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Cerebrovascular damage in subjective cognitive decline: A systematic review and meta-analysis. Ageing Res Rev 2022; 82:101757. [PMID: 36240992 DOI: 10.1016/j.arr.2022.101757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/05/2022] [Accepted: 10/09/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) has been postulated as an early marker of Alzheimer's Disease (AD) but it can also be associated to other non-AD pathologies such as Vascular Dementia (VaD). Nevertheless, there is scarce data about SCD as a potential harbinger of cerebrovascular pathology. Thus, we conducted a systematic review and meta-analysis on the association between SCD and cerebrovascular damage measured by neuroimaging markers. METHOD This study was performed following the PRISMA guidelines. The search was conducted in 3 databases (PubMed, Scopus and Web of Science) from origin to December 8th, 2021. Primary studies including cognitively unimpaired adults with SCD and neuroimaging markers of cerebrovascular damage (i.e., white matter signal abnormalities, WMSA) were selected. Qualitative synthesis and meta-analysis of studies with a case-control design was performed. RESULTS Of 241 articles identified, 21 research articles were selected. Eight case-control studies were included for the meta-analysis. A significant overall effect-size was observed for the mean WMSA burden in SCD relative to controls, where the WMSA burden was higher in SCD. CONCLUSION Our findings show the potential usefulness of SCD as a harbinger of cerebrovascular disease in cognitively healthy individuals. Further research is needed in order to elucidate the role of SCD as a preclinical marker of vascular cognitive impairment.
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Yeung MK, Chau AKY, Chiu JYC, Shek JTL, Leung JPY, Wong TCH. Differential and subtype-specific neuroimaging abnormalities in amnestic and nonamnestic mild cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev 2022; 80:101675. [PMID: 35724862 DOI: 10.1016/j.arr.2022.101675] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/25/2022]
Abstract
While mild cognitive impairment (MCI) has been classified into amnestic MCI (aMCI) and nonamnestic MCI (naMCI), the neuropathological bases of these two subtypes remain elusive. Here, we performed a systematic review and meta-analysis to determine the subtype specificity of neuroimaging abnormalities in MCI and to identify neural features that may differ between aMCI and naMCI. We synthesized 50 studies that used common neuroimaging modalities, including magnetic resonance imaging and positron emission tomography, to compare brain atrophy, white matter abnormalities, cortical thinning, cerebral hypometabolism, amyloid/tau deposition, or other features among aMCI, naMCI, and normal cognition. Compared with normal cognition, aMCI shows diverse neuroimaging abnormalities of large effect sizes. In contrast, naMCI exhibits restricted abnormalities of small effect sizes. Some features, including medial temporal lobe atrophy and white matter abnormalities, are shared by the two MCI subtypes. Overall, brain abnormalities are worse, if not similar, in aMCI than in naMCI. The only neuroimaging abnormality specific to aMCI is increased amyloid burden; no feature specific to naMCI was found. Taken together, our findings have elucidated the neuropathological changes that occur in aMCI and naMCI. Clarifying the neuroimaging profiles of aMCI and naMCI can improve the early identification, differentiation, and intervention of prodromal dementia.
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Affiliation(s)
- Michael K Yeung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China; University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
| | - Anson Kwok-Yun Chau
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jason Yin-Chuen Chiu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jay Tsz-Lok Shek
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Jody Po-Yi Leung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Toby Chun-Ho Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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López-Cuenca I, Salobrar-García E, Sánchez-Puebla L, Espejel E, García del Arco L, Rojas P, Elvira-Hurtado L, Fernández-Albarral JA, Ramírez-Toraño F, Barabash A, Salazar JJ, Ramírez JM, de Hoz R, Ramírez AI. Retinal Vascular Study Using OCTA in Subjects at High Genetic Risk of Developing Alzheimer’s Disease and Cardiovascular Risk Factors. J Clin Med 2022; 11:jcm11113248. [PMID: 35683633 PMCID: PMC9181641 DOI: 10.3390/jcm11113248] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023] Open
Abstract
In 103 subjects with a high genetic risk of developing Alzheimer’s disease (AD), family history (FH) of AD and ApoE ɛ4 characterization (ApoE ɛ4)) were analyzed for changes in the retinal vascular network by OCTA (optical coherence tomography angiography), and AngioTool and Erlangen-Angio-Tool (EA-Tool) as imaging analysis software. Retinal vascularization was analyzed by measuring hypercholesterolemia (HCL) and high blood pressure (HBP). Angio-Tool showed a statistically significant higher percentage of area occupied by vessels in the FH+ ApoE ɛ4- group vs. in the FH+ ApoE ɛ4+ group, and EA-Tool showed statistically significant higher vascular densities in the C3 ring in the FH+ ApoE ɛ4+ group when compared with: i)FH- ApoE ɛ4- in sectors H3, H4, H10 and H11; and ii) FH+ ApoE ɛ4- in sectors H4 and H12. In participants with HCL and HBP, statistically significant changes were found, in particular using EA-Tool, both in the macular area, mainly in the deep plexus, and in the peripapillary area. In conclusion, OCTA in subjects with genetic risk factors for the development of AD showed an apparent increase in vascular density in some sectors of the retina, which was one of the first vascular changes detectable. These changes constitute a promising biomarker for monitoring the progression of pathological neuronal degeneration.
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Affiliation(s)
- Inés López-Cuenca
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Elena Salobrar-García
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Lidia Sánchez-Puebla
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Eva Espejel
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Lucía García del Arco
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Pilar Rojas
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Madrid Eye Institute, Gregorio Marañón General University Hospital, 28007 Madrid, Spain
| | - Lorena Elvira-Hurtado
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - José A. Fernández-Albarral
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Federico Ramírez-Toraño
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, 28233 Madrid, Spain;
- Department of Experimental Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre, Carlos III Health Institute, 28029 Madrid, Spain
- Department of Medicine II, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Juan J. Salazar
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - José M. Ramírez
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Rosa de Hoz
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
- Correspondence: (R.d.H.); (A.I.R.)
| | - Ana I. Ramírez
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
- Correspondence: (R.d.H.); (A.I.R.)
