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Braak S, Penninx BW, Su T, Pijnenburg Y, Nijland D, Campos AV, de la Torre-Luque A, Saris IMJ, Reus LM, Beckenstrom AC, Malik A, Dawson GR, Marston H, Alvarez-Linera J, Ayuso-Mateos JLL, Arango C, van der Wee N, Kas MJ, Aghajani M. Social dysfunction relates to shifts within socioaffective brain systems among Schizophrenia and Alzheimer's disease patients. Eur Neuropsychopharmacol 2024; 86:1-10. [PMID: 38909542 DOI: 10.1016/j.euroneuro.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 06/25/2024]
Abstract
Social dysfunction represents one of the most common signs of neuropsychiatric disorders, such as Schizophrenia (SZ) and Alzheimer's disease (AD). Perturbed socioaffective neural processing is crucially implicated in SZ/AD and generally linked to social dysfunction. Yet, transdiagnostic properties of social dysfunction and its neurobiological underpinnings remain unknown. As part of the European PRISM project, we examined whether social dysfunction maps onto shifts within socioaffective brain systems across SZ and AD patients. We probed coupling of social dysfunction with socioaffective neural processing, as indexed by an implicit facial emotional processing fMRI task, across SZ (N = 46), AD (N = 40) and two age-matched healthy control (HC) groups (N = 26 HC-younger and N = 27 HC-older). Behavioural (i.e., social withdrawal, interpersonal dysfunction, diminished prosocial or recreational activity) and subjective (i.e., feelings of loneliness) aspects of social dysfunction were assessed using the Social Functioning Scale and De Jong-Gierveld loneliness questionnaire, respectively. Across SZ/AD/HC participants, more severe behavioural social dysfunction related to hyperactivity within fronto-parieto-limbic brain systems in response to sad emotions (P = 0.0078), along with hypoactivity of these brain systems in response to happy emotions (P = 0.0418). Such relationships were not found for subjective experiences of social dysfunction. These effects were independent of diagnosis, and not confounded by clinical and sociodemographic factors. In conclusion, behavioural aspects of social dysfunction across SZ/AD/HC participants are associated with shifts within fronto-parieto-limbic brain systems. These findings pinpoint altered socioaffective neural processing as a putative marker for social dysfunction, and could aid personalized care initiatives grounded in social behaviour.
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Affiliation(s)
- Simon Braak
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress and Neurodegeneration programs, Amsterdam, the Netherlands.
| | - Brenda Wjh Penninx
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress and Neurodegeneration programs, Amsterdam, the Netherlands
| | - Tanja Su
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress and Neurodegeneration programs, Amsterdam, the Netherlands
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Daphne Nijland
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress and Neurodegeneration programs, Amsterdam, the Netherlands
| | - Alba Vieira Campos
- Centre of Biomedical Research in Mental Health, CIBERSAM, Spain; Memory Unit, Department of Neurology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Alejandro de la Torre-Luque
- Centre of Biomedical Research in Mental Health, CIBERSAM, Spain; Department of Legal Medicine, Psychiatry and Pathology. Complutense University of Madrid, Madrid, Spain
| | - Ilja M J Saris
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood, Anxiety, Psychosis, Sleep & Stress and Neurodegeneration programs, Amsterdam, the Netherlands
| | - Lianne M Reus
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands; Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, California, United States
| | | | - Asad Malik
- P1vital Ltd. Manor House, Howbery Park, Wallingford, United Kingdom
| | - Gerard R Dawson
- P1vital Ltd. Manor House, Howbery Park, Wallingford, United Kingdom
| | | | | | - Jose-Luis L Ayuso-Mateos
- Centre of Biomedical Research in Mental Health, CIBERSAM, Spain; Department of Psychiatry, Universidad Autonoma de Madrid, Instituto de Investigación Sanitaria Princesa, Spain
| | - Celso Arango
- Centre of Biomedical Research in Mental Health, CIBERSAM, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Gregorio Marañon University Hospital, IiSGM, Spain; Universidad Complutense de Madrid, Spain
| | - Nic van der Wee
- Leiden University Medical Centre, Department of Psychiatry, the Netherlands
| | - Martien J Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, the Netherlands
| | - Moji Aghajani
- Amsterdam UMC, location Vrije Universiteit Amsterdam, Department of Psychiatry, Boelelaan 1117, Amsterdam, the Netherlands; Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, the Netherlands
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By S, Kahl A, Cogswell PM. Alzheimer's Disease Clinical Trials: What Have We Learned From Magnetic Resonance Imaging. J Magn Reson Imaging 2024. [PMID: 39031716 DOI: 10.1002/jmri.29462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 07/22/2024] Open
Abstract
Alzheimer's disease (AD) is the leading cause of cognitive impairment and dementia worldwide with rising prevalence, incidence and mortality. Despite many decades of research, there remains an unmet need for disease-modifying treatment that can significantly alter the progression of disease. Recently, with United States Food and Drug Administration (FDA) drug approvals, there have been tremendous advances in this area, with agents demonstrating effects on cognition and biomarkers. Magnetic resonance imaging (MRI) plays an instrumental role in these trials. This review article aims to outline how MRI is used for screening eligibility, monitoring safety and measuring efficacy in clinical trials, leaning on the landscape of past and recent AD clinical trials that have used MRI as examples; further, insight on promising MRI biomarkers for future trials is provided. LEVEL OF EVIDENCE: 1. TECHNICAL EFFICACY: Stage 4.
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Affiliation(s)
- Samantha By
- Bristol Myers Squibb, Lawrenceville, New Jersey, USA
| | - Anja Kahl
- Bristol Myers Squibb, Lawrenceville, New Jersey, USA
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Dávila G, Torres-Prioris MJ, López-Barroso D, Berthier ML. Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System. CNS Drugs 2023; 37:599-637. [PMID: 37341896 PMCID: PMC10374790 DOI: 10.1007/s40263-023-01017-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
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Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain.
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain.
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
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Schiffmann R, Cox TM, Dedieu JF, Gaemers SJM, Hennermann JB, Ida H, Mengel E, Minini P, Mistry P, Musholt PB, Scott D, Sharma J, Peterschmitt MJ. Venglustat combined with imiglucerase for neurological disease in adults with Gaucher disease type 3: the LEAP trial. Brain 2023; 146:461-474. [PMID: 36256599 PMCID: PMC9924909 DOI: 10.1093/brain/awac379] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 08/15/2022] [Accepted: 09/11/2022] [Indexed: 11/14/2022] Open
Abstract
Gaucher disease type 3 is a chronic neuronopathic disorder with wide-ranging effects, including hepatosplenomegaly, anaemia, thrombocytopenia, skeletal disease and diverse neurological manifestations. Biallelic mutations in GBA1 reduce lysosomal acid β-glucosidase activity, and its substrates, glucosylceramide and glucosylsphingosine, accumulate. Enzyme replacement therapy and substrate reduction therapy ameliorate systemic features of Gaucher disease, but no therapies are approved for neurological manifestations. Venglustat is an investigational, brain-penetrant, glucosylceramide synthase inhibitor with potential to improve the disease by rebalancing influx of glucosylceramide with impaired lysosomal recycling. The Phase 2, open-label LEAP trial (NCT02843035) evaluated orally administered venglustat 15 mg once-daily in combination with maintenance dose of imiglucerase enzyme replacement therapy during 1 year of treatment in 11 adults with Gaucher disease type 3. Primary endpoints were venglustat safety and tolerability and change in concentration of glucosylceramide and glucosylsphingosine in CSF from baseline to Weeks 26 and 52. Secondary endpoints included change in plasma concentrations of glucosylceramide and glucosylsphingosine, venglustat pharmacokinetics in plasma and CSF, neurologic function, infiltrative lung disease and systemic disease parameters. Exploratory endpoints included changes in brain volume assessed with volumetric MRI using tensor-based morphometry, and resting functional MRI analysis of regional brain activity and connectivity between resting state networks. Mean (SD) plasma venglustat AUC0-24 on Day 1 was 851 (282) ng•h/ml; Cmax of 58.1 (26.4) ng/ml was achieved at a median tmax 2.00 h. After once-daily venglustat, plasma concentrations (4 h post-dose) were higher compared with Day 1, indicating ∼2-fold accumulation. One participant (Patient 9) had low-to-undetectable venglustat exposure at Weeks 26 and 52. Based on mean plasma and CSF venglustat concentrations (excluding Patient 9), steady state appeared to be reached on or before Week 4. Mean (SD) venglustat concentration at Week 52 was 114 (65.8) ng/ml in plasma and 6.14 (3.44) ng/ml in CSF. After 1 year of treatment, median (inter-quartile range) glucosylceramide decreased 78% (72, 84) in plasma and 81% (77, 83) in CSF; median (inter-quartile range) glucosylsphingosine decreased 56% (41, 60) in plasma and 70% (46, 76) in CSF. Ataxia improved slightly in nine patients: mean (SD, range) total modified Scale for Assessment and Rating of Ataxia score decreased from 2.68 [1.54 (0.0 to 5.5)] at baseline to 1.55 [1.88 (0.0 to 5.0)] at Week 52 [mean change: -1.14 (95% CI: -2.06 to -0.21)]. Whole brain volume increased slightly in patients with venglustat exposure and biomarker reduction in CSF (306.7 ± 4253.3 mm3) and declined markedly in Patient 9 (-13894.8 mm3). Functional MRI indicated stronger connectivity at Weeks 26 and 52 relative to baseline between a broadly distributed set of brain regions in patients with venglustat exposure and biomarker reduction but not Patient 9, although neurocognition, assessed by Vineland II, deteriorated in all domains over time, which illustrates disease progression despite the intervention. There were no deaths, serious adverse events or discontinuations. In adults with Gaucher disease type 3 receiving imiglucerase, addition of once-daily venglustat showed acceptable safety and tolerability and preliminary evidence of clinical stability with intriguing but intrinsically inconsistent signals in selected biomarkers, which need to be validated and confirmed in future research.
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Affiliation(s)
- Raphael Schiffmann
- Correspondence to: Raphael Schiffmann, MD, MHSc, FAAN Texas Neurology 6080 N Central Expy, Ste 100, Dallas, TX 75246, USA E-mail:
| | - Timothy M Cox
- Department of Medicine, University of Cambridge and Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | | | | | - Julia B Hennermann
- Center for Pediatric and Adolescent Medicine Villa Metabolica, University Medical Center Mainz, 55131 Mainz, Germany
| | - Hiroyuki Ida
- Department of Pediatrics, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Eugen Mengel
- Center for Pediatric and Adolescent Medicine Villa Metabolica, University Medical Center Mainz, 55131 Mainz, Germany
- Clinical Science for LSD, SphinCS, 65239 Hochheim, Germany
| | - Pascal Minini
- Biostatistics and Programming, Sanofi, 91385 Chilly-Mazarin, France
| | - Pramod Mistry
- Yale Lysosomal Disease Center and Gaucher Disease Treatment Center, Yale School of Medicine, New Haven, CT 06510, USA
| | | | - David Scott
- Medical and Scientific Affairs, Neuroscience, Clario, San Mateo, CA 94404, USA
| | - Jyoti Sharma
- Pharmacokinetics, Dynamics and Metabolism, Sanofi, Bridgewater, NJ 08807, USA
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Du Y, Zhang S, Qiu Q, Zhang J, Fang Y, Zhao L, Wei W, Wang J, Wang J, Li X. The effect of hippocampal radiomic features and functional connectivity on the relationship between hippocampal volume and cognitive function in Alzheimer's disease. J Psychiatr Res 2023; 158:382-391. [PMID: 36646036 DOI: 10.1016/j.jpsychires.2023.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
Hippocampal volume is associated with cognitive function in Alzheimer's disease (AD). Hippocampal radiomic features and resting-state functional connectivity (rs-FC) are promising biomarkers and correlate with AD pathology. However, few studies have been conducted on how hippocampal biomarkers affect the cognition-structure relationship. Therefore, we aimed to investigate the effects of hippocampal radiomic features and resting-state functional connectivity (rs-FC) on this relationship in AD. We enrolled 70 AD patients and 65 healthy controls (HCs). The FreeSurfer software was used to measure hippocampal volume. We selected hippocampal radiomic features to build a model to distinguish AD patients from HCs and used a seed-based approach to calculate the hippocampal rs-FC. Furthermore, we conducted mediation and moderation analyses to investigate the effect of hippocampal radiomic features and rs-FC on the relationship between hippocampal volume and cognition in AD. The results suggested that hippocampal radiomic features mediated the association between bilateral hippocampal volume and cognition in AD. Additionally, patients with AD showed weaker rs-FC between the bilateral hippocampus and right ventral posterior cingulate cortex and stronger rs-FC between the left hippocampus and left insula than HCs. The rs-FC between the hippocampus and insula moderated the relationship between hippocampal volume and cognition in AD, suggesting that this rs-FC could exacerbate or ameliorate the effects of hippocampal volume on cognition and may be essential in improving cognitive function in AD. Our findings may not only expand existing biological knowledge of the interrelationships among hippocampal biomarkers and cognition but also provide potential targets for treatment strategies for AD.
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Affiliation(s)
- Yang Du
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Shaowei Zhang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Qi Qiu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jianye Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | - Yuan Fang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Lu Zhao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Wenjing Wei
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China
| | - Jinhong Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China; Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, 200030, China.
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Lista S, Vergallo A, Teipel SJ, Lemercier P, Giorgi FS, Gabelle A, Garaci F, Mercuri NB, Babiloni C, Gaire BP, Koronyo Y, Koronyo-Hamaoui M, Hampel H, Nisticò R. Determinants of approved acetylcholinesterase inhibitor response outcomes in Alzheimer's disease: relevance for precision medicine in neurodegenerative diseases. Ageing Res Rev 2023; 84:101819. [PMID: 36526257 DOI: 10.1016/j.arr.2022.101819] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 11/11/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
Acetylcholinesterase inhibitors (ChEI) are the global standard of care for the symptomatic treatment of Alzheimer's disease (AD) and show significant positive effects in neurodegenerative diseases with cognitive and behavioral symptoms. Although experimental and large-scale clinical evidence indicates the potential long-term efficacy of ChEI, primary outcomes are generally heterogeneous across outpatient clinics and regional healthcare systems. Sub-optimal dosing or slow tapering, heterogeneous guidelines about the timing for therapy initiation (prodromal versus dementia stages), healthcare providers' ambivalence to treatment, lack of disease awareness, delayed medical consultation, prescription of ChEI in non-AD cognitive disorders, contribute to the negative outcomes. We present an evidence-based overview of determinants, spanning genetic, molecular, and large-scale networks, involved in the response to ChEI in patients with AD and other neurodegenerative diseases. A comprehensive understanding of cerebral and retinal cholinergic system dysfunctions along with ChEI response predictors in AD is crucial since disease-modifying therapies will frequently be prescribed in combination with ChEI. Therapeutic algorithms tailored to genetic, biological, clinical (endo)phenotypes, and disease stages will help leverage inter-drug synergy and attain optimal combined response outcomes, in line with the precision medicine model.
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Affiliation(s)
- Simone Lista
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France; School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy.
| | - Andrea Vergallo
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE) Rostock/Greifswald, Rostock, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Pablo Lemercier
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Filippo Sean Giorgi
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Audrey Gabelle
- Memory Resources and Research Center (CMRR), Neurology Department, Gui de Chauliac University Hospital, Montpellier, France
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; Casa di Cura "San Raffaele Cassino", Cassino, Italy
| | - Nicola B Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; IRCCS Santa Lucia Foundation, Rome, Italy
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; Hospital San Raffaele Cassino, Cassino, Italy
| | - Bhakta Prasad Gaire
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Biomedical Sciences, Division of Applied Cell Biology and Physiology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Harald Hampel
- Sorbonne University, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Robert Nisticò
- School of Pharmacy, University of Rome "Tor Vergata", Rome, Italy; Laboratory of Pharmacology of Synaptic Plasticity, EBRI Rita Levi-Montalcini Foundation, Rome, Italy.
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Increased Hippocampal-Inferior Temporal Gyrus White Matter Connectivity following Donepezil Treatment in Patients with Early Alzheimer's Disease: A Diffusion Tensor Probabilistic Tractography Study. J Clin Med 2023; 12:jcm12030967. [PMID: 36769615 PMCID: PMC9917574 DOI: 10.3390/jcm12030967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/17/2023] [Accepted: 01/21/2023] [Indexed: 01/31/2023] Open
Abstract
The incidence of Alzheimer's disease (AD) has been increasing each year, and a defective hippocampus has been primarily associated with an early stage of AD. However, the effect of donepezil treatment on hippocampus-related networks is unknown. Thus, in the current study, we evaluated the hippocampal white matter (WM) connectivity in patients with early-stage AD before and after donepezil treatment using probabilistic tractography, and we further determined the WM integrity and changes in brain volume. Ten patients with early-stage AD (mean age = 72.4 ± 7.9 years; seven females and three males) and nine healthy controls (HC; mean age = 70.7 ± 3.5 years; six females and three males) underwent a magnetic resonance (MR) examination. After performing the first MR examination, the patients received donepezil treatment for 6 months. The brain volumes and diffusion tensor imaging scalars of 11 regions of interest (the superior/middle/inferior frontal gyrus, the superior/middle/inferior temporal gyrus, the amygdala, the caudate nucleus, the hippocampus, the putamen, and the thalamus) were measured using MR imaging and DTI, respectively. Seed-based structural connectivity analyses were focused on the hippocampus. The patients with early AD had a lower hippocampal volume and WM connectivity with the superior frontal gyrus and higher mean diffusivity (MD) and radial diffusivity (RD) in the amygdala than HC (p < 0.05, Bonferroni-corrected). However, brain areas with a higher (or lower) brain volume and WM connectivity were not observed in the HC compared with the patients with early AD. After six months of donepezil treatment, the patients with early AD showed increased hippocampal-inferior temporal gyrus (ITG) WM connectivity (p < 0.05, Bonferroni-corrected).
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8
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Dong H, Guo L, Yang H, Zhu W, Liu F, Xie Y, Zhang Y, Xue K, Li Q, Liang M, Zhang N, Qin W. Association between gray matter atrophy, cerebral hypoperfusion, and cognitive impairment in Alzheimer's disease. Front Aging Neurosci 2023; 15:1129051. [PMID: 37091519 PMCID: PMC10117777 DOI: 10.3389/fnagi.2023.1129051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/15/2023] [Indexed: 04/25/2023] Open
Abstract
Background Alzheimer's disease (AD) is one of the most severe neurodegenerative diseases leading to dementia in the elderly. Cerebral atrophy and hypoperfusion are two important pathophysiological characteristics. However, it is still unknown about the area-specific causal pathways between regional gray matter atrophy, cerebral hypoperfusion, and cognitive impairment in AD patients. Method Forty-two qualified AD patients and 49 healthy controls (HC) were recruited in this study. First, we explored voxel-wise inter-group differences in gray matter volume (GMV) and arterial spin labeling (ASL) -derived cerebral blood flow (CBF). Then we explored the voxel-wise associations between GMV and Mini-Mental State Examination (MMSE) score, GMV and CBF, and CBF and MMSE to identify brain targets contributing to cognitive impairment in AD patients. Finally, a mediation analysis was applied to test the causal pathways among atrophied GMV, hypoperfusion, and cognitive impairment in AD. Results Voxel-wise permutation test identified that the left middle temporal gyrus (MTG) had both decreased GMV and CBF in the AD. Moreover, the GMV of this region was positively correlated with MMSE and its CBF, and CBF of this region was also positively correlated with MMSE in AD (p < 0.05, corrected). Finally, mediation analysis revealed that gray matter atrophy of left MTG drives cognitive impairment of AD via the mediation of CBF (proportion of mediation = 55.82%, β = 0.242, 95% confidence interval by bias-corrected and accelerated bootstrap: 0.082 to 0.530). Conclusion Our findings indicated suggested that left MTG is an important hub linking gray matter atrophy, hypoperfusion, and cognitive impairment for AD, and might be a potential treatment target for AD.
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Affiliation(s)
- Haoyang Dong
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Lining Guo
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Hailei Yang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Wenshuang Zhu
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Fang Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yingying Xie
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Yu Zhang
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Kaizhong Xue
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiang Li
- Technical College for the Deaf, Tianjin University of Technology, Tianjin, China
| | - Meng Liang
- School of Medical Imaging, Tianjin Medical University, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- *Correspondence: Nan Zhang,
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
- Wen Qin,
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9
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Berthier ML, Edelkraut L, López-González FJ, López-Barroso D, Mohr B, Pulvermüller F, Starkstein SE, Jorge RE, Torres-Prioris MJ, Dávila G. Donepezil alone and combined with intensive language-action therapy on depression and apathy in chronic post-stroke aphasia: A feasibility study. BRAIN AND LANGUAGE 2023; 236:105205. [PMID: 36495749 DOI: 10.1016/j.bandl.2022.105205] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/17/2022] [Accepted: 11/18/2022] [Indexed: 06/17/2023]
Abstract
This study explored the feasibility and effectiveness of a short-term (10-week) intervention trial using Donepezil administered alone and combined with intensive language action therapy (ILAT) for the treatment of apathy and depression in ten people with chronic post-stroke aphasia. Outcome measures were the Western Aphasia Battery and the Stroke Aphasia Depression Questionnaire-21. Structural magnetic resonance imaging and 18fluorodeoxyglucose positron emission tomography were acquired at baseline and after two endpoints (Donepezil alone and Donepezil-ILAT). The intervention was found to be feasible to implement. Large treatment effects were found. Donepezil alone and combined with ILAT reduced aphasia severity, while apathy and depression only improved with Donepezil-ILAT. Structural and functional neuroimaging data did not show conclusive results but provide hints for future research. Given these overall positive findings on feasibility, language and behavioral benefits, further studies in larger sample sizes and including a placebo-control group are indicated.
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Affiliation(s)
- Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
| | - Lisa Edelkraut
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Francisco J López-González
- Molecular Imaging Unit, Centro de Investigaciones Médico-Sanitarias, General Foundation of the University of Malaga, Malaga, Spain; Molecular Imaging Group, Radiology Department, Faculty of Medicine, University of Santiago de Compostela, Galicia, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Bettina Mohr
- Zentrum für Neuropsychologie und Intensive Sprachtherapie - ZeNIS, Berlin, Germany
| | - Friedemann Pulvermüller
- Brain Language Laboratory, Department of Philosophy and Humanities, WE4, Freie Universität Berlin, Germany; Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Germany
| | - Sergio E Starkstein
- Faculty of Health and Medical Sciences, The University of Western Australia (M704), Perth, Australia
| | - Ricardo E Jorge
- Department of Psychiatry and Behavioural Sciences, Baylor College of Medicine, Houston, TX, United States
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain; Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain; Area of Psychobiology, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
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10
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Orth L, Meeh J, Gur RC, Neuner I, Sarkheil P. Frontostriatal circuitry as a target for fMRI-based neurofeedback interventions: A systematic review. Front Hum Neurosci 2022; 16:933718. [PMID: 36092647 PMCID: PMC9449529 DOI: 10.3389/fnhum.2022.933718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/08/2022] [Indexed: 11/19/2022] Open
Abstract
Dysregulated frontostriatal circuitries are viewed as a common target for the treatment of aberrant behaviors in various psychiatric and neurological disorders. Accordingly, experimental neurofeedback paradigms have been applied to modify the frontostriatal circuitry. The human frontostriatal circuitry is topographically and functionally organized into the “limbic,” the “associative,” and the “motor” subsystems underlying a variety of affective, cognitive, and motor functions. We conducted a systematic review of the literature regarding functional magnetic resonance imaging-based neurofeedback studies that targeted brain activations within the frontostriatal circuitry. Seventy-nine published studies were included in our survey. We assessed the efficacy of these studies in terms of imaging findings of neurofeedback intervention as well as behavioral and clinical outcomes. Furthermore, we evaluated whether the neurofeedback targets of the studies could be assigned to the identifiable frontostriatal subsystems. The majority of studies that targeted frontostriatal circuitry functions focused on the anterior cingulate cortex, the dorsolateral prefrontal cortex, and the supplementary motor area. Only a few studies (n = 14) targeted the connectivity of the frontostriatal regions. However, post-hoc analyses of connectivity changes were reported in more cases (n = 32). Neurofeedback has been frequently used to modify brain activations within the frontostriatal circuitry. Given the regulatory mechanisms within the closed loop of the frontostriatal circuitry, the connectivity-based neurofeedback paradigms should be primarily considered for modifications of this system. The anatomical and functional organization of the frontostriatal system needs to be considered in decisions pertaining to the neurofeedback targets.
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Affiliation(s)
- Linda Orth
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
- *Correspondence: Linda Orth
| | - Johanna Meeh
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Irene Neuner
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Aachen, Germany
- Institute of Neuroscience and Medicine 4, Forschungszentrum Jülich, Jülich, Germany
| | - Pegah Sarkheil
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
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11
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Wu Q, Xu X, Zhai C, Zhao Z, Dai W, Wang T, Shen Y. High-frequency repetitive transcranial magnetic stimulation improves spatial episodic learning and memory performance by regulating brain plasticity in healthy rats. Front Neurosci 2022; 16:974940. [PMID: 35992904 PMCID: PMC9389218 DOI: 10.3389/fnins.2022.974940] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 07/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background Repetitive transcranial magnetic stimulation (rTMS) is an effective way to stimulate changes in structural and functional plasticity, which is a part of learning and memory. However, to our knowledge, rTMS-induced specific activity and neural plasticity in different brain regions that affect cognition are not fully understood; nor are its mechanisms. Therefore, we aimed to investigate rTMS-induced cognition-related neural plasticity changes and their mechanisms in different brain regions. Methods A total of 30 healthy adult rats were randomly divided into the control group and the rTMS group (n = 15 rats per group). The rats in the control and the rTMS group received either 4 weeks of sham or high-frequency rTMS (HF-rTMS) over the prefrontal cortex (PFC). Cognitive function was detected by Morris water maze. Functional imaging was acquired by resting-state functional magnetic resonance imaging (rs-fMRI) before and after rTMS. The protein expressions of BDNF, TrkB, p-Akt, Akt, NR1, NR2A, and NR2B in the PFC, hippocampus, and primary motor cortex (M1) were detected by Western blot following rTMS. Results After 4 weeks of rTMS, the cognitive ability of healthy rats who underwent rTMS showed a small but significant behavioral improvement in spatial episodic learning and memory performance. Compared with the pre-rTMS or the control group, rats in the rTMS group showed increased regional homogeneity (ReHo) in multiple brain regions in the interoceptive/default mode network (DMN) and cortico-striatal-thalamic network, specifically the bilateral PFC, bilateral hippocampus, and the left M1. Western blot analyses showed that rTMS led to a significant increase in the expressions of N-methyl-D-aspartic acid (NMDA) receptors, including NR1, NR2A, and NR2B in the PFC, hippocampus, and M1, as well as an upregulation of BDNF, TrkB, and p-Akt in these three brain regions. In addition, the expression of NR1 in these three brain regions correlated with rTMS-induced cognitive improvement. Conclusion Overall, these data suggested that HF-rTMS can enhance cognitive performance through modulation of NMDA receptor-dependent brain plasticity.
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Affiliation(s)
- Qi Wu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Rehabilitation, Hengyang Medical School, The First Affiliated Hospital, University of South China, Hengyang, China
| | - Xingjun Xu
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chenyuan Zhai
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiyong Zhao
- College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China
| | - Wenjun Dai
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tong Wang
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Tong Wang,
| | - Ying Shen
- Rehabilitation Medicine Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Ying Shen,
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12
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Cognitive Capacity Genome-Wide Polygenic Scores Identify Individuals with Slower Cognitive Decline in Aging. Genes (Basel) 2022; 13:genes13081320. [PMID: 35893057 PMCID: PMC9331374 DOI: 10.3390/genes13081320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/23/2022] [Accepted: 07/20/2022] [Indexed: 12/04/2022] Open
Abstract
The genetic protective factors for cognitive decline in aging remain unknown. Predicting an individual’s rate of cognitive decline—or with better cognitive resilience—using genetics will allow personalized intervention for cognitive enhancement and the optimal selection of target samples in clinical trials. Here, using genome-wide polygenic scores (GPS) of cognitive capacity as the genomic indicators for variations of human intelligence, we analyzed the 18-year records of cognitive and behavioral data of 8511 European-ancestry adults from the Wisconsin Longitudinal Study (WLS), specifically focusing on the cognitive assessments that were repeatedly administered to the participants with their average ages of 64.5 and 71.5. We identified a significant interaction effect between age and cognitive capacity GPS, which indicated that a higher cognitive capacity GPS significantly correlated with a slower cognitive decline in the domain of immediate memory recall (β = 1.86 × 10−1, p-value = 1.79 × 10−3). The additional phenome-wide analyses identified several associations between cognitive capacity GPSs and cognitive/behavioral phenotypes, such as similarities task (β = 1.36, 95% CI = (1.22, 1.51), p-value = 3.59 × 10−74), number series task (β = 0.94, 95% CI = (0.85, 1.04), p-value = 2.55 × 10−78), IQ scores (β = 1.42, 95% CI = (1.32, 1.51), p-value = 7.74 × 10−179), high school classrank (β = 1.86, 95% CI = (1.69, 2.02), p-value = 3.07 × 10−101), Openness from the BIG 5 personality factor (p-value = 2.19 × 10−14, β = 0.57, 95% CI = (0.42, 0.71)), and leisure activity of reading books (β = 0.50, 95% CI = (0.40, 0.60), p-value = 2.03 × 10−21), attending cultural events, such as concerts, plays, or museums (β = 0.60, 95% CI = (0.49, 0.72), p-value = 2.06 × 10−23), and watching TV (β = −0.48, 95% CI = (−0.59, −0.37), p-value = 4.16 × 10−18). As the first phenome-wide analysis of cognitive and behavioral phenotypes, this study presents the novel genetic protective effects of cognitive ability on the decline of memory recall in an aging population.
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13
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Saris IMJ, Aghajani M, Reus LM, Visser PJ, Pijnenburg Y, van der Wee NJA, Bilderbeck AC, Raslescu A, Malik A, Mennes M, Koops S, Arrango C, Ayuso-Mateos JL, Dawson GR, Marston H, Kas MJ, Penninx BWJH. Social dysfunction is transdiagnostically associated with default mode network dysconnectivity in schizophrenia and Alzheimer's disease. World J Biol Psychiatry 2022; 23:264-277. [PMID: 34378488 DOI: 10.1080/15622975.2021.1966714] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Social dysfunction is one of the most common signs of major neuropsychiatric disorders. The Default Mode Network (DMN) is crucially implicated in both psychopathology and social dysfunction, although the transdiagnostic properties of social dysfunction remains unknown. As part of the pan-European PRISM (Psychiatric Ratings using Intermediate Stratified Markers) project, we explored cross-disorder impact of social dysfunction on DMN connectivity. METHODS We studied DMN intrinsic functional connectivity in relation to social dysfunction by applying Independent Component Analysis and Dual Regression on resting-state fMRI data, among schizophrenia (SZ; N = 48), Alzheimer disease (AD; N = 47) patients and healthy controls (HC; N = 55). Social dysfunction was operationalised via the Social Functioning Scale (SFS) and De Jong-Gierveld Loneliness Scale (LON). RESULTS Both SFS and LON were independently associated with diminished DMN connectional integrity within rostromedial prefrontal DMN subterritories (pcorrected range = 0.02-0.04). The combined effect of these indicators (Mean.SFS + LON) on diminished DMN connectivity was even more pronounced (both spatially and statistically), independent of diagnostic status, and not confounded by key clinical or sociodemographic effects, comprising large sections of rostromedial and dorsomedial prefrontal cortex (pcorrected=0.01). CONCLUSIONS These findings pinpoint DMN connectional alterations as putative transdiagnostic endophenotypes for social dysfunction and could aid personalised care initiatives grounded in social behaviour.
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Affiliation(s)
- Ilja M J Saris
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, VU Medical Centre and GGZ inGeest, Amsterdam, The Netherlands
| | - Moji Aghajani
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, VU Medical Centre and GGZ inGeest, Amsterdam, The Netherlands.,Institute of Education and Child Studies, Section Forensic Family and Youth Care, Leiden University, Leiden, The Netherlands
| | - Lianne M Reus
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Pieter-Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Yolande Pijnenburg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Centre, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | | | | | | | | | - Sanne Koops
- Department of Biomedical Sciences of Cells and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center of Groningen, Groningen, The Netherlands
| | - Celso Arrango
- Hospital General Universitario Gregorio Marañón, CIBERSAM, IiSGM, Universidad Complutense, School of Medicine, Madrid, Spain.,Centre of Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Jose Luis Ayuso-Mateos
- Centre of Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain.,Department of Psychiatry, La Princesa University Hospital, Universidad Autonoma de Madrid, Marid, Spain
| | | | - Hugh Marston
- Translational Neuroscience, Eli Lilly and Company, Windlesham, UK.,CNS Diseases Research, Boehringer Ingelheim GmbH and Company, Biberach, Germany
| | - Martien J Kas
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam UMC, VU Medical Centre and GGZ inGeest, Amsterdam, The Netherlands
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14
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Trepl J, Dahlmanns M, Kornhuber J, Groemer TW, Dahlmanns JK. Common network effect-patterns after monoamine reuptake inhibition in dissociated hippocampus cultures. J Neural Transm (Vienna) 2022; 129:261-275. [PMID: 35211818 PMCID: PMC8930948 DOI: 10.1007/s00702-022-02477-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/11/2022] [Indexed: 12/04/2022]
Abstract
The pharmacological treatment of major depressive disorder with currently available antidepressant drugs is still unsatisfying as response to medication is delayed and in some patients even non-existent. To understand complex psychiatric diseases such as major depressive disorder and their treatment, research focus is shifting from investigating single neurons towards a view of the entire functional and effective neuronal network, because alterations on single synapses through antidepressant drugs may translate to alterations in the entire network. Here, we examined the effects of monoamine reuptake inhibitors on in vitro hippocampal network dynamics using calcium fluorescence imaging and analyzing the data with means of graph theoretical parameters. Hypothesizing that monoamine reuptake inhibitors operate through changes of effective connectivity on micro-scale neuronal networks, we measured the effects of the selective monoamine reuptake inhibitors GBR-12783, Sertraline, Venlafaxine, and Amitriptyline on neuronal networks. We identified a common pattern of effects of the different tested monoamine reuptake inhibitors. After treatment with GBR-12783, Sertraline, and Venlafaxine, the connectivity degree, measuring the number of existing connections in the network, was significantly decreased. All tested substances led to networks with more submodules and a reduced global efficiency. No monoamine reuptake inhibitor did affect network-wide firing rate, the characteristic path length, or the network strength. In our study, we found that monoamine reuptake inhibition in neuronal networks in vitro results in a sharpening of the network structure. These alterations could be the basis for the reorganization of a large-scale miswired network in major depressive disorder.
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Affiliation(s)
- Julia Trepl
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Marc Dahlmanns
- Institute for Physiology and Pathophysiology, Friedrich-Alexander University Erlangen-Nürnberg, 91054, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Teja Wolfgang Groemer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Jana Katharina Dahlmanns
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen, Germany.
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15
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Péran P, Salabert AS, Dondaine T, Leclerc X, Gros-Dagnac H, Ranjeva JP, Lopes R, Lanteaume L, Blin O, Thalamas C, Bordet R, Payoux P. Functional connectivity and cognitive changes after donepezil treatment in healthy participants. Psychopharmacology (Berl) 2021; 238:3071-3082. [PMID: 34370064 DOI: 10.1007/s00213-021-05923-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 07/06/2021] [Indexed: 10/20/2022]
Abstract
RATIONALE Donepezil is a potent, noncompetitive, reversible, clinically effective acetylcholinesterase inhibitor. The effects of this drug on healthy brains have seldom been investigated. OBJECTIVES The primary objective of the present study was to identify possible functional connectivity markers of the effect of donepezil in healthy young adult volunteers. METHODS The study had a double-blind, randomized, crossover design. 30 healthy adult volunteers underwent resting-state MRI scans during 15 days of donepezil or placebo treatment, in accordance with the design. RESULTS Results showed significant differences in intrinsic functional connectivity between donepezil and placebo, mainly in the right executive control network (RECN). More specifically, we found a decrease in the connectivity of the right inferior parietal node with other RECN nodes. Analysis using the cingulate cortex and parahippocampal regions as seeds also revealed complex modulation of functional connectivity in the donepezil condition. CONCLUSIONS In conclusion, donepezil treatment for 15 days may result in reorganization of resting-state networks, compared with placebo.
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Affiliation(s)
- P Péran
- Toulouse NeuroImaging Center (ToNIC), Université de Toulouse, INSERM, UPS, 31024, Toulouse Cedex 3, France.
| | - A S Salabert
- Toulouse NeuroImaging Center (ToNIC), Université de Toulouse, INSERM, UPS, 31024, Toulouse Cedex 3, France
| | - T Dondaine
- Degenerative & Vascular Cognitive Disorders Research Unit, INSERM-Lille University-Lille University Hospital, Lille, France
| | - X Leclerc
- Degenerative & Vascular Cognitive Disorders Research Unit, INSERM-Lille University-Lille University Hospital, Lille, France
| | - H Gros-Dagnac
- Toulouse NeuroImaging Center (ToNIC), Université de Toulouse, INSERM, UPS, 31024, Toulouse Cedex 3, France
| | - J-P Ranjeva
- Centre for Metabolic Exploration by Magnetic Resonance (CEMEREM), Aix-Marseille University-CNRS-CRMBM-Timone University Hospital, Marseille, France
| | - R Lopes
- Degenerative & Vascular Cognitive Disorders Research Unit, INSERM-Lille University-Lille University Hospital, Lille, France
| | - L Lanteaume
- Centre for Metabolic Exploration by Magnetic Resonance (CEMEREM), Aix-Marseille University-CNRS-CRMBM-Timone University Hospital, Marseille, France.,Department of Clinical Pharmacology (UPCET), Aix-Marseille University-INSERM-Timone University Hospital, Marseille, France
| | - O Blin
- Centre for Metabolic Exploration by Magnetic Resonance (CEMEREM), Aix-Marseille University-CNRS-CRMBM-Timone University Hospital, Marseille, France.,Department of Clinical Pharmacology (UPCET), Aix-Marseille University-INSERM-Timone University Hospital, Marseille, France
| | - C Thalamas
- Clinical Investigation Center (CIC1436), Toulouse, France
| | - R Bordet
- Degenerative & Vascular Cognitive Disorders Research Unit, INSERM-Lille University-Lille University Hospital, Lille, France
| | - P Payoux
- Toulouse NeuroImaging Center (ToNIC), Université de Toulouse, INSERM, UPS, 31024, Toulouse Cedex 3, France
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16
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Baik K, Kim SM, Jung JH, Lee YH, Chung SJ, Yoo HS, Ye BS, Lee PH, Sohn YH, Kang SW, Kang SY. Donepezil for mild cognitive impairment in Parkinson's disease. Sci Rep 2021; 11:4734. [PMID: 33637811 PMCID: PMC7910590 DOI: 10.1038/s41598-021-84243-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 02/15/2021] [Indexed: 11/26/2022] Open
Abstract
We investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.
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Affiliation(s)
- Kyoungwon Baik
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | | | - Jin Ho Jung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yang Hyun Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seok Jong Chung
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Han Soo Yoo
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Byoung Seok Ye
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Wan Kang
- iMediSync Inc., Seoul, Republic of Korea. .,Data Center for Korean EEG, College of Nursing, Seoul National University, 103, Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
| | - Suk Yun Kang
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7, Keunjaebong-gil, Hwaseong, Gyeonggi-do, 18450, Republic of Korea.
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17
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Crosstalk between Depression and Dementia with Resting-State fMRI Studies and Its Relationship with Cognitive Functioning. Biomedicines 2021; 9:biomedicines9010082. [PMID: 33467174 PMCID: PMC7830949 DOI: 10.3390/biomedicines9010082] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 12/11/2022] Open
Abstract
Alzheimer’s disease (AD) is the most common type of dementia, and depression is a risk factor for developing AD. Epidemiological studies provide a clinical correlation between late-life depression (LLD) and AD. Depression patients generally remit with no residual symptoms, but LLD patients demonstrate residual cognitive impairment. Due to the lack of effective treatments, understanding how risk factors affect the course of AD is essential to manage AD. Advances in neuroimaging, including resting-state functional MRI (fMRI), have been used to address neural systems that contribute to clinical symptoms and functional changes across various psychiatric disorders. Resting-state fMRI studies have contributed to understanding each of the two diseases, but the link between LLD and AD has not been fully elucidated. This review focuses on three crucial and well-established networks in AD and LLD and discusses the impacts on cognitive decline, clinical symptoms, and prognosis. Three networks are the (1) default mode network, (2) executive control network, and (3) salience network. The multiple properties emphasized here, relevant for the hypothesis of the linkage between LLD and AD, will be further developed by ongoing future studies.
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Sinha N, Berg CN, Yassa MA, Gluck MA. Increased dynamic flexibility in the medial temporal lobe network following an exercise intervention mediates generalization of prior learning. Neurobiol Learn Mem 2021; 177:107340. [PMID: 33186745 PMCID: PMC7861122 DOI: 10.1016/j.nlm.2020.107340] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 07/29/2020] [Accepted: 11/01/2020] [Indexed: 11/28/2022]
Abstract
Recent work has conceptualized the brain as a network comprised of groups of sub-networks or modules. "Flexibility" of brain network(s) indexes the dynamic reconfiguration of comprising modules. Using novel techniques from dynamic network neuroscience applied to high-resolution resting-state functional magnetic resonance imaging (fMRI), the present study investigated the effects of an aerobic exercise intervention on the dynamic rearrangement of modular community structure-a measure of neural flexibility-within the medial temporal lobe (MTL) network. The MTL is one of the earliest brain regions impacted by Alzheimer's disease. It is also a major site of neuroplasticity that is sensitive to the effects of exercise. In a two-group non-randomized, repeated measures and matched control design with 34 healthy older adults, we observed an exercise-related increase in flexibility within the MTL network. Furthermore, MTL network flexibility mediated the beneficial effect aerobic exercise had on mnemonic flexibility, as measured by the ability to generalize past learning to novel task demands. Our results suggest that exercise exerts a rehabilitative and protective effect on MTL function, resulting in dynamically evolving networks of regions that interact in complex communication patterns. These reconfigurations may underlie exercise-induced improvements on cognitive measures of generalization, which are sensitive to subtle changes in the MTL.
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Affiliation(s)
- Neha Sinha
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, NJ, USA.
| | - Chelsie N Berg
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, NJ, USA.
| | - Michael A Yassa
- Center for the Neurobiology of Learning and Memory, Department of Neurobiology and Behavior, University of California, Irvine, CA, USA.
| | - Mark A Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, NJ, USA.
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Spina S, Brown JA, Deng J, Gardner RC, Nana AL, Hwang JHL, Gaus SE, Huang EJ, Kramer JH, Rosen HJ, Kornak J, Neuhaus J, Miller BL, Grinberg LT, Boxer AL, Seeley WW. Neuropathological correlates of structural and functional imaging biomarkers in 4-repeat tauopathies. Brain 2020; 142:2068-2081. [PMID: 31081015 DOI: 10.1093/brain/awz122] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 02/23/2019] [Accepted: 03/07/2019] [Indexed: 12/24/2022] Open
Abstract
Neurodegenerative dementia syndromes are characterized by spreading of pathological protein deposition along syndrome-specific neural networks. Structural and functional MRI measures can assess the integrity of these networks and have been proposed as biomarkers of disease progression for clinical trials. The relationship between in vivo imaging measures and pathological features, at the single subject level, remains largely unknown. Patient-specific maps of atrophy and seed-based intrinsic connectivity disruption, as compared to normal controls, were obtained for 27 patients subsequently diagnosed with progressive supranuclear palsy (n = 16, seven males, age at death 68.9 ± 6.0 years, imaging-to-pathology interval = 670.2 ± 425.1 days) or corticobasal degeneration (n = 11, two males, age at death 66.7 ± 5.4 years, imaging-to-pathology interval = 696.2 ± 482.2 days). A linear mixed effect model with crossed random effects was used to test regional and single-subject level associations between post-mortem regional measures of neurodegeneration and tau inclusion burden, on the one hand, and regional volume loss and seed-based intrinsic connectivity reduction, on the other. A significant association was found between tau inclusion burden and in vivo volume loss, at the regional level and independent of neurodegeneration severity, in both progressive supranuclear palsy [n = 340 regions; beta 0.036; 95% confidence interval (CI): 0.001, 0.072; P = 0.046] and corticobasal degeneration (n = 215 regions; beta 0.044; 95% CI: 0.009, 0.079; P = 0.013). We also found a significant association between post-mortem neurodegeneration and in vivo volume loss in both progressive supranuclear palsy (n = 340 regions; beta 0.155; 95% CI: 0.061, 0.248; P = 0.001) and corticobasal degeneration (n = 215 regions; beta 0.277; 95% CI: 0.104, 0.450; P = 0.002). We found a significant association between regional neurodegeneration and intrinsic connectivity dysfunction in corticobasal degeneration (n = 215 regions; beta 0.074; 95% CI: 0.005, 0.143; P = 0.035), but no other associations between post-mortem measures of tauopathy and intrinsic connectivity dysfunction reached statistical significance. Our data suggest that in vivo structural imaging measures reflect independent contributions from neurodegeneration and tau burden in progressive supranuclear palsy and corticobasal degeneration. Seed-based measures of intrinsic connectivity dysfunction showed less reliable predictive value when used as in vivo biomarkers of tauopathy. The findings provide important guidance for the use of imaging biomarkers as indirect in vivo assays of microscopic pathology.
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Affiliation(s)
- Salvatore Spina
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Jesse A Brown
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Jersey Deng
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Raquel C Gardner
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Alissa L Nana
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Ji-Hye L Hwang
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Stephanie E Gaus
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Eric J Huang
- Department of Pathology, University of California San Francisco, USA
| | - Joel H Kramer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Howie J Rosen
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California San Francisco, USA
| | - John Neuhaus
- Department of Epidemiology and Biostatistics, University of California San Francisco, USA
| | - Bruce L Miller
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - Lea T Grinberg
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA.,Department of Pathology, University of California San Francisco, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA
| | - William W Seeley
- Memory and Aging Center, Department of Neurology, University of California San Francisco, USA.,Department of Pathology, University of California San Francisco, USA
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Gu Y, Lin Y, Huang L, Ma J, Zhang J, Xiao Y, Dai Z. Abnormal dynamic functional connectivity in Alzheimer's disease. CNS Neurosci Ther 2020; 26:962-971. [PMID: 32378335 PMCID: PMC7415210 DOI: 10.1111/cns.13387] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 12/12/2022] Open
Abstract
Aims Alzheimer's disease (AD) is a progressive neurodegenerative disorder. Previous studies have demonstrated abnormalities in functional connectivity (FC) of AD under the assumption that FC is stationary during scanning. However, studies on the FC dynamics of AD, which may provide more insightful perspectives in understanding the neural mechanisms of AD, remain largely unknown. Methods Combining the sliding‐window approach and the k‐means algorithm, we identified three reoccurring dynamic FC states from resting‐state fMRI data of 26 AD and 26 healthy controls. The between‐group differences both in FC states and in regional temporal variability were calculated, followed by a correlation analysis of these differences with cognitive performances of AD patients. Results We identified three reoccurring FC states and found abnormal FC mainly in the frontal and temporal cortices. The temporal properties of FC states were changed in AD as characterized by decreased dwell time in State I and increased dwell time in State II. Besides, we found decreased regional temporal variability mainly in the somatomotor, temporal and parietal regions. Disrupted dynamic FC was significantly correlated with cognitive performances of AD patients. Conclusion Our findings suggest abnormal dynamic FC in AD patients, which provides novel insights for understanding the pathophysiological mechanisms of AD.
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Affiliation(s)
- Yue Gu
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Ying Lin
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Liangliang Huang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Junji Ma
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jinbo Zhang
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yu Xiao
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Zhengjia Dai
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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21
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Faria AV, Meyer A, Friedman R, Tippett DC, Hillis AE. Baseline MRI associates with later naming status in primary progressive aphasia. BRAIN AND LANGUAGE 2020; 201:104723. [PMID: 31864209 PMCID: PMC7282486 DOI: 10.1016/j.bandl.2019.104723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 07/29/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
Advanced imaging studies in neurodegenerative disease have yielded new insights into subtypes of disease, progression of disease in various brain regions, and changes in structural and functional connectivity between brain regions related to symptom progression. However, few studies have revealed imaging markers at baseline that correlate with rate or degree of decline in function. Here we tested the hypothesis that imaging features at baseline correlate with outcome of naming in primary progressive aphasia. We obtained longitudinal multimodal imaging in 15 individuals with primary progressive aphasia at the same time points as assessment of naming. We found that functional connectivity between particular brain regions (measured with resting state functional connectivity magnetic resonance imaging) is strongly associated with accuracy of naming 21 months later, independently of baseline severity of naming impairment. These data indicate that functional connectivity may carry information about later performance in naming, and is potentially useful for refining prognosis.
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Affiliation(s)
- Andreia V Faria
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Aaron Meyer
- Department of Neurology, Georgetown University School of Medicine, Washington, USA
| | - Rhonda Friedman
- Department of Neurology, Georgetown University School of Medicine, Washington, USA
| | - Donna C Tippett
- Department of Otolaryngology & Head & Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Physical Medicine & Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins University, Baltimore, MD, USA
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Abstract
As the worldwide population ages, the prevalence of Alzheimer's disease (AD) increases. However, the results of promising medications have been unsatisfactory. Chinese acupuncture has a long history of treating dementia, but lack of evidence from well-designed randomized controlled trials that validate its efficacy and safety, as well as its lack of clear underlying mechanisms, contribute to its limited application in clinical practice. In recent years, brain imaging technologies, such as functional magnetic resonance imaging and positron emission tomography, have been used to assess brain responses to acupuncture in a dynamic, visual, and objective way. These techniques are frequently used to explore neurological mechanisms of responses to acupuncture in AD and provide neuroimaging evidence as well as starting points to elucidate the possible mechanisms. This review summarizes the existing brain imaging evidence that explains the effects of acupuncture for AD and analyzes brain responses to acupuncture at cognitive-related acupoints [Baihui (GV 20), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6), and Taixi (KI 3)] from perspectives of acupoint specificity and acupoint combinations. Key issues and directions to consider in future studies are also put forward. This review should deepen our understanding of how brain imaging studies can be used to explore the underlying mechanisms of acupuncture in AD.
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Bruno JL, Hosseini SH, Lightbody AA, Manchanda MK, Reiss AL. Brain circuitry, behavior, and cognition: A randomized placebo-controlled trial of donepezil in fragile X syndrome. J Psychopharmacol 2019; 33:975-985. [PMID: 31264943 PMCID: PMC6894490 DOI: 10.1177/0269881119858304] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Fragile X syndrome, the most common inherited cause for intellectual disability, is associated with alterations in cholinergic among other neurotransmitter systems. This study investigated the effects of donepezil hydrochloride, a cholinesterase inhibitor that has potential to correct aberrant cholinergic signaling. METHOD Forty-two individuals with fragile X syndrome (mean age=19.61 years) were randomized to receive 2.5-10.0 mg of donepezil (n=20, seven females) or placebo (n=22, eight females) per day. One individual in the active group withdrew at week 7. Outcomes included the contingency naming test, the aberrant behavior checklist, and behavior and brain activation patterns during a functional magnetic resonance imaging gaze discrimination task. RESULTS There were no significant differences between active and placebo groups on cognitive (contingency naming task) or behavioral (total score or subscales of the aberrant behavior checklist) outcomes. At baseline, the active and placebo groups did not differ in functional magnetic resonance imaging activation patterns during the gaze task. After 12 weeks of treatment the active group displayed reduced activation in response to the averted vs direct gaze contrast, relative to the placebo group, in the left superior frontal gyrus. CONCLUSIONS Reduced functional brain activation for the active group may represent less arousal in response to direct eye gaze, relative to the placebo group. Change in functional magnetic resonance imaging activation patterns may serve as a more sensitive metric and predictor of response to treatment when compared to cognitive and behavioral assessments. Our results suggest that donepezil may have an impact on brain functioning, but longer term follow-up and concomitant behavioral intervention may be required to demonstrate improvement in cognition and behavior.
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Affiliation(s)
- Jennifer L. Bruno
- Center for Interdisciplinary Brain Sciences Research, Stanford University.,To whom correspondence should be addressed: 401 Quarry Road, Palo Alto, CA 94304, Phone: 818-415-9119, Fax: (650) 724-4761,
| | - S.M. Hadi Hosseini
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Amy A. Lightbody
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Mai K. Manchanda
- Center for Interdisciplinary Brain Sciences Research, Stanford University
| | - Allan L. Reiss
- Center for Interdisciplinary Brain Sciences Research, Stanford University.,Department of Radiology, Stanford University.,Department of Pediatrics, Stanford University
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Donepezil's Effects on Brain Functions of Patients With Alzheimer Disease: A Regional Homogeneity Study Based on Resting-State Functional Magnetic Resonance Imaging. Clin Neuropharmacol 2019; 42:42-48. [PMID: 30875345 PMCID: PMC6426347 DOI: 10.1097/wnf.0000000000000324] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Donepezil is known to increase cholinergic synaptic transmission in Alzheimer disease (AD), although how it affects cortical brain activity and how it consequently affects brain functions need further clarification. To investigate the therapeutic mechanism of donepezil underlying its effect on brain function, regional homogeneity (ReHo) technology was used in this study. PATIENTS AND METHODS This study included 11 mild-to-moderate AD patients who completed 24 weeks of donepezil treatment and 11 matched healthy controls. All participants finished neuropsychological assessment and resting-state functional magnetic resonance imaging scanning to compare whole-brain ReHo before and after donepezil treatment. RESULTS Significantly decreased Alzheimer's Disease Assessment Scale-Cognitive Subscale scores (P = 0.010) and increased Mini-Mental State Examination scores (P = 0.043) were observed in the AD patients. In addition, in the right gyrus rectus (P = 0.021), right precentral gyrus (P = 0.026), and left superior temporal gyrus (P = 0.043) of the AD patients, decreased ReHo was exhibited. CONCLUSION Donepezil-mediated improvement of cognitive function in AD patients is linked to spontaneous brain activities of the right gyrus rectus, right precentral gyrus, and left superior temporal gyrus, which could be used as potential biomarkers for monitoring the therapeutic effect of donepezil.
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25
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Klaassens BL, van Gerven JMA, Klaassen ES, van der Grond J, Rombouts SARB. Cholinergic and serotonergic modulation of resting state functional brain connectivity in Alzheimer's disease. Neuroimage 2019; 199:143-152. [PMID: 31112788 DOI: 10.1016/j.neuroimage.2019.05.044] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 05/14/2019] [Accepted: 05/16/2019] [Indexed: 11/19/2022] Open
Abstract
Disruption of cholinergic and serotonergic neurotransmitter systems is associated with cognitive, emotional and behavioural symptoms of Alzheimer's disease (AD). To investigate the responsiveness of these systems in AD we measured the effects of a single-dose of the selective serotonin reuptake inhibitor citalopram and acetylcholinesterase inhibitor galantamine in 12 patients with AD and 12 age-matched controls on functional brain connectivity with resting state functional magnetic resonance imaging. In this randomized, double blind, placebo-controlled crossover study, functional magnetic resonance images were repeatedly obtained before and after dosing, resulting in a dataset of 432 scans. Connectivity maps of ten functional networks were extracted using a dual regression method and drug vs. placebo effects were compared between groups with a multivariate analysis with signals coming from cerebrospinal fluid and white matter as covariates at the subject level, and baseline and heart rate measurements as confound regressors in the higher-level analysis (at p < 0.05, corrected). A galantamine induced difference between groups was observed for the cerebellar network. Connectivity within the cerebellar network and between this network and the thalamus decreased after galantamine vs. placebo in AD patients, but not in controls. For citalopram, voxelwise network connectivity did not show significant group × treatment interaction effects. However, we found default mode network connectivity with the precuneus and posterior cingulate cortex to be increased in AD patients, which could not be detected within the control group. Further, in contrast to the AD patients, control subjects showed a consistent reduction in mean connectivity with all networks after administration of citalopram. Since AD has previously been characterized by reduced connectivity between the default mode network and the precuneus and posterior cingulate cortex, the effects of citalopram on the default mode network suggest a restoring potential of selective serotonin reuptake inhibitors in AD. The results of this study also confirm a change in cerebellar connections in AD, which is possibly related to cholinergic decline.
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Affiliation(s)
- Bernadet L Klaassens
- Leiden University, Institute of Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands; Centre for Human Drug Research, Leiden, the Netherlands.
| | | | | | - Jeroen van der Grond
- Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands
| | - Serge A R B Rombouts
- Leiden University, Institute of Psychology, Leiden, the Netherlands; Leiden University Medical Center, Department of Radiology, Leiden, the Netherlands; Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
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Chao LL. Effects of Home Photobiomodulation Treatments on Cognitive and Behavioral Function, Cerebral Perfusion, and Resting-State Functional Connectivity in Patients with Dementia: A Pilot Trial. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:133-141. [PMID: 31050950 DOI: 10.1089/photob.2018.4555] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objective: To examine the effects of transcranial and intranasal photobiomodulation (PBM) therapy, administered at home, in patients with dementia. Background: This study sought to replicate and build upon a previously published case series report describing improved cognitive function in five patients with mild-to-moderate dementia after 12 weeks of transcranial and intranasal near-infrared (NIR) PBM therapy. Materials and methods: Eight participants (mean age: 79.8 ± 5.8 years old) diagnosed with dementia by their physicians were randomized to 12 weeks of usual care (UC, n = 4) or home PBM treatments (n = 4). The NIR PBM treatments were administered by a study partner at home three times per week with the Vielight Neuro Gamma device. The participants were assessed with the Alzheimer's Disease Assessment Scale-cognitive (ADAS-cog) subscale and the Neuropsychiatric Inventory (NPI) at baseline and 6 and 12 weeks, and with arterial spin-labeled perfusion magnetic resonance imaging (MRI) and resting-state functional MRI at baseline and 12 weeks. Results: At baseline, the UC and PBM groups did not differ demographically or clinically. However, after 12 weeks, there were improvements in ADAS-cog (group × time interaction: F1,6 = 16.35, p = 0.007) and NPI (group × time interaction: F1,6 = 7.52, p = 0.03), increased cerebral perfusion (group × time interaction: F1,6 = 8.46, p < 0.03), and increased connectivity between the posterior cingulate cortex and lateral parietal nodes within the default-mode network in the PBM group. Conclusions: Because PBM was well tolerated and associated with no adverse side effects, these results support the potential of PBM therapy as a viable home treatment for individuals with dementia.
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Affiliation(s)
- Linda L Chao
- 1 Center for Imaging of Neurodegenerative Diseases, San Francisco VA Medical Center, San Francisco, California.,2 Department of Radiology and Biomedical Imaging and University of California, San Francisco, San Francisco, California.,3 Department of Psychiatry, University of California, San Francisco, San Francisco, California
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Guo H, Grajauskas L, Habash B, D'Arcy RCN, Song X. Functional MRI technologies in the study of medication treatment effect on Alzheimer's disease. Aging Med (Milton) 2018; 1:75-95. [PMID: 31942484 PMCID: PMC6880690 DOI: 10.1002/agm2.12017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/02/2018] [Indexed: 12/14/2022] Open
Abstract
Alzheimer's disease (AD) is the most common cause of late-life dementia. Characterized by progressive neurodegeneration, the disease is expressed as gradual memory loss together with decline in cognitive abilities and other brain functions. Despite extensive research over the past decade, the cause and cure of AD both remain largely unknown. Several AD-associated deficits have been targeted for interventions, including those based on amyloid-beta, tau, and inflammation hypotheses. Only 2 types of medications-cholinesterase inhibitors and memantine-have been approved, to control the cognitive symptoms of AD such as the loss of memory, language, and executive function. Noninvasive in vivo functional magnetic resonance imaging (MRI) technologies, including the blood oxygen level-dependent functional MRI, arterial spin labeling-based perfusion MRI, and the proton magnetic resonance spectroscopy have been used to study the effect of ChEIs and memantine in the brain. Most of these studies have demonstrated increased functional activation and connectivity, increased regional brain blood flow and volume post-treatment, and positive responses of critical brain metabolites reflecting neuronal status and functionality in patients with AD and mild cognitive impairment. The findings have contributed to the understanding of the mechanisms underlying the medication treatments and support the crucial role of functional MRI technologies in the development and refinement of AD medication therapies.
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Affiliation(s)
- Hui Guo
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Diagnostic ImagingTianjin Medical University General HospitalTianjinChina
| | - Lukas Grajauskas
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
| | - Baraa Habash
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
| | - Ryan CN D'Arcy
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
- Department of Computing ScienceSimon Fraser UniversityBurnabyBCCanada
| | - Xiaowei Song
- SFU ImageTech LaboratorySurrey Memorial HospitalSurreyBCCanada
- Health Sciences and InnovationSurrey Memorial HospitalFraser HealthSurreyBCCanada
- Department of Engineering ScienceSimon Fraser UniversityBurnabyBCCanada
- Department of Computing ScienceSimon Fraser UniversityBurnabyBCCanada
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Hohenfeld C, Werner CJ, Reetz K. Resting-state connectivity in neurodegenerative disorders: Is there potential for an imaging biomarker? Neuroimage Clin 2018; 18:849-870. [PMID: 29876270 PMCID: PMC5988031 DOI: 10.1016/j.nicl.2018.03.013] [Citation(s) in RCA: 145] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 02/06/2018] [Accepted: 03/14/2018] [Indexed: 12/14/2022]
Abstract
Biomarkers in whichever modality are tremendously important in diagnosing of disease, tracking disease progression and clinical trials. This applies in particular for disorders with a long disease course including pre-symptomatic stages, in which only subtle signs of clinical progression can be observed. Magnetic resonance imaging (MRI) biomarkers hold particular promise due to their relative ease of use, cost-effectiveness and non-invasivity. Studies measuring resting-state functional MR connectivity have become increasingly common during recent years and are well established in neuroscience and related fields. Its increasing application does of course also include clinical settings and therein neurodegenerative diseases. In the present review, we critically summarise the state of the literature on resting-state functional connectivity as measured with functional MRI in neurodegenerative disorders. In addition to an overview of the results, we briefly outline the methods applied to the concept of resting-state functional connectivity. While there are many different neurodegenerative disorders cumulatively affecting a substantial number of patients, for most of them studies on resting-state fMRI are lacking. Plentiful amounts of papers are available for Alzheimer's disease (AD) and Parkinson's disease (PD), but only few works being available for the less common neurodegenerative diseases. This allows some conclusions on the potential of resting-state fMRI acting as a biomarker for the aforementioned two diseases, but only tentative statements for the others. For AD, the literature contains a relatively strong consensus regarding an impairment of the connectivity of the default mode network compared to healthy individuals. However, for AD there is no considerable documentation on how that alteration develops longitudinally with the progression of the disease. For PD, the available research points towards alterations of connectivity mainly in limbic and motor related regions and networks, but drawing conclusions for PD has to be done with caution due to a relative heterogeneity of the disease. For rare neurodegenerative diseases, no clear conclusions can be drawn due to the few published results. Nevertheless, summarising available data points towards characteristic connectivity alterations in Huntington's disease, frontotemporal dementia, dementia with Lewy bodies, multiple systems atrophy and the spinocerebellar ataxias. Overall at this point in time, the data on AD are most promising towards the eventual use of resting-state fMRI as an imaging biomarker, although there remain issues such as reproducibility of results and a lack of data demonstrating longitudinal changes. Improved methods providing more precise classifications as well as resting-state network changes that are sensitive to disease progression or therapeutic intervention are highly desirable, before routine clinical use could eventually become a reality.
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Affiliation(s)
- Christian Hohenfeld
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany
| | - Cornelius J Werner
- RWTH Aachen University, Department of Neurology, Aachen, Germany; RWTH Aachen University, Section Interdisciplinary Geriatrics, Aachen, Germany
| | - Kathrin Reetz
- RWTH Aachen University, Department of Neurology, Aachen, Germany; JARA-BRAIN Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich GmbH and RWTH Aachen University, Aachen, Germany.
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Canu E, Sarasso E, Filippi M, Agosta F. Effects of pharmacological and nonpharmacological treatments on brain functional magnetic resonance imaging in Alzheimer's disease and mild cognitive impairment: a critical review. ALZHEIMERS RESEARCH & THERAPY 2018; 10:21. [PMID: 29458420 PMCID: PMC5819240 DOI: 10.1186/s13195-018-0347-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 01/22/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND A growing number of pharmacological and nonpharmacological trials have been performed to test the efficacy of approved or experimental treatments in Alzheimer disease (AD) and mild cognitive impairment (MCI). In this context, functional magnetic resonance imaging (fMRI) may be a good candidate to detect brain changes after a short period of treatment. MAIN BODY This critical review aimed to identify and discuss the available studies that have tested the efficacy of pharmacological and nonpharmacological treatments in AD and MCI cases using task-based or resting-state fMRI measures as primary outcomes. A PubMed-based literature search was performed with the use of the three macro-areas: 'disease', 'type of MRI', and 'type of treatment'. Each contribution was individually reviewed according to the Cochrane Collaboration's tool for assessing risk of bias. Study limitations were systematically detected and critically discussed. We selected 34 pharmacological and 13 nonpharmacological articles. According to the Cochrane Collaboration's tool for assessing risk of bias, 40% of these studies were randomized but only a few described clearly the randomization procedure, 36% declared the blindness of participants and personnel, and only 21% reported the blindness of outcome assessment. In addition, 28% of the studies presented more than 20% drop-outs at short- and/or long-term assessments. Additional common shortcomings of the reviewed works were related to study design, patient selection, sample size, choice of outcome measures, management of drop-out cases, and fMRI methods. CONCLUSION There is an urgent need to obtain efficient treatments for AD and MCI. fMRI is powerful enough to detect even subtle changes over a short period of treatment; however, the soundness of methods should be improved to enable meaningful data interpretation.
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Affiliation(s)
- Elisa Canu
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy
| | - Elisabetta Sarasso
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.,Laboratory of Movement Analysis, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.
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Serotonergic and cholinergic modulation of functional brain connectivity: A comparison between young and older adults. Neuroimage 2017; 169:312-322. [PMID: 29258890 DOI: 10.1016/j.neuroimage.2017.12.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 11/08/2017] [Accepted: 12/13/2017] [Indexed: 12/16/2022] Open
Abstract
Aging is accompanied by changes in neurotransmission. To advance our understanding of how aging modifies specific neural circuitries, we examined serotonergic and cholinergic stimulation with resting state functional magnetic resonance imaging (RS-fMRI) in young and older adults. The instant response to the selective serotonin reuptake inhibitor citalopram (30 mg) and the acetylcholinesterase inhibitor galantamine (8 mg) was measured in 12 young and 17 older volunteers during a randomized, double blind, placebo-controlled, crossover study. A powerful dataset consisting of 522 RS-fMRI scans was obtained by acquiring multiple scans per subject before and after drug administration. Group × treatment interaction effects on voxelwise connectivity with ten functional networks were investigated (p < .05, FWE-corrected) using a non-parametric multivariate analysis technique with cerebrospinal fluid, white matter, heart rate and baseline measurements as covariates. Both groups showed a decrease in sensorimotor network connectivity after citalopram administration. The comparable findings after citalopram intake are possibly due to relatively similar serotonergic systems in the young and older subjects. Galantamine altered connectivity between the occipital visual network and regions that are implicated in learning and memory in the young subjects. The lack of a cholinergic response in the elderly might relate to the well-known association between cognitive and cholinergic deterioration at older age.
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Tian Y, Yang L, Xu W, Zhang H, Wang Z, Zhang H, Zheng S, Shi Y, Xu P. Predictors for drug effects with brain disease: Shed new light from EEG parameters to brain connectomics. Eur J Pharm Sci 2017; 110:26-36. [PMID: 28456573 DOI: 10.1016/j.ejps.2017.04.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/24/2017] [Accepted: 04/24/2017] [Indexed: 01/21/2023]
Abstract
Though researchers spent a lot of effort to develop treatments for neuropsychiatric disorders, the poor translation of drug efficacy data from animals to human hampered the success of these therapeutic approaches in human. Pharmaceutical industry is challenged by low clinical success rates for new drug registration. To maximize the success in drug development, biomarkers are required to act as surrogate end points and predictors of drug effects. The pathology of brain disease could be in part due to synaptic dysfunction. Electroencephalogram (EEG), generating from the result of the postsynaptic potential discharge between cells, could be a potential measure to bridge the gaps between animal and human data. Here we discuss recent progress on using relevant EEG characteristics and brain connectomics as biomarkers to monitor drug effects and measure cognitive changes on animal models and human in real-time. It is expected that the novel approach, i.e. EEG connectomics, will offer a deeper understanding on the drug efficacy at a microcirculatory level, which will be useful to support the development of new treatments for neuropsychiatric disorders.
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Affiliation(s)
- Yin Tian
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China.
| | - Li Yang
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Wei Xu
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Huiling Zhang
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Zhongyan Wang
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Haiyong Zhang
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Shuxing Zheng
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Yupan Shi
- Biomedical Engineering Department, Key Laboratory of Photoelectronic Information Sensing and Transmitting Technology, High School Innovation Team of Architecture and Core Technologies of Smart Medical System, ChongQing University of Posts and Telecommunications, ChongQing 400065, China
| | - Peng Xu
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China
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32
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Kim SH, Kandiah N, Hsu J, Suthisisang C, Udommongkol C, Dash A. Beyond symptomatic effects: potential of donepezil as a neuroprotective agent and disease modifier in Alzheimer's disease. Br J Pharmacol 2017; 174:4224-4232. [PMID: 28901528 PMCID: PMC5715569 DOI: 10.1111/bph.14030] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 09/06/2017] [Accepted: 09/06/2017] [Indexed: 01/11/2023] Open
Abstract
Alzheimer's disease (AD) is associated with neurodegenerative changes resulting clinically in progressive cognitive and functional deficits. The only therapies are the cholinesterase inhibitors donepezil, galantamine and rivastigmine and the N-methyl-D-aspartate-receptor antagonist memantine. Donepezil acts primarily on the cholinergic system as a symptomatic treatment, but it also has potential for disease modification and may reduce the rate of progression of AD. This review explores the potential for disease modifying effects of donepezil. Several neuroprotective mechanisms that are independent of cholinesterase inhibition, are suggested. Donepezil has demonstrated a range of effects, including protecting against amyloid β, ischaemia and glutamate toxicity; slowing of progression of hippocampal atrophy; and up-regulation of nicotinic acetylcholine receptors. Clinically, early and continuous treatment with donepezil is considered to preserve cognitive function more effectively than delayed treatment. The possible neuroprotective effects of donepezil and the potential for disease pathway modification highlight the importance of early diagnosis and treatment initiation in AD.
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Affiliation(s)
- Seung Hyun Kim
- Department of NeurologyHanyang University College of MedicineSeoulKorea
- Seongdong‐Gu Regional Center for DementiaSeoulKorea
| | - Nagaendran Kandiah
- Department of NeurologyNational Neuroscience Institute and Duke‐NUS SingaporeSingapore
| | - Jung‐Lung Hsu
- Department of NeurologyChang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang‐Gung UniversityTaoyuanTaiwan
| | | | - Chesda Udommongkol
- Division of Neurology, Department of MedicinePhramongkutklao HospitalBangkokThailand
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Abstract
Resting state studies in neuropsychiatric disorders have already provided much useful information, but the field is regarded as being at a relatively preliminary stage and subject to several design issues that set limits on the overall utility.
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Affiliation(s)
- Godfrey David Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University School of Medicine, New Haven, CT, USA; Olin Neuropsychiatry Research Center, Institute of Living, 200 Retreat Avenue, Hartford, CT 06106, USA.
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34
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Zhou J, Liu S, Ng KK, Wang J. Applications of Resting-State Functional Connectivity to Neurodegenerative Disease. Neuroimaging Clin N Am 2017; 27:663-683. [DOI: 10.1016/j.nic.2017.06.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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35
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Prognosis of Hippocampal Function after Sub-lethal Irradiation Brain Injury in Patients with Nasopharyngeal Carcinoma. Sci Rep 2017; 7:14697. [PMID: 29089622 PMCID: PMC5665929 DOI: 10.1038/s41598-017-13972-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 10/04/2017] [Indexed: 12/21/2022] Open
Abstract
This work emphasizes the value of assessing hippocampal function by making a timely MRI-based prognosis following a minor dose of hippocampal irradiation after nasopharyngeal carcinomas (NPC) radiotherapy. A quasi-experiment with case-control design and functional assessments (e.g., neuroimaging analysis with fMRI) was conducted to assess hippocampal function after radiotherapy. We delivered 70 Gy of irradiation to nasopharyngeal carcinomas by 6MV helical radiotherapy and collected data from twenty NPC patients and 24 healthy age-matched subjects. Inevitably, hippocampi also received an average dose of 6.89 Gy (range, 2.0-14 Gy). Seed-based functional connectivity of the hippocampus was applied to estimate the cognitive alteration by time before, one month, and four months after irradiation. Afterward, longitudinal-and-cross-sessional statistical inference was determined with time-dependent measurement analysis of variance (ANOVA) with controlled covariance. Over time, there were longitudinal changes in the functional connectivity of hippocampal-related cortices, including the right middle frontal lobe, left superior temporal lobe, and left postcentral gyrus. The findings indicate the presence of functional plasticity, demonstrating how minor irradiation affects functional performance during the early delayed phase of irradiation-induced brain injury.
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36
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Reduced basal forebrain atrophy progression in a randomized Donepezil trial in prodromal Alzheimer's disease. Sci Rep 2017; 7:11706. [PMID: 28916821 PMCID: PMC5601919 DOI: 10.1038/s41598-017-09780-3] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/31/2017] [Indexed: 01/20/2023] Open
Abstract
Acetylcholinesterase inhibitors are approved drugs currently used for the treatment of Alzheimer's disease (AD) dementia. Basal forebrain cholinergic system (BFCS) atrophy is reported to precede both entorhinal cortex atrophy and memory impairment in AD, challenging the traditional model of the temporal sequence of topographical pathology associated with AD. We studied the effect of one-year Donepezil treatment on the rate of BFCS atrophy in prodromal AD patients using a double-blind, randomized, placebo-controlled trial of Donepezil (10 mg/day). Reduced annual BFCS rates of atrophy were found in the Donepezil group compared to the Placebo treated arm. Secondary analyses on BFCS subregions demonstrated the largest treatment effects in the Nucleus Basalis of Meynert (NbM) and the medial septum/diagonal band (Ch1/2). Donepezil administered at a prodromal stage of AD seems to substantially reduce the rate of atrophy of the BFCS nuclei with highest concentration of cholinergic neurons projecting to the cortex (NbM), hippocampus and entorhinal cortex (Ch1/2).
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37
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Wrosch JK, Einem VV, Breininger K, Dahlmanns M, Maier A, Kornhuber J, Groemer TW. Rewiring of neuronal networks during synaptic silencing. Sci Rep 2017; 7:11724. [PMID: 28916806 PMCID: PMC5601899 DOI: 10.1038/s41598-017-11729-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 08/29/2017] [Indexed: 12/14/2022] Open
Abstract
Analyzing the connectivity of neuronal networks, based on functional brain imaging data, has yielded new insight into brain circuitry, bringing functional and effective networks into the focus of interest for understanding complex neurological and psychiatric disorders. However, the analysis of network changes, based on the activity of individual neurons, is hindered by the lack of suitable meaningful and reproducible methodologies. Here, we used calcium imaging, statistical spike time analysis and a powerful classification model to reconstruct effective networks of primary rat hippocampal neurons in vitro. This method enables the calculation of network parameters, such as propagation probability, path length, and clustering behavior through the measurement of synaptic activity at the single-cell level, thus providing a fuller understanding of how changes at single synapses translate to an entire population of neurons. We demonstrate that our methodology can detect the known effects of drug-induced neuronal inactivity and can be used to investigate the extensive rewiring processes affecting population-wide connectivity patterns after periods of induced neuronal inactivity.
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Affiliation(s)
- Jana Katharina Wrosch
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, 91054, Erlangen, Germany.
| | - Vicky von Einem
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, 91054, Erlangen, Germany.,Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University of Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Katharina Breininger
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University of Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Marc Dahlmanns
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Department of Computer Science, Friedrich-Alexander University of Erlangen-Nürnberg, 91058, Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, 91054, Erlangen, Germany
| | - Teja Wolfgang Groemer
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University of Erlangen-Nuremberg, 91054, Erlangen, Germany
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38
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Chirles TJ, Reiter K, Weiss LR, Alfini AJ, Nielson KA, Smith JC. Exercise Training and Functional Connectivity Changes in Mild Cognitive Impairment and Healthy Elders. J Alzheimers Dis 2017; 57:845-856. [PMID: 28304298 DOI: 10.3233/jad-161151] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Effective interventions are needed to improve brain function in mild cognitive impairment (MCI), an early stage of Alzheimer's disease (AD). The posterior cingulate cortex (PCC)/precuneus is a hub of the default mode network (DMN) and is preferentially vulnerable to disruption of functional connectivity in MCI and AD. OBJECTIVE We investigated whether 12 weeks of aerobic exercise could enhance functional connectivity of the PCC/precuneus in MCI and healthy elders. METHODS Sixteen MCI and 16 healthy elders (age range = 60-88) engaged in a supervised 12-week walking exercise intervention. Functional MRI was acquired at rest; the PCC/precuneus was used as a seed for correlated brain activity maps. RESULTS A linear mixed effects model revealed a significant interaction in the right parietal lobe: the MCI group showed increased connectivity while the healthy elders showed decreased connectivity. In addition, both groups showed increased connectivity with the left postcentral gyrus. Comparing pre to post intervention changes within each group, the MCI group showed increased connectivity in 10 regions spanning frontal, parietal, temporal and insular lobes, and the cerebellum. Healthy elders did not demonstrate any significant connectivity changes. CONCLUSION The observed results show increased functional connectivity of the PCC/precuneus in individuals with MCI after 12 weeks of moderate intensity walking exercise training. The protective effects of exercise training on cognition may be realized through the enhancement of neural recruitment mechanisms, which may possibly increase cognitive reserve. Whether these effects of exercise training may delay further cognitive decline in patients diagnosed with MCI remains to be demonstrated.
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Affiliation(s)
| | | | | | | | - Kristy A Nielson
- Marquette University, Milwaukee, WI, USA.,Medical College of Wisconsin, Milwaukee, WI, USA
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39
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Ferris CF, Kulkarni P, Yee JR, Nedelman M, de Jong IEM. The Serotonin Receptor 6 Antagonist Idalopirdine and Acetylcholinesterase Inhibitor Donepezil Have Synergistic Effects on Brain Activity-A Functional MRI Study in the Awake Rat. Front Pharmacol 2017; 8:279. [PMID: 28659792 PMCID: PMC5467007 DOI: 10.3389/fphar.2017.00279] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 05/03/2017] [Indexed: 12/05/2022] Open
Abstract
The 5-HT6 receptor is a promising target for cognitive disorders, in particular for Alzheimer's disease (AD) and other CNS disorders. The high-affinity and selective 5-HT6 receptor antagonist idalopirdine (Lu AE58054) is currently in development for mild-moderate AD as adjunct therapy to acetylcholinesterase inhibitors (AChEIs). We studied the effects of idalopirdine alone and in combination with the AChEI donepezil on brain activity using BOLD (Blood Oxygen Level Dependent) functional magnetic resonance imaging (fMRI) in the awake rat. Idalopirdine (2 mg/kg, i.v.) alone had a modest effect on brain activity, resulting in activation of eight brain regions at the peak response. Of these, the cholinergic diagonal band of Broca, the infralimbic cortex, the ventral pallidum, the nucleus accumbens shell, and the magnocellular preoptic area were shared with the effects of donepezil (0.3 mg/kg, i.v.). Donepezil alone activated 19 brain regions at the peak response, including several cortical regions, areas of the septo-hippocampal system and the serotonergic raphe nucleus. When idalopirdine and donepezil were combined, there was a robust stimulation pattern with activation of 36 brain regions spread across the extended-amygdala-, striato-pallidal, and septo-hippocampal networks as well as the cholinergic system. These findings indicate that, whilst idalopirdine and donepezil recruit a number of overlapping regions including one of the forebrain cholinergic nuclei, the synergistic effect of both compounds extends beyond the cholinergic system and the effects of donepezil alone toward recruitment of multiple neural circuits and neurotransmitter systems. These data provide new insight into the mechanisms via which idalopirdine might improve cognition in donepezil-treated AD patients.
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Affiliation(s)
- Craig F Ferris
- Department of Psychology, Center for Translational NeuroImaging, Northeastern UniversityBoston, MA, United States
| | - Praveen Kulkarni
- Department of Psychology, Center for Translational NeuroImaging, Northeastern UniversityBoston, MA, United States
| | - Jason R Yee
- Department of Psychology, Center for Translational NeuroImaging, Northeastern UniversityBoston, MA, United States
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40
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Amyloid β Peptide-Induced Changes in Prefrontal Cortex Activity and Its Response to Hippocampal Input. INTERNATIONAL JOURNAL OF PEPTIDES 2017; 2017:7386809. [PMID: 28127312 PMCID: PMC5239987 DOI: 10.1155/2017/7386809] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 11/02/2016] [Indexed: 12/24/2022]
Abstract
Alterations in prefrontal cortex (PFC) function and abnormalities in its interactions with other brain areas (i.e., the hippocampus) have been related to Alzheimer Disease (AD). Considering that these malfunctions correlate with the increase in the brain's amyloid beta (Aβ) peptide production, here we looked for a causal relationship between these pathognomonic signs of AD. Thus, we tested whether or not Aβ affects the activity of the PFC network and the activation of this cortex by hippocampal input stimulation in vitro. We found that Aβ application to brain slices inhibits PFC spontaneous network activity as well as PFC activation, both at the population and at the single-cell level, when the hippocampal input is stimulated. Our data suggest that Aβ can contribute to AD by disrupting PFC activity and its long-range interactions throughout the brain.
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41
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Jiang C, Yang S, Tao J, Huang J, Li Y, Ye H, Chen S, Hong W, Chen L. Clinical Efficacy of Acupuncture Treatment in Combination With RehaCom Cognitive Training for Improving Cognitive Function in Stroke: A 2 × 2 Factorial Design Randomized Controlled Trial. J Am Med Dir Assoc 2016; 17:1114-1122. [DOI: 10.1016/j.jamda.2016.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/15/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
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42
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Klaassens BL, Rombouts SARB, Winkler AM, van Gorsel HC, van der Grond J, van Gerven JMA. Time related effects on functional brain connectivity after serotonergic and cholinergic neuromodulation. Hum Brain Mapp 2016; 38:308-325. [PMID: 27622387 PMCID: PMC5215384 DOI: 10.1002/hbm.23362] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 07/22/2016] [Accepted: 08/22/2016] [Indexed: 01/12/2023] Open
Abstract
Psychopharmacological research, if properly designed, may offer insight into both timing and area of effect, increasing our understanding of the brain's neurotransmitter systems. For that purpose, the acute influence of the selective serotonin reuptake inhibitor citalopram (30 mg) and the acetylcholinesterase inhibitor galantamine (8 mg) was repeatedly measured in 12 healthy young volunteers with resting state functional magnetic resonance imaging (RS‐fMRI). Eighteen RS‐fMRI scans were acquired per subject during this randomized, double blind, placebo‐controlled, crossover study. Within‐group comparisons of voxelwise functional connectivity with 10 functional networks were examined (P < 0.05, FWE‐corrected) using a non‐parametric multivariate approach with cerebrospinal fluid, white matter, heart rate, and baseline measurements as covariates. Although both compounds did not change cognitive performance on several tests, significant effects were found on connectivity with multiple resting state networks. Serotonergic stimulation primarily reduced connectivity with the sensorimotor network and structures that are related to self‐referential mechanisms, whereas galantamine affected networks and regions that are more involved in learning, memory, and visual perception and processing. These results are consistent with the serotonergic and cholinergic trajectories and their functional relevance. In addition, this study demonstrates the power of using repeated measures after drug administration, which offers the chance to explore both combined and time specific effects. Hum Brain Mapp 38:308–325, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Bernadet L Klaassens
- Leiden University, Institute of Psychology, Leiden, the Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Serge A R B Rombouts
- Leiden University, Institute of Psychology, Leiden, the Netherlands.,Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands
| | - Anderson M Winkler
- Oxford Centre for Functional MRI of the Brain, Oxford University, Oxford, United Kingdom
| | - Helene C van Gorsel
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.,Leiden University, Leiden Institute for Brain and Cognition, Leiden, the Netherlands.,Centre for Human Drug Research, Leiden, the Netherlands
| | - Jeroen van der Grond
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
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43
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The Significance of the Default Mode Network (DMN) in Neurological and Neuropsychiatric Disorders: A Review. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2016; 89:49-57. [PMID: 27505016 PMCID: PMC4797836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The relationship of cortical structure and specific neuronal circuitry to global brain function, particularly its perturbations related to the development and progression of neuropathology, is an area of great interest in neurobehavioral science. Disruption of these neural networks can be associated with a wide range of neurological and neuropsychiatric disorders. Herein we review activity of the Default Mode Network (DMN) in neurological and neuropsychiatric disorders, including Alzheimer's disease, Parkinson's disease, Epilepsy (Temporal Lobe Epilepsy - TLE), attention deficit hyperactivity disorder (ADHD), and mood disorders. We discuss the implications of DMN disruptions and their relationship to the neurocognitive model of each disease entity, the utility of DMN assessment in clinical evaluation, and the changes of the DMN following treatment.
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44
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Functional connectivity increase in the default-mode network of patients with Alzheimer's disease after long-term treatment with Galantamine. Eur Neuropsychopharmacol 2016; 26:602-13. [PMID: 26796681 DOI: 10.1016/j.euroneuro.2015.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 10/14/2015] [Accepted: 12/01/2015] [Indexed: 11/23/2022]
Abstract
Acetylcholinesterase inhibitors (AChEIs) are efficacious for the treatment of mild to moderate forms of Alzheimer's dementia (AD). Default-mode network (DMN) connectivity is considered to be early impaired in AD. Long-term effects of AChEIs on the DMN in AD have not yet been investigated. Twenty-eight AD patients and 11 age-matched healthy volunteers (HC) participated in the prospective study. AD patients were randomly assigned to either a pharmacotherapy arm (Galantamine, AD G) or to a placebo arm (AD P+G) for the period of 6 months followed by open-label Galantamine therapy from month 7-12. All subjects underwent neuropsychological testing, resting-state functional and structural MRI at baseline and after 12 months, AD patients additionally in between after 6 months. Thirteen AD patients completed the treatment trial and underwent all functional MRI follow-up sequences of good quality. Functional connectivity significantly increased within the AD G group in the posterior cingulate cortex and in the Precuneus between baseline and 12 months follow-up (pcorr<0.05). Between-group analyses demonstrated that functional connectivity in the AD G group significantly increased in the posterior cingulate cortex as well as in the Precuneus compared to the HC group and in the anteromedial aspect of the temporal lobes compared to the AD P+G group, respectively, at 12 months follow-up (pcorr<0.05). Cognitive performance remained stable within groups over time indicating that resting-state fMRI may be sensitive for the detection of pharmacologically induced effects on brain function of AD patients.
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fMRI in Neurodegenerative Diseases: From Scientific Insights to Clinical Applications. NEUROMETHODS 2016. [DOI: 10.1007/978-1-4939-5611-1_23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kuzmickienė J, Kaubrys G. Cognitive Results of CANTAB Tests and Their Change Due to the First Dose of Donepezil May Predict Treatment Efficacy in Alzheimer Disease. Med Sci Monit 2015; 21:3887-99. [PMID: 26656642 PMCID: PMC4684140 DOI: 10.12659/msm.896327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background Ability to predict the efficacy of treatment in Alzheimer disease (AD) may be very useful in clinical practice. Cognitive predictors should be investigated alongside with the demographic, genetic, and other predictors of treatment efficacy. The aim of this study was to establish whether the baseline measures of CANTAB tests and their changes due to the first donepezil dose are able to predict the efficacy of treatment after 4 months of therapy. We also compared the predictive value of cognitive, clinical, and demographic predictors of treatment efficacy in AD. Material/Methods Seventy-two AD patients (62 treatment-naïve and 10 donepezil-treated) and 30 controls were enrolled in this prospective, randomized, rater-blinded, follow-up study. Treatment-naïve AD patients were randomized to 2 groups to take the first donepezil dose after the first or second CANTAB testing, separated by 4 hours. Follow-up Test 3 was performed 4 months after the initial assessment. Results The groups were similar in age, education, gender, Hachinski index, and depression. General Regression Models (GRM) have shown that cognitive changes after the first dose of donepezil in PAL (t-values for regression coefficients from 3.43 to 6.44), PRMd (t=4.33), SWM (t=5.85) test scores, and baseline results of PAL (t=2.57–2.86), PRM (t=3.08), and CRT (t=3.42) tests were significant predictors of long-term donepezil efficacy in AD (p<0.05). Conclusions The cognitive changes produced by the first donepezil dose in CANTAB PAL, PRM, and SWM test measures are able to predict the long-term efficacy of donepezil in AD. Baseline PAL, PRM, and CRT test results were significant predictors.
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Affiliation(s)
- Jurgita Kuzmickienė
- Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University; Center of Neurology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | - Gintaras Kaubrys
- Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University; Center of Neurology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
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Orban P, Madjar C, Savard M, Dansereau C, Tam A, Das S, Evans AC, Rosa-Neto P, Breitner JCS, Bellec P. Test-retest resting-state fMRI in healthy elderly persons with a family history of Alzheimer's disease. Sci Data 2015; 2:150043. [PMID: 26504522 PMCID: PMC4603392 DOI: 10.1038/sdata.2015.43] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2015] [Accepted: 07/21/2015] [Indexed: 11/21/2022] Open
Abstract
We present a test-retest dataset of resting-state fMRI data obtained in 80 cognitively normal elderly volunteers enrolled in the “Pre-symptomatic Evaluation of Novel or Experimental Treatments for Alzheimer's Disease” (PREVENT-AD) Cohort. Subjects with a family history of Alzheimer's disease in first-degree relatives were recruited as part of an on-going double blind randomized clinical trial of Naproxen or placebo. Two pairs of scans were acquired ~3 months apart, allowing the assessment of both intra- and inter-session reliability, with the possible caveat of treatment effects as a source of inter-session variation. Using the NeuroImaging Analysis Kit (NIAK), we report on the standard quality of co-registration and motion parameters of the data, and assess their validity based on the spatial distribution of seed-based connectivity maps as well as intra- and inter-session reliability metrics in the default-mode network. This resource, released publicly as sample UM1 of the Consortium for Reliability and Reproducibility (CoRR), will benefit future studies focusing on the preclinical period preceding the appearance of dementia in Alzheimer's disease.
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Affiliation(s)
- Pierre Orban
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
| | - Cécile Madjar
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - Mélissa Savard
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - Christian Dansereau
- Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
| | - Angela Tam
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada
| | - Samir Das
- McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McConnell Brain Imaging Center, Montreal Neurological Institute, 3801 University , Montreal, QC H3A 2B4, Canada
| | - Alan C Evans
- McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McConnell Brain Imaging Center, Montreal Neurological Institute, 3801 University , Montreal, QC H3A 2B4, Canada
| | - Pedro Rosa-Neto
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada ; McGill University Research Centre for Studies in Aging, 6825 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada
| | - John C S Breitner
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Douglas Mental Health University Institute Research Centre, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; McGill University, 845 Sherbrooke W , Montreal, QC H3A 0G4, Canada
| | - Pierre Bellec
- StoP-AD Centre, Centre for Studies on Prevention of Alzheimer's disease, 6875 LaSalle Boulevard , Montreal, QC H4H 1R3, Canada ; Centre de recherche de l'Institut Universitaire de Gériatrie de Montréal, 4545 Queen Mary , Montreal, QC H3W 1W5, Canada ; Université de Montréal, 2900 Boulevard Edouard-Montpetit , Montreal, QC H3T 1J4, Canada
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Chen G, Ward BD, Chen G, Li SJ. Decreased effective connectivity from cortices to the right parahippocampal gyrus in Alzheimer's disease subjects. Brain Connect 2015; 4:702-8. [PMID: 25132215 DOI: 10.1089/brain.2014.0295] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
The purpose of this study was to detect effective connectivity (EC) changes in the default mode network and hippocampus network in 20 patients with Alzheimer's disease (AD) and 20 cognitively normal (CN) subjects, using multivariate Granger causality. The authors used the maximum coefficients in the multivariate autoregression model to quantitatively measure the different EC strength levels between the CN and AD groups. It was demonstrated that the EC strength difference can classify AD from CN subjects. Further, the right parahippocampal gyrus (PHP_R) showed imbalanced bidirectional EC connections. The PHP_R received weaker input connections from the neocortices, but its output connections were significantly increased in AD. These findings may provide neural physiological mechanisms for interpreting AD subjects' memory deficits during the encoding processes.
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Affiliation(s)
- Guangyu Chen
- Department of Biophysics, Medical College of Wisconsin , Milwaukee, Wisconsin
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State-based functional connectivity changes associate with cognitive decline in amnestic mild cognitive impairment subjects. Behav Brain Res 2015; 288:94-102. [PMID: 25907751 DOI: 10.1016/j.bbr.2015.04.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Revised: 04/04/2015] [Accepted: 04/09/2015] [Indexed: 11/21/2022]
Abstract
Episodic memory (EM) dysfunction is a central characteristic of amnestic mild cognitive impairment (aMCI) subjects, and has a high risk of converting to Alzheimer's disease (AD). However, it is unknown how the EM network is modulated when a situation is switched. Twenty-six aMCI and twenty-two cognitively normal (CN) subjects were enrolled in this study. All of the subjects completed multi-dimensional neuropsychological tests and underwent functional magnetic resonance imaging scans during a resting-state and an episodic memory retrieval task state. The EM network was constructed using a seed-based functional connectivity (FC) approach. AMCI subjects showed poorer cognitive performances in the episodic memory and executive function. We demonstrated that connectivity of the left posterior parahippocampal gyrus (LpPHG) connected to the left ventral medial prefrontal cortex and the right postcentral gyrus (RPCG) was significantly decreased in aMCI subjects compared to CN subjects. Meanwhile, there was increased connectivity of the LpPHG to the right dorsal medial prefrontal cortex (RDMPFC), RPCG, left inferior parietal cortex, and bilateral superior parietal lobe in all of the subjects that changed from a resting-state to a task-state. Interestingly, the changed LpPHG-RDMPFC connectivity strength was significantly correlated with EM scores and executive function in the aMCI subjects. As a result, general brain regions are functionally organized and integrated into the EM network, and this strongly suggests that more cognitive resources are mobilized to meet the challenge of cognitive demand in the task state. These findings extend our understanding of the underlying mechanisms of EM deficits in aMCI subjects.
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Megumi F, Yamashita A, Kawato M, Imamizu H. Functional MRI neurofeedback training on connectivity between two regions induces long-lasting changes in intrinsic functional network. Front Hum Neurosci 2015; 9:160. [PMID: 25870552 PMCID: PMC4377493 DOI: 10.3389/fnhum.2015.00160] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 03/07/2015] [Indexed: 11/22/2022] Open
Abstract
Motor or perceptual learning is known to influence functional connectivity between brain regions and induce short-term changes in the intrinsic functional networks revealed as correlations in slow blood-oxygen-level dependent (BOLD) signal fluctuations. However, no cause-and-effect relationship has been elucidated between a specific change in connectivity and a long-term change in global networks. Here, we examine the hypothesis that functional connectivity (i.e., temporal correlation between two regions) is increased and preserved for a long time when two regions are simultaneously activated or deactivated. Using the connectivity-neurofeedback training paradigm, subjects successfully learned to increase the correlation of activity between the lateral parietal and primary motor areas, regions that belong to different intrinsic networks and negatively correlated before training under the resting conditions. Furthermore, whole-brain hypothesis-free analysis as well as functional network analyses demonstrated that the correlation in the resting state between these areas as well as the correlation between the intrinsic networks that include the areas increased for at least 2 months. These findings indicate that the connectivity-neurofeedback training can cause long-term changes in intrinsic connectivity and that intrinsic networks can be shaped by experience-driven modulation of regional correlation.
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Affiliation(s)
- Fukuda Megumi
- Advanced Telecommunications Research Institutes International Kyoto, Japan ; Graduate School of Information Science, Nara Institute of Science and Technology Ikoma, Japan ; Institute of Cognitive Neuroscience, University College London London, UK
| | - Ayumu Yamashita
- Advanced Telecommunications Research Institutes International Kyoto, Japan ; Department of Systems Science, Graduate School of Informatics, Kyoto University Sakyo-ku, Japan
| | - Mitsuo Kawato
- Advanced Telecommunications Research Institutes International Kyoto, Japan ; Graduate School of Information Science, Nara Institute of Science and Technology Ikoma, Japan
| | - Hiroshi Imamizu
- Advanced Telecommunications Research Institutes International Kyoto, Japan ; Center for Information and Neural Networks, National Institute of Information and Communications Technology and Osaka University Suita, Japan
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