cohort included 108 subjects [25 cognitively normal, 21 amnestic mild cognitive impairment, 47 non-amnestic mild cognitive impairment and 15 Alzheimer’s disease]. A second cohort included 34 subjects [15 cognitively normal and 19 amnestic mild cognitive impairment] recruited in Montreal. All subjects underwent clinical and neuropsychological assessment in addition to diffusion and T1 MRI. Individual fractional anisotropy and mean diffusivity maps were generated using FSL-DTIfit. In addition, hippocampal structural connectivity maps expressing the probability of connectivity between the hippocampus and cortex were generated using a pipeline based on FSL-probtrackX. Voxel-based group comparison statistics of fractional anisotropy, mean diffusivity and hippocampal structural connectivity were estimated using Tract-Based Spatial Statistics. The proportion of abnormal to total white matter volume was estimated using the total volume of the white matter skeleton. We found that in both cohorts, amnestic mild cognitive impairment patients had 27-29% white matter volume showing higher mean diffusivity but no significant fractional anisotropy abnormalities. No fractional anisotropy or mean diffusivity differences were observed between non-amnestic mild cognitive impairment patients and cognitively normal subjects. Alzheimer’s disease patients had 66.3% of normalized white matter volume with increased mean diffusivity and 54.3% of the white matter had reduced fractional anisotropy. Reduced structural connectivity was found in the hippocampal connections to temporal, inferior parietal, posterior cingulate and frontal regions only in the Alzheimer’s group. The severity of white matter degeneration appears to be higher in advanced clinical stages, supporting the construct that these abnormalities are part of the pathophysiological processes of Alzheimer’s disease.
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Affiliation(s)
- Jared Rowley
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Vladimir Fonov
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, Massachusetts, United States of America
| | | | - Dorothee Schoemaker
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Liyong Wu
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Sara Mohades
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Monica Shin
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Viviane Sziklas
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Laksanun Cheewakriengkrai
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Amir Shmuel
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Alain Dagher
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - Serge Gauthier
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- * E-mail:
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Decreased white matter integrity in neuropsychologically defined mild cognitive impairment is independent of cortical thinning. J Int Neuropsychol Soc 2013; 19:925-37. [PMID: 23809097 PMCID: PMC4356249 DOI: 10.1017/s1355617713000660] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Improved understanding of the pattern of white matter changes in early and prodromal Alzheimer’s disease (AD) states such as mild cognitive impairment (MCI) is necessary to support earlier preclinical detection of AD, and debate remains whether white matter changes in MCI are secondary to gray matter changes. We applied neuropsychologically based MCI criteria to a sample of normally aging older adults; 32 participants met criteria for MCI and 81 participants were classified as normal control (NC) subjects. Whole-head high resolution T1 and diffusion tensor imaging scans were completed. Tract-Based Spatial Statistics was applied and a priori selected regions of interest were extracted. Hippocampal volume and cortical thickness averaged across regions with known vulnerability to AD were derived. Controlling for corticalthic kness, the MCI group showed decreased average fractional anisotropy (FA) and decreased FA in parietal white matter and in white matter underlying the entorhinal and posterior cingulate cortices relative to the NC group. Statistically controlling for cortical thickness, medial temporal FA was related to memory and parietal FA was related to executive functioning. These results provide further support for the potential role of white matter integrity as an early biomarker for individuals at risk for AD and highlight that changes in white matter may be independent of gray matter changes.
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46
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Lebel C, Shaywitz B, Holahan J, Shaywitz S, Marchione K, Beaulieu C. Diffusion tensor imaging correlates of reading ability in dysfluent and non-impaired readers. BRAIN AND LANGUAGE 2013; 125:215-222. [PMID: 23290366 DOI: 10.1016/j.bandl.2012.10.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Revised: 10/17/2012] [Accepted: 10/26/2012] [Indexed: 06/01/2023]
Abstract
Many children and adults have specific reading disabilities; insight into the brain structure underlying these difficulties is evolving from imaging. Previous research highlights the left temporal-parietal white matter as important in reading, yet the degree of involvement of other areas remains unclear. Diffusion tensor imaging (DTI) and voxel-based analysis were used to examine correlations between reading ability and tissue structure in healthy adolescents and young adults (n=136) with a range of reading ability. Three complementary reading scores (word reading, decoding, and reading fluency) yielded positive correlations with fractional anisotropy (FA) that spanned bilateral brain regions, particularly in the frontal lobes, but also included the thalamus and parietal and temporal areas. An analysis of the unique effects of each reading assessment revealed that most of the variance in FA values could be attributed to sight word reading ability.
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Affiliation(s)
- Catherine Lebel
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada T6G 2V2
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47
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Abstract
A wide range of imaging studies provides growing support for the potential role of diffusion tensor imaging (DTI) in evaluating microstructural white matter integrity in Alzheimer disease (AD) and mild cognitive impairment (MCI). Our review aims to present DTI principles, post-processing and analysis frameworks and to report the results of particular studies. The distribution of AD-related white matter abnormalities is widely discussed in the light of deteriorated connectivity within certain tracts due to secondary white matter degeneration; primary alterations are also assumed to contribute to the pattern. The question whether it is more effective to assess the whole-brain diffusion or to directly concentrate on specific regions remains an interesting issue. Assessing white matter microstructure alterations, as evaluated by group-level differences of tensor-derived parameters, may be a promising neuroimaging tool for differential diagnosis between AD, MCI and other cognitive disorders, as well as being particularly helpful in the interpretation of underlying pathological processes.
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48
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Shan JC, Liu CM, Chiu MJ, Liu CC, Chien YL, Hwang TJ, Lin YT, Hsieh MH, Jaw FS, Hwu HG. A diagnostic model incorporating P50 sensory gating and neuropsychological tests for schizophrenia. PLoS One 2013; 8:e57197. [PMID: 23460831 PMCID: PMC3584115 DOI: 10.1371/journal.pone.0057197] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 01/18/2013] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Endophenotypes in schizophrenia research is a contemporary approach to studying this heterogeneous mental illness, and several candidate neurophysiological markers (e.g. P50 sensory gating) and neuropsychological tests (e.g. Continuous Performance Test (CPT) and Wisconsin Card Sorting Test (WCST)) have been proposed. However, the clinical utility of a single marker appears to be limited. In the present study, we aimed to construct a diagnostic model incorporating P50 sensory gating with other neuropsychological tests in order to improve the clinical utility. METHODS We recruited clinically stable outpatients meeting DSM-IV criteria of schizophrenia and age- and gender-matched healthy controls. Participants underwent P50 sensory gating experimental sessions and batteries of neuropsychological tests, including CPT, WCST and Wechsler Adult Intelligence Scale Third Edition (WAIS-III). RESULTS A total of 106 schizophrenia patients and 74 healthy controls were enrolled. Compared with healthy controls, the patient group had significantly a larger S2 amplitude, and thus poorer P50 gating ratio (gating ratio = S2/S1). In addition, schizophrenia patients had a poorer performance on neuropsychological tests. We then developed a diagnostic model by using multivariable logistic regression analysis to differentiate patients from healthy controls. The final model included the following covariates: abnormal P50 gating (defined as P50 gating ratio >0.4), three subscales derived from the WAIS-III (Arithmetic, Block Design, and Performance IQ), sensitivity index from CPT and smoking status. This model had an adequate accuracy (concordant percentage = 90.4%; c-statistic = 0.904; Hosmer-Lemeshow Goodness-of-Fit Test, p = 0.64>0.05). CONCLUSION To the best of our knowledge, this is the largest study to date using P50 sensory gating in subjects of Chinese ethnicity and the first to use P50 sensory gating along with other neuropsychological tests to develop a diagnostic model for schizophrenia. Further research to validate the predictive accuracy of this model by applying it on other samples is warranted.
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Affiliation(s)
- Jia-Chi Shan
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Ming-Jang Chiu
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Department of Neurology, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Chung Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzung-Jeng Hwang
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Yi-Ting Lin
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
| | - Ming H. Hsieh
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Fu-Shan Jaw
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hai-Gwo Hwu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
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49
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Using mental imagery to improve memory in patients with Alzheimer disease: trouble generating or remembering the mind's eye? Alzheimer Dis Assoc Disord 2012; 26:124-34. [PMID: 21946012 DOI: 10.1097/wad.0b013e31822e0f73] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
This study was conducted to understand whether patients with mild Alzheimer disease (AD) could use general or self-referential mental imagery to improve their recognition of visually presented words. Experiment 1 showed that, unlike healthy controls, patients generally did not benefit from either type of imagery. To help determine whether the patients' inability to benefit from mental imagery at encoding was due to poor memory or due to an impairment in mental imagery, participants performed 4 imagery tasks with varying imagery and cognitive demands. Experiment 2 showed that patients successfully performed basic visual imagery, but degraded semantic memory, coupled with visuospatial and executive functioning deficits, impaired their ability to perform more complex types of imagery. Given that patients with AD can perform basic mental imagery, our results suggest that episodic memory deficits likely prevent AD patients from storing or retrieving general mental images generated during encoding. Overall, the results of both experiments suggest that neurocognitive deficits do not allow patients with AD to perform complex mental imagery, which may be most beneficial to improving memory. However, our data also suggest that intact basic mental imagery and rehearsal could possibly be helpful if used in a rehabilitation multisession intervention approach.
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50
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Wang TY, Kuo YC, Ma HI, Lee CC, Pai MC. Validation of the route map recall test for getting lost behavior in Alzheimer's disease patients. Arch Clin Neuropsychol 2012; 27:781-9. [PMID: 22951671 DOI: 10.1093/arclin/acs073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Getting lost (GL) behavior is among the early symptoms in Alzheimer's disease (AD). Only a few tests, however, have been developed to screen for this symptom. The aim of this study was to develop an instrument, the Route Map Recall Test (RMRT), for the screening of the GL problem in AD patients. We examined the psychometric properties of the RMRT and its clinical utility to predict the GL risk in 23 AD patients and 43 cognitively healthy older adults. The results showed that the RMRT has a sound reliability (test-retest, r = .752, p < .001; Cronbach's α = 0.887, p < .001). The convergent validity was supported by the high correlations with Trail Making Test A and B. With the optimal criteria (93.5/104), the discriminative validity for the diagnosis of AD showed good sensitivity (86%) and specificity (70%), and sensitivity (100%) and specificity (67%) for GL in AD patients. The findings support the RMRT to be a useful tool for clinical screening of AD patients and their GL risk.
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Affiliation(s)
- Tsui-Ying Wang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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