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Ueba Y, Murakami T, Yamamoto T, Kuroe A, Yamasaki M, Kaneda D, Otani D, Kiyobayashi S, Ikeda K, Yabe D, Ogura M, Inagaki N. Voxel-based specific regional analysis system for Alzheimer's disease utility as a screening tool for unrecognized cognitive dysfunction of elderly patients in diabetes outpatient clinics: Multicenter retrospective exploratory study. J Diabetes Investig 2022; 13:177-184. [PMID: 34191406 PMCID: PMC8756315 DOI: 10.1111/jdi.13622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/10/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022] Open
Abstract
AIMS/INTRODUCTION An efficient screening strategy for identification of cognitive dysfunction remains a clinical issue in the management of elderly adults with diabetes. A magnetic resonance imaging voxel-based specific regional analysis system for Alzheimer's disease (VSRAD) has been developed as an automated brain morphometry system that includes the hippocampus. We carried out a multicenter retrospective study to evaluate the utility of VSRAD for screening cognitive dysfunction in diabetes outpatient clinics. MATERIALS AND METHODS We enrolled patients with diabetes aged >65 years who underwent brain magnetic resonance imaging scans for the purpose of a medical checkup between November 2018 and May 2019. Patients who were already suspected or diagnosed with mild cognitive impairment and/or dementia as well as those with a history of cerebrovascular disease were excluded. RESULTS A total of 67 patients were enrolled. Five patients were diagnosed with mild cognitive impairment or dementia (clinical cognitive dysfunction). Patients with clinical cognitive dysfunction showed a significantly higher z-score in VSRAD analysis (2.57 ± 0.47 vs 1.15 ± 0.55, P < 0.01). The sensitivities and specificities for diagnosis of clinical cognitive dysfunction were 80 and 48% for the Mini-Mental State Examination, 100 and 89% for the z-score, and 100 and 90% for the combination of the Mini-Mental State Examination score and z-score, respectively. CONCLUSIONS VSRAD analysis can distinguish patients with clinical cognitive dysfunction in the elderly with diabetes, and also shows reasonable sensitivity and specificity compared with the Mini-Mental State Examination alone. Thus, VSRAD analysis can be useful for early identification of clinical cognitive dysfunction in the elderly with diabetes.
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Affiliation(s)
- Yoko Ueba
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Takaaki Murakami
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Taizo Yamamoto
- Department of Diabetes, and EndocrinologyShiga General HospitalShigaJapan
| | - Akira Kuroe
- Department of Diabetes, and MetabolismHikone Municipal HospitalShigaJapan
| | | | - Daita Kaneda
- Institute of NeuropathologyFukushimura HospitalToyohashi, AichiJapan
| | - Daisuke Otani
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Sakura Kiyobayashi
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Kaori Ikeda
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Daisuke Yabe
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
- Department of Diabetes and EndocrinologyGifu University Graduate School of MedicineGifuJapan
| | - Masahito Ogura
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
| | - Nobuya Inagaki
- Department of Diabetes, Endocrinology, and NutritionKyoto University HospitalKyotoJapan
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Lane HY, Tu CH, Lin WC, Lin CH. Brain Activity of Benzoate, a D-Amino Acid Oxidase Inhibitor, in Patients With Mild Cognitive Impairment in a Randomized, Double-Blind, Placebo Controlled Clinical Trial. Int J Neuropsychopharmacol 2021; 24:392-399. [PMID: 33406269 PMCID: PMC8130199 DOI: 10.1093/ijnp/pyab001] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 01/05/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Current anti-dementia drugs cannot benefit mild cognitive impairment (MCI). Sodium benzoate (a D-amino acid oxidase [DAO] inhibitor) has been found to improve the cognitive function of patients with early-phase Alzheimer's disease (mild Alzheimer's disease or MCI). However, its effect on brain function remains unknown. This study aimed to evaluate the influence of benzoate on functional magnetic resonance imaging in patients with amnestic MCI. METHODS This was a 24-week, randomized, double-blind, placebo-controlled trial that enrolled 21 patients with amnestic MCI and allocated them randomly to either of 2 treatment groups: (1) benzoate group (250-1500 mg/d), or (2) placebo group. We assessed the patients' working memory, verbal learning and memory, and resting-state functional magnetic resonance imaging and regional homogeneity (ReHo) maps at baseline and endpoint. RESULTS Resting-state ReHo decreased in right orbitofrontal cortex after benzoate treatment but did not change after placebo. Moreover, after benzoate treatment, the change in working memory was positively correlated with the change in ReHo in right precentral gyrus and right middle occipital gyrus; and the change in verbal learning and memory was positively correlated with the change in ReHo in left precuneus. In contrast, after placebo treatment, the change in working memory or in verbal learning and memory was not correlated with the change in ReHo in any brain region. CONCLUSION The current study is the first to our knowledge to demonstrate that a DAO inhibitor, sodium benzoate herein, can alter brain activity as well as cognitive functions in individuals with MCI. The preliminary finding lends supports for DAO inhibition as a novel approach for early dementing processes.
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Affiliation(s)
- Hsien-Yuan Lane
- Department of Psychiatry and Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan ,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan ,Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, Taiwan
| | - Cheng-Hao Tu
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
| | - Wei-Che Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Chieh-Hsin Lin
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan,School of Medicine, Chang Gung University, Taoyuan, Taiwan ,Correspondence: Chieh-Hsin Lin, MD, PhD, Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Niaosong District, Kaohsiung City, 833, Taiwan ()
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Rossini F, Zauner H, Bergmann J, Kronbichler M, Spindler I, Golaszewski S, Trinka E, Staffen W. HMPAO-SPECT Can Discriminate between Patients with Subjective Cognitive Complaints with and without Cognitive Deficits and those with Mild Cognitive Impairment. Curr Alzheimer Res 2020; 16:843-851. [PMID: 31453786 DOI: 10.2174/1567205016666190827115138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 08/09/2019] [Accepted: 08/21/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Growing evidence suggests that pathological processes leading to Alzheimer's disease occurs gradually and begins to develop decades before the earliest clinical symptoms occur. The use of biomarkers has been proposed to detect evidence of preclinical Alzheimer's pathologic change in asymptomatic subjects. Subjective cognitive complaints (SCC) i.e. self-reported cognitive decline with normal cognition have been reported as an indicator of future cognitive decline, however, this condition is unspecific. OBJECTIVE In the present study we used the regional brain perfusion measured by HMPAO-SPECT as Biomarker of neurodegeneration to compare the regional brain perfusion of patient with subjective cognitive complaints with and without minimal cognitive dysfunction (SCC+ and SCC- respectively) in respect to patients with mild cognitive impairment (MCI). METHODS We retrospectively examined 736 Patients who referred to our Memory Clinic because of suspected cognitive dysfunction. After exclusion of patients with overt dementia, automated, quantitatively assessed relative cerebral blood flow of 10 forebrain regions (thalamus, parietotemporal, medial temporal, posterior temporal, posterior cingulate gyrus, each region left hemispheric and right hemispheric) and neuropsychological assessment of 64 SCC (32 SCC+; 32 SCC-) and 28 MCI subjects were analysed. RESULTS .The most relevant differences between groups in cognitive performance concerned verbal memory. Left hemispheric medial temporal region could significantly discriminate between all three groups, with a progressive decrease n perfusion from SCC towards MCI. Area under the curve of left medial temporal region showed a sensitivity of 0,61 and a specificity of 0,78 for discriminating MCI from SCC. CONCLUSION Automated analysis of HMPAO-SPECT data of MCI and SCC+ patients showed significant perfusion differences in medial temporal region and impaired verbal memory, both of which are known features of Alzheimer's disease. Perfusion patterns and verbal memory performance in SCC+ are more similar to MCI than SCC-. Thus, SPECT analysis could distinguish those subjects whose perfusion pattern resembles that of an MCI from those who do not. In our opinion, this could identify two populations with a different risk of progression to AD, with SCC+ subjects needing further diagnostic examination and repeated follow-up.
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Affiliation(s)
- F Rossini
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - H Zauner
- Rehabilitation Center of the Pensionsversicherungsanstalt, Großgmain, Austria
| | - J Bergmann
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria
| | - M Kronbichler
- Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - I Spindler
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria
| | - S Golaszewski
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - E Trinka
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Neuroscience Institute, Christian Doppler Medical Centre, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
| | - W Staffen
- Department of Neurology, Christian Doppler Medical Centre, Paracelsus Medical University, Salzburg, Austria.,Centre for Cognitive Neuroscience, Salzburg, Austria
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Yeung MK, Chan AS. Functional near-infrared spectroscopy reveals decreased resting oxygenation levels and task-related oxygenation changes in mild cognitive impairment and dementia: A systematic review. J Psychiatr Res 2020; 124:58-76. [PMID: 32120065 DOI: 10.1016/j.jpsychires.2020.02.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023]
Abstract
Nuclear medicine and functional magnetic resonance imaging studies have shown that mild cognitive impairment (MCI) and dementia, including Alzheimer's disease (AD), are characterized by changes in cerebral blood flow. This article reviews the application of an alternative method, functional near-infrared spectroscopy (fNIRS), to the study of cerebral oxygenation changes in MCI and dementia. We synthesized 36 fNIRS studies that examined hemodynamic changes during both the resting state and the execution of tasks of word retrieval, memory, motor control, and visuospatial perception in MCI and dementia. This qualitative review reveals that (amnestic) MCI and AD patients have disrupted frontal and long-range connectivity in the resting state compared to individuals with normal cognition (NC). These patients also exhibit reduced frontal oxygenation changes in various cognitive domains. The review also shows that disrupted connectivity and decreased frontal oxygenation levels/changes are more severe in AD than in (amnestic) MCI, confirming that MCI is an intermediate stage between NC and dementia. Thus, there is reduced resting frontal perfusion, which is greater than expected for age, and a lack of frontal compensatory responses to functional decline across cognitive operations (i.e., word retrieval and memory functioning) in MCI and AD. These indices might potentially serve as perfusion- or oxygenation-based biomarkers for MCI/dementia. To expand the utility of fNIRS for MCI and dementia, further studies that measure tissue oxygenation in a wider range of brain regions and cognitive domains, compare different MCI and dementia types, and correlate changes in cerebral oxygenation over time with disease progression are needed.
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Affiliation(s)
- Michael K Yeung
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Agnes S Chan
- Neuropsychology Laboratory, Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China; Chanwuyi Research Center for Neuropsychological Well-being, The Chinese University of Hong Kong, Hong Kong SAR, China.
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O'Bryhim BE, Apte RS, Kung N, Coble D, Van Stavern GP. Association of Preclinical Alzheimer Disease With Optical Coherence Tomographic Angiography Findings. JAMA Ophthalmol 2019; 136:1242-1248. [PMID: 30352114 DOI: 10.1001/jamaophthalmol.2018.3556] [Citation(s) in RCA: 163] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Importance Biomarker testing for asymptomatic, preclinical Alzheimer disease (AD) is invasive and expensive. Optical coherence tomographic angiography (OCTA) is a noninvasive technique that allows analysis of retinal and microvascular anatomy, which is altered in early-stage AD. Objective To determine whether OCTA can detect early retinal alterations in cognitively normal study participants with preclinical AD diagnosed by criterion standard biomarker testing. Design, Setting, and Participants This case-control study included 32 participants recruited from the Charles F. and Joanne Knight Alzheimer Disease Research Center, Washington University in St Louis, St Louis, Missouri. Results of extensive neuropsychometric testing determined that all participants were cognitively normal. Participants underwent positron emission tomography and/or cerebral spinal fluid testing to determine biomarker status. Individuals with prior ophthalmic disease, media opacity, diabetes, or uncontrolled hypertension were excluded. Data were collected from July 1, 2016, through September 30, 2017, and analyzed from July 30, 2016, through December 31, 2017. Main Outcomes and Measures Automated measurements of retinal nerve fiber layer thickness, ganglion cell layer thickness, inner and outer foveal thickness, vascular density, macular volume, and foveal avascular zone were collected using an OCTA system from both eyes of all participants. Separate model III analyses of covariance were used to analyze individual data outcome. Results Fifty-eight eyes from 30 participants (53% female; mean [SD] age, 74.5 [5.6] years; age range, 62-92 years) were included in the analysis. One participant was African American and 29 were white. Fourteen participants had biomarkers positive for AD and thus a diagnosis of preclinical AD (mean [SD] age, 73.5 [4.7] years); 16 without biomarkers served as a control group (mean [SD] age, 75.4 [6.6] years). The foveal avascular zone was increased in the biomarker-positive group compared with controls (mean [SD], 0.364 [0.095] vs 0.275 [0.060] mm2; P = .002). Mean (SD) inner foveal thickness was decreased in the biomarker-positive group (66.0 [9.9] vs 75.4 [10.6] μm; P = .03). Conclusions and Relevance This study suggests that cognitively healthy individuals with preclinical AD have retinal microvascular abnormalities in addition to architectural alterations and that these changes occur at earlier stages of AD than has previously been demonstrated. Longitudinal studies in larger cohorts are needed to determine whether this finding has value in identifying preclinical AD.
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Affiliation(s)
- Bliss Elizabeth O'Bryhim
- Department of Ophthalmology and Vision Science, Washington University in St Louis, St Louis, Missouri
| | - Rajendra S Apte
- Department of Ophthalmology and Vision Science, Washington University in St Louis, St Louis, Missouri.,Department of Medicine, Washington University in St Louis, St Louis, Missouri.,Department of Developmental Biology, Washington University in St Louis, St Louis, Missouri
| | | | - Dean Coble
- Division of Biostatistics, Washington University in St Louis, St Louis, Missouri
| | - Gregory P Van Stavern
- Department of Ophthalmology and Vision Science, Washington University in St Louis, St Louis, Missouri.,Department of Neurology, Washington University in St Louis, St Louis, Missouri
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9
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Van Patten R, Greif T, Britton K, Tremont G. Single-photon emission computed tomography (SPECT) perfusion and neuropsychological performance in mild cognitive impairment. J Clin Exp Neuropsychol 2019; 41:530-543. [PMID: 30880594 DOI: 10.1080/13803395.2019.1586838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Single-photon emission computed tomography (SPECT) is an affordable neuroimaging technique that measures cerebral perfusion and has been utilized repeatedly in aging populations. However, we are aware of no studies to date examining relationships between SPECT imaging and comprehensive neuropsychological evaluations in a clinical sample of patients with mild cognitive impairment (MCI). Participants were 124 older adults with MCI (age, M = 75.07 years, SD = 7.65; years of education, M = 14.03, SD = 3.09; 60.2% female) who underwent neuropsychological evaluations and brain SPECT scans as part of their routine clinical care. Based on SPECT interpretations, participants were grouped by suspected etiology (i.e., the neuroradiologists noted that hypoperfusion patterns were most consistent with Alzheimer's disease, AD; frontotemporal lobar degeneration, FTLD; or other disease processes) and regional hypoperfusion (e.g., frontal, temporal, right/left hemisphere). Neuropsychological tests were grouped into domain scores (i.e., attention/processing speed, language, visuospatial, memory, executive; verbal/nonverbal). Consistent with a priori predictions, patients with an AD pattern of hypoperfusion scored lower than comparison groups on the attention/processing speed (partial χ2 = 0.10) and memory (partial χ2 = 0.07) composites. More patients with the AD-hypoperfusion signal met criteria for amnestic MCI (82%) than did those with a non-AD pattern (70%); this result approached statistical significance (p = .07). Contrary to hypotheses, patients whose SPECT scans were most consistent with FTLD did not underperform on the executive composite, and most regional analyses were nonsignificant. When integrating SPECT data into their clinical conceptualizations of MCI, neuropsychologists should place more weight on AD patterns of hypoperfusion, while de-emphasizing data suggestive of FTLD or regional pathology. Alternative neurodiagnostic markers may be more informative in these instances.
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Affiliation(s)
- Ryan Van Patten
- a Department of Psychiatry and Human Behavior, Warren Alpert Medical School , Brown University , Providence , RI , USA.,b Department of Psychiatry , Unviersity of California-San Diego , San Diego , CA , USA
| | - Taylor Greif
- c Department of Psychology , Saint Louis University , St. Louis , MO , USA
| | - Karysa Britton
- d Neuropsychology Program , Rhode Island Hospital , Providence , RI , USA
| | - Geoffrey Tremont
- a Department of Psychiatry and Human Behavior, Warren Alpert Medical School , Brown University , Providence , RI , USA.,d Neuropsychology Program , Rhode Island Hospital , Providence , RI , USA
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10
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Bauckneht M, Chincarini A, Piva R, Arnaldi D, Girtler N, Massa F, Pardini M, Grazzini M, Efeturk H, Pagani M, Sambuceti G, Nobili F, Morbelli S. Metabolic correlates of reserve and resilience in MCI due to Alzheimer's Disease (AD). ALZHEIMERS RESEARCH & THERAPY 2018; 10:35. [PMID: 29615111 PMCID: PMC5883593 DOI: 10.1186/s13195-018-0366-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/08/2018] [Indexed: 12/23/2022]
Abstract
Background We explored the presence of both reserve and resilience in late-converter mild cognitive impairment due to Alzheimer’s disease (MCI-AD) and in patients with slowly progressing amyloid-positive MCI by assessing the topography and extent of neurodegeneration with respect to both “aggressive” and typically progressing phenotypes and in the whole group of patients with MCI, grounding the stratification on education level. Methods We analyzed 94 patients with MCI-AD followed until conversion to dementia and 39 patients with MCI who had brain amyloidosis (AMY+ MCI), all with available baseline 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) results. Using a data-driven approach based on conversion time, patients with MCI-AD were divided into typical AD and late-converter subgroups. Similarly, on the basis of annual rate of Mini Mental State Examination score reduction, AMY+ MCI group was divided, obtaining smoldering (first tertile) and aggressive (third tertile) subgroups. Finally, we divided the whole group (MCI-AD and AMY+ MCI) according to years of schooling, obtaining four subgroups: poorly educated (Low-EDUC; first quartile), patients with average education (Average-EDUC; second quartile), highly educated (High-EDUC; third quartile), and exceptionally educated (Except-EDUC; fourth quartile). FDG-PET of typical AD, late converters, and aggressive and smoldering AMY+ MCI subgroups, as well as education level-based subgroups, were compared with healthy volunteer control subjects (CTR) and within each group using a two-samples t test design (SPM8; p < 0.05 family-wise error-corrected). Results Late converters were characterized by relatively preserved metabolism in the right middle temporal gyrus (Brodmann area [BA] 21) and in the left orbitofrontal cortex (BA 47) with respect to typical AD. When compared with CTR, the High-EDUC subgroup demonstrated a more extended bilateral hypometabolism in the posterior parietal cortex, posterior cingulate cortex, and precuneus than the Low- and Average-EDUC subgroups expressing the same level of cognitive impairment. The Except-EDUC subgroup showed a cluster of significant hypometabolism including only the left posterior parietal cortex (larger than the Low- and Average-EDUC subgroups but not further extended with respect to the High-EDUC subgroup). Conclusions Middle and inferior temporal gyri may represent sites of resilience rather than a hallmark of a more aggressive pattern (when hypometabolic). These findings thus support the existence of a relatively homogeneous AD progression pattern of hypometabolism despite AD heterogeneity and interference of cognitive reserve. In fact, cortical regions whose “metabolic resistance” was associated with slower clinical progression had different localization with respect to the regions affected by education-related reserve. Electronic supplementary material The online version of this article (10.1186/s13195-018-0366-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | | | - Roberta Piva
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Nicola Girtler
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Matteo Grazzini
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Hulya Efeturk
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies (ICST), Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.,Department of Nuclear Medicine, Karolinska Hospital Stockholm, Stockholm, Sweden
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. .,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy.
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11
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Disrupted global metastability and static and dynamic brain connectivity across individuals in the Alzheimer's disease continuum. Sci Rep 2017; 7:40268. [PMID: 28074926 PMCID: PMC5225495 DOI: 10.1038/srep40268] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/05/2016] [Indexed: 11/09/2022] Open
Abstract
As findings on the neuropathological and behavioral components of Alzheimer's disease (AD) continue to accrue, converging evidence suggests that macroscale brain functional disruptions may mediate their association. Recent developments on theoretical neuroscience indicate that instantaneous patterns of brain connectivity and metastability may be a key mechanism in neural communication underlying cognitive performance. However, the potential significance of these patterns across the AD spectrum remains virtually unexplored. We assessed the clinical sensitivity of static and dynamic functional brain disruptions across the AD spectrum using resting-state fMRI in a sample consisting of AD patients (n = 80) and subjects with either mild (n = 44) or subjective (n = 26) cognitive impairment (MCI, SCI). Spatial maps constituting the nodes in the functional brain network and their associated time-series were estimated using spatial group independent component analysis and dual regression, and whole-brain oscillatory activity was analyzed both globally (metastability) and locally (static and dynamic connectivity). Instantaneous phase metrics showed functional coupling alterations in AD compared to MCI and SCI, both static (putamen, dorsal and default-mode) and dynamic (temporal, frontal-superior and default-mode), along with decreased global metastability. The results suggest that brains of AD patients display altered oscillatory patterns, in agreement with theoretical premises on cognitive dynamics.
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12
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Kim J, Cho SG, Song M, Kang SR, Kwon SY, Choi KH, Choi SM, Kim BC, Song HC. Usefulness of 3-dimensional stereotactic surface projection FDG PET images for the diagnosis of dementia. Medicine (Baltimore) 2016; 95:e5622. [PMID: 27930593 PMCID: PMC5266065 DOI: 10.1097/md.0000000000005622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To compare diagnostic performance and confidence of a standard visual reading and combined 3-dimensional stereotactic surface projection (3D-SSP) results to discriminate between Alzheimer disease (AD)/mild cognitive impairment (MCI), dementia with Lewy bodies (DLB), and frontotemporal dementia (FTD).[F]fluorodeoxyglucose (FDG) PET brain images were obtained from 120 patients (64 AD/MCI, 38 DLB, and 18 FTD) who were clinically confirmed over 2 years follow-up. Three nuclear medicine physicians performed the diagnosis and rated diagnostic confidence twice; once by standard visual methods, and once by adding of 3D-SSP. Diagnostic performance and confidence were compared between the 2 methods.3D-SSP showed higher sensitivity, specificity, accuracy, positive, and negative predictive values to discriminate different types of dementia compared with the visual method alone, except for AD/MCI specificity and FTD sensitivity. Correction of misdiagnosis after adding 3D-SSP images was greatest for AD/MCI (56%), followed by DLB (13%) and FTD (11%). Diagnostic confidence also increased in DLB (visual: 3.2; 3D-SSP: 4.1; P < 0.001), followed by AD/MCI (visual: 3.1; 3D-SSP: 3.8; P = 0.002) and FTD (visual: 3.5; 3D-SSP: 4.2; P = 0.022). Overall, 154/360 (43%) cases had a corrected misdiagnosis or improved diagnostic confidence for the correct diagnosis.The addition of 3D-SSP images to visual analysis helped to discriminate different types of dementia in FDG PET scans, by correcting misdiagnoses and enhancing diagnostic confidence in the correct diagnosis. Improvement of diagnostic accuracy and confidence by 3D-SSP images might help to determine the cause of dementia and appropriate treatment.
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Affiliation(s)
| | | | | | | | | | - Kang-Ho Choi
- Department of Neurology, Chonnam National University Hospital, Donggu, Gwangju, Republic of Korea
| | - Seong-Min Choi
- Department of Neurology, Chonnam National University Hospital, Donggu, Gwangju, Republic of Korea
| | - Byeong-Chae Kim
- Department of Neurology, Chonnam National University Hospital, Donggu, Gwangju, Republic of Korea
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13
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Subjective cognitive impairment: Towards early identification of Alzheimer disease. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2013.02.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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14
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Tu MC, Lo CP, Chen CY. Tc-99m-ECD SPECT as the measure for therapeutic response in patients with cobalamin deficiency: Two case reports. Medicine (Baltimore) 2016; 95:e4851. [PMID: 27684816 PMCID: PMC5265909 DOI: 10.1097/md.0000000000004851] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Cobalamin (Cbl) is an essential vitamin for human health. While an increasing body of evidence supports the negative impact of Cbl deficiency on cognition, the causality has yet to be determined, and the reported therapeutic responses after Cbl supplement therapy have been inconsistent. Besides, few reports have described neuroimaging characteristics associated with the therapeutic response. METHODS To describe and compare technetium-99m ethyl cysteinate dimer single-photon emission computed tomography (Tc-99m-ECD SPECT) findings in 2 patients with Cbl deficiency with distinct therapeutic responses. RESULTS Case 1 scored 12/30 in the mini-mental state examination (MMSE) and 34/100 in the cognitive abilities screening instrument (CASI). Profound deficits in mental manipulation, drawing, short-term/long-term memory, and verbal fluency were noted. Case 2 scored 24/30 in the MMSE and 78/100 in the CASI, mainly due to impaired mental manipulation, abstract thinking, and borderline performance in short-term memory and verbal fluency. While both cases showed widespread hypoperfusion within bilateral frontotemporal regions and thalamus on Tc-99m-ECD SPECT, Case 2 demonstrated relatively preserved radio-uptake in the frontal regions, especially the anterior cingulate cortex (ACC) and prefrontal cortex (PFC), consistent with the better therapeutic response (Case 1: 12/30 to 11/30 in the MMSE; Case 2: 24/30 to 28/30 in the MMSE). CONCLUSION Given that the ACC integrates the limbic system and frontosubcortical circuits and the PFC governs executive function, the extent and severity of hypofrontality may be responsible for the worse prognosis. Our Tc-99m-ECD SPECT observations revealed that the negative impact on cerebral metabolic tone is relevant to the severity of Cbl deficiency, and the functional integrity of the ACC and PFC is highly associated with the preservation of global cognitive function in our cases with Cbl deficiency.
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Affiliation(s)
- Min-Chien Tu
- Department of Neurology
- School of Medicine, Tzu Chi University, Hualien
| | - Chung-Ping Lo
- Department of Radiology
- School of Medicine, Tzu Chi University, Hualien
| | - Ching-Yuan Chen
- Department of Nuclear Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung
- School of Medicine, Tzu Chi University, Hualien
- Graduate Institute of Medical Imaging and Radiological Sciences, Central Taiwan University of Science and Technology, Taichung, Taiwan
- Correspondence: Ching-Yuan Chen, Department of Nuclear Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation. No. 88, Sec. 1, Fengxing Rd., Tanzi Dist., Taichung City 427, Taiwan (R.O.C.) (e-mail: )
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15
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Roquet D, Sourty M, Botzung A, Armspach JP, Blanc F. Brain perfusion in dementia with Lewy bodies and Alzheimer's disease: an arterial spin labeling MRI study on prodromal and mild dementia stages. ALZHEIMERS RESEARCH & THERAPY 2016; 8:29. [PMID: 27401267 PMCID: PMC4940880 DOI: 10.1186/s13195-016-0196-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/06/2016] [Indexed: 01/29/2023]
Abstract
Background We aimed to describe specific changes in brain perfusion in patients with dementia with Lewy bodies (DLB) at both the prodromal (also called mild cognitive impairment) and mild dementia stages, relative to patients with Alzheimer’s disease (AD) and controls. Methods Altogether, 96 participants in five groups (prodromal DLB, prodromal AD, DLB with mild dementia, AD with mild dementia, and healthy elderly controls) took part in an arterial spin labeling MRI study. Three analyses were performed: a global perfusion value comparison, a voxel-wise analysis of both absolute and relative perfusion, and a linear discriminant analysis. These were used to assess the global decrease in perfusion, regional changes, and the sensitivity and specificity of these changes. Results Patterns of perfusion in DLB differed from AD and controls in both the prodromal stage and dementia, DLB having more deficits in frontal, insular, and temporal cortices whereas AD showed reduced perfusion in parietal and parietotemporal cortices. Decreases but also increases of perfusion in DLB relative to controls were observed in both absolute and relative measurements. All these regional changes of perfusion classified DLB patients with respect to either healthy controls or AD with sensitivity from 87 to 100 % and specificity from 90 to 96 % depending on the stage of the disease. Conclusions Our results are consistent with previous studies. We extend the scope of those studies by integrating prodromal DLB patients and by describing both hypo- and hyperperfusion in DLB. While decreases in perfusion may relate to functional impairments, increases might suggest a functional compensation of some brain areas. Electronic supplementary material The online version of this article (doi:10.1186/s13195-016-0196-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Daniel Roquet
- ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France.
| | - Marion Sourty
- ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France
| | - Anne Botzung
- ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
| | - Jean-Paul Armspach
- ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France
| | - Frédéric Blanc
- ICube laboratory, University of Strasbourg, CNRS, FMTS(Fédération de Médecine Translationnelle de Strasbourg), ICube - IPB, Faculté de Médecine, 4 rue Kirschleger, Strasbourg, 67085, France.,University Hospital of Strasbourg, CMRR (Memory Resources and Research Centre), Strasbourg, France
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16
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Abstract
This chapter will focus on the descriptive, analytic, and intervention-oriented epidemiology of dementia and its most frequent etiologic type due to Alzheimer's disease. The chapter opens with a brief presentation of the concept of dementia, followed by the presentation of dementia of the Alzheimer type (DAT), including natural history, clinical manifestation, neuropathology, medical prognosis, and management. Further, the chapter presents the prevalence and incidence of dementia, with special consideration of secular trends in prevalence and incidence of DAT, and prognosis of the socioeconomic impact of dementia. Thereafter the main risk factors for DAT are covered. The chapter also addresses the results of ongoing therapeutic and preventive intervention trials for DAT. Finally, the future challenges of the epidemiology of dementia with a focus on the impact of the new diagnostic criteria for neurocognitive disorders, as well as the development of biomarkers for DAT and other types of dementia, will be briefly discussed.
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Affiliation(s)
- S F Sacuiu
- Department of Neuropsychiatry, Sahlgrenska University Hospital and Department of Psychiatry and Neurochemistry, University of Gothenburg Institute of Neuroscience and Physiology, Gothenburg, Sweden.
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17
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Tu MC, Lo CP, Chen CY, Huang CF. Correlation of Tc-99 m ethyl cysteinate dimer single-photon emission computed tomography and clinical presentations in patients with low cobalamin status. BMC Neurol 2015; 15:251. [PMID: 26630935 PMCID: PMC4668675 DOI: 10.1186/s12883-015-0500-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 11/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background Cobalamin (Cbl) deficiency has been associated with various neuropsychiatric symptoms of different severities. While some studies dedicated in structural neuroimaging credibly address negative impact of low Cbl status, functional imaging reports are limited. We herein retrospectively review the correlation of Tc-99 m ethyl cysteinate dimer single-photon emission computed tomography (Tc-99 m-ECD SPECT) and clinical presentations among patients with low serum cobalamin (Cbl) status (<250 pg/ml). Methods Twelve symptomatic patients with low serum Cbl status were enrolled. Clinical presentations, Tc-99 m-ECD SPECT, and neuropsychological tests were reviewed. Results Dysexecutive syndrome (67 %), forgetfulness (50 %), attention deficits (42 %), and sleep disorders (33 %) constituted the major clinical presentations. All patients (100 %) had temporal hypoperfusion on the Tc-99 m-ECD SPECT. Five patients (42 %) had hypoperfusion restricted within temporal regions and deep nuclei; seven patients (58 %) had additional frontal hypoperfusion. In patients with hypoperfusion restricted within temporal regions and deep nuclei, psychiatric symptoms with spared cognition were their main presentations. Among patients with additional frontal hypoperfusion, six of seven patients (86 %) showed impaired cognitive performances (two of them were diagnosed as having dementia). Among ten patients who finished neuropsychological tests, abstract thinking (70 %) was the most commonly affected, followed by verbal fluency (60 %), short-term memory (50 %), and attention (50 %). Anxiety and sleep problems were the major clinically remarkable psychiatric features (33 % both). Four Tc-99 m-ECD SPECT follow-up studies were available; the degree and extent of signal reversal correlated with cognitive changes after Cbl replacement therapy. Conclusions Our TC-99 m-ECD SPECT observations provide pivotal information of neurobiological changes within basal ganglia and fronto-temporal regions in conjunction with disease severity among patients with Cbl deficiency. Hypoperfusion within thalamus/basal ganglia and temporal regions may be seen in the earlier state of Cbl deficiency, when psychiatric symptoms predominate. Hypoperfusion beyond thalamus/basal ganglia and involving frontal regions appears when cognitive problems, mostly dysexecutive syndrome, are manifested. Symmetric hypofrontality of SPECT in the context of dysexcutive syndrome serves as a distinguishing feature of non-amnestic mild cognitive impairment attributed to Cbl deficiency. Concordant with TC-99 m-ECD SPECT findings, the psychiatric symptoms and dysexcutive syndrome undergird impaired limbic and dorsolateral prefrontal circuits originating from basal ganglia respectively.
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Affiliation(s)
- Min-Chien Tu
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan. .,School of Medicine, Tzu Chi University, Hualien, Taiwan.
| | - Chung-Ping Lo
- Department of Radiology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Ching-Yuan Chen
- Department of Nuclear Medicine, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Medical Imaging and Radiological Sciences, Central Taiwan, University of Science and Technology, Taichung, Taiwan
| | - Ching-Feng Huang
- Department of Neurology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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18
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Coutinho AMN, Porto FHG, Duran FLS, Prando S, Ono CR, Feitosa EAAF, Spíndola L, de Oliveira MO, do Vale PHF, Gomes HR, Nitrini R, Brucki SMD, Buchpiguel CA. Brain metabolism and cerebrospinal fluid biomarkers profile of non-amnestic mild cognitive impairment in comparison to amnestic mild cognitive impairment and normal older subjects. ALZHEIMERS RESEARCH & THERAPY 2015; 7:58. [PMID: 26373380 PMCID: PMC4572657 DOI: 10.1186/s13195-015-0143-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/18/2015] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is classically considered a transitional stage between normal aging and dementia. Non-amnestic MCI (naMCI) patients, however, typically demonstrate cognitive deficits other than memory decline. Furthermore, as a group, naMCI have a lower rate of an eventual dementia diagnosis as compared to amnestic subtypes of MCI (aMCI). Unfortunately, studies investigating biomarker profiles of naMCI are scarce. The study objective was to investigate the regional brain glucose metabolism (rBGM) with [18F]FDG-PET and cerebrospinal fluid (CSF) biomarkers in subjects with naMCI as compared to a control group (CG) and aMCI subjects. METHODS Ninety-five patients were included in three different groups: naMCI (N = 32), aMCI (N = 33) and CG (N = 30). Patients underwent brain MRI and [18F]FDG-PET. A subsample (naMCI = 26, aMCI = 28) also had an assessment of amyloid-β, tau, and phosphorylated tau levels in the CSF. RESULTS Both MCI groups had lower rBGM in relation to the CG in the precuneus. Subjects with naMCI showed decreased right prefrontal metabolism as well as higher levels of CSF amyloid-β relative to aMCI subjects. CONCLUSION While amnestic MCI subjects showed a biomarker profile classically related to MCI due to Alzheimer's disease, naMCI patients illustrated a decrease in both prefrontal hypometabolism and higher CSF amyloid-β levels relative to the aMCI group. These biomarker findings indicate that naMCI is probably a heterogeneous group with similar precuneus hypometabolism compared to aMCI, but additional frontal hypometabolism and less amyloid-β deposition in the brain. Clinical follow-up and reappraisal of biomarkers of the naMCI group is needed to determine the outcome and probable etiological diagnosis.
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Affiliation(s)
- Artur M N Coutinho
- Department of Radiology/Nuclear Medicine Center/LIM43, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Trav. Ovídio Pires de Campos S/N, prédio do Centro de Medicina Nuclear, 2 andar - LIM43, Cerqueira Cesar, São Paulo, CEP 05403-010, Brazil.
| | - Fábio H G Porto
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Fabio L S Duran
- Department of Psychiatry - R. Dr. Ovídio Pires de Campos, São Paulo, 785 CEP 01060-970, Brazil.
| | - Silvana Prando
- Department of Radiology/Nuclear Medicine Center/LIM43, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Trav. Ovídio Pires de Campos S/N, prédio do Centro de Medicina Nuclear, 2 andar - LIM43, Cerqueira Cesar, São Paulo, CEP 05403-010, Brazil.
| | - Carla R Ono
- Department of Radiology/Nuclear Medicine Center/LIM43, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Trav. Ovídio Pires de Campos S/N, prédio do Centro de Medicina Nuclear, 2 andar - LIM43, Cerqueira Cesar, São Paulo, CEP 05403-010, Brazil.
| | - Esther A A F Feitosa
- Department of Radiology/Nuclear Medicine Center/LIM43, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Trav. Ovídio Pires de Campos S/N, prédio do Centro de Medicina Nuclear, 2 andar - LIM43, Cerqueira Cesar, São Paulo, CEP 05403-010, Brazil.
| | - Lívia Spíndola
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Maira O de Oliveira
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Patrícia H F do Vale
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Helio R Gomes
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Ricardo Nitrini
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Sonia M D Brucki
- Department of Neurology...Av. Dr. Enéas de Carvalho Aguiar, São Paulo, 255 CEP 05403-900, Brazil.
| | - Carlos A Buchpiguel
- Department of Radiology/Nuclear Medicine Center/LIM43, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo,Trav. Ovídio Pires de Campos S/N, prédio do Centro de Medicina Nuclear, 2 andar - LIM43, Cerqueira Cesar, São Paulo, CEP 05403-010, Brazil.
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Reis C, Wang Y, Akyol O, Ho WM, Ii RA, Stier G, Martin R, Zhang JH. What's New in Traumatic Brain Injury: Update on Tracking, Monitoring and Treatment. Int J Mol Sci 2015; 16:11903-65. [PMID: 26016501 PMCID: PMC4490422 DOI: 10.3390/ijms160611903] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 05/04/2015] [Accepted: 05/06/2015] [Indexed: 12/11/2022] Open
Abstract
Traumatic brain injury (TBI), defined as an alteration in brain functions caused by an external force, is responsible for high morbidity and mortality around the world. It is important to identify and treat TBI victims as early as possible. Tracking and monitoring TBI with neuroimaging technologies, including functional magnetic resonance imaging (fMRI), diffusion tensor imaging (DTI), positron emission tomography (PET), and high definition fiber tracking (HDFT) show increasing sensitivity and specificity. Classical electrophysiological monitoring, together with newly established brain-on-chip, cerebral microdialysis techniques, both benefit TBI. First generation molecular biomarkers, based on genomic and proteomic changes following TBI, have proven effective and economical. It is conceivable that TBI-specific biomarkers will be developed with the combination of systems biology and bioinformation strategies. Advances in treatment of TBI include stem cell-based and nanotechnology-based therapy, physical and pharmaceutical interventions and also new use in TBI for approved drugs which all present favorable promise in preventing and reversing TBI.
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Affiliation(s)
- Cesar Reis
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
| | - Yuechun Wang
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, 11041 Campus Street, Risley Hall, Room 219, Loma Linda, CA 92354, USA.
- Department of Physiology, School of Medicine, University of Jinan, Guangzhou 250012, China.
| | - Onat Akyol
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, 11041 Campus Street, Risley Hall, Room 219, Loma Linda, CA 92354, USA.
| | - Wing Mann Ho
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, 11041 Campus Street, Risley Hall, Room 219, Loma Linda, CA 92354, USA.
- Department of Neurosurgery, University Hospital Innsbruck, Tyrol 6020, Austria.
| | - Richard Applegate Ii
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
| | - Gary Stier
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
| | - Robert Martin
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
| | - John H Zhang
- Department of Anesthesiology, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
- Department of Physiology and Pharmacology, Loma Linda University School of Medicine, 11041 Campus Street, Risley Hall, Room 219, Loma Linda, CA 92354, USA.
- Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA.
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Garcia-Ptacek S, Cavallin L, Kåreholt I, Kramberger MG, Winblad B, Jelic V, Eriksdotter M. Subjective cognitive impairment subjects in our clinical practice. Dement Geriatr Cogn Dis Extra 2014; 4:419-30. [PMID: 25538726 PMCID: PMC4264484 DOI: 10.1159/000366270] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The clinical challenge in subjective cognitive impairment (SCI) is to identify which individuals will present cognitive decline. We created a statistical model to determine which variables contribute to SCI and mild cognitive impairment (MCI) versus Alzheimer's disease (AD) diagnoses. Methods A total of 993 subjects diagnosed at a memory clinic (2007-2009) were included retrospectively: 433 with SCI, 373 with MCI and 187 with AD. Descriptive statistics were provided. A logistic regression model analyzed the likelihood of SCI and MCI patients being diagnosed with AD, using age, gender, Mini-Mental State Examination score, the ratio of β-amyloid 42 divided by total tau, and phosphorylated tau as independent variables. Results The SCI subjects were younger (57.8 ± 8 years) than the MCI (64.2 ± 10.6 years) and AD subjects (70.1 ± 9.7 years). They were more educated, had less medial temporal lobe atrophy (MTA) and frequently normal cerebrospinal fluid biomarkers. Apolipoprotein E4/E4 homozygotes and apolipoprotein E3/E4 heterozygotes were significantly less frequent in the SCI group (6 and 36%) than in the AD group (28 and 51%). Within the regression model, cardiovascular risk factors, confluent white matter lesions, MTA and central atrophy increased the AD likelihood for SCI subjects. Conclusions SCI patients form a distinct group. In our model, factors suggesting cardiovascular risk, MTA and central atrophy increased the AD likelihood for SCI subjects.
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Affiliation(s)
- Sara Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Sweden ; Department of Neurology, Hospital Clínico San Carlos, Ljubljana, Slovenia ; Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Lena Cavallin
- Department of Clinical Science, Intervention and Technology, Care Sciences and Society, Karolinska Institutet, Sweden ; Department of Radiology, Karolinska University Hospital, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet and Stockholm University, Sweden ; Institute for Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Milica Gregoric Kramberger
- Karolinska Institutet Alzheimer Disease Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden ; Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Bengt Winblad
- Department of Neurology, University Medical Centre, Ljubljana, Slovenia
| | - Vesna Jelic
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, Sweden
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21
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Al-Bachari S, Parkes LM, Vidyasagar R, Hanby MF, Tharaken V, Leroi I, Emsley HCA. Arterial spin labelling reveals prolonged arterial arrival time in idiopathic Parkinson's disease. NEUROIMAGE-CLINICAL 2014; 6:1-8. [PMID: 25379411 PMCID: PMC4215519 DOI: 10.1016/j.nicl.2014.07.014] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 07/24/2014] [Accepted: 07/29/2014] [Indexed: 12/30/2022]
Abstract
Idiopathic Parkinson's disease (IPD) is the second most common neurodegenerative disease, yet effective disease modifying treatments are still lacking. Neurodegeneration involves multiple interacting pathological pathways. The extent to which neurovascular mechanisms are involved is not well defined in IPD. We aimed to determine whether novel magnetic resonance imaging (MRI) techniques, including arterial spin labelling (ASL) quantification of cerebral perfusion, can reveal altered neurovascular status (NVS) in IPD. Fourteen participants with IPD (mean ± SD age 65.1 ± 5.9 years) and 14 age and cardiovascular risk factor matched control participants (mean ± SD age 64.6 ± 4.2 years) underwent a 3T MRI scan protocol. ASL images were collected before, during and after a 6 minute hypercapnic challenge. FLAIR images were used to determine white matter lesion score. Quantitative images of cerebral blood flow (CBF) and arterial arrival time (AAT) were calculated from the ASL data both at rest and during hypercapnia. Cerebrovascular reactivity (CVR) images were calculated, depicting the change in CBF and AAT relative to the change in end-tidal CO2. A significant (p = 0.005) increase in whole brain averaged baseline AAT was observed in IPD participants (mean ± SD age 1532 ± 138 ms) compared to controls (mean ± SD age 1335 ± 165 ms). Voxel-wise analysis revealed this to be widespread across the brain. However, there were no statistically significant differences in white matter lesion score, CBF, or CVR between patients and controls. Regional CBF, but not AAT, in the IPD group was found to correlate positively with Montreal cognitive assessment (MoCA) scores. These findings provide further evidence of alterations in NVS in IPD. Investigation of neurovascular status (NVS) in IPD using arterial spin labelling Diffuse prolonged arterial arrival time in IPD compared to controls Reduced regional CBF in the IPD group correlated with cognitive impairment. Clinical evidence of altered NVS in IPD warrants further research.
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Key Words
- 3T, 3 Tesla
- AAT, arterial arrival time
- AD, Alzheimer’s disease
- ASL, arterial spin labelling
- Arterial arrival time
- Arterial spin labelling
- CBF, cerebral blood flow
- CO2, carbon dioxide
- CV, cerebrovascular
- CVD, cerebrovascular disease
- CVR, cerebrovascular reactivity
- CVRAAT, cerebrovascular reactivity measures of arterial arrival time
- CVRCBF, cerebrovascular reactivity measures of cerebral blood flow
- Cerebral blood flow
- Cerebrovascular reactivity
- DS, digit span
- DSST, digit symbol substitution test
- DWMH, deep white matter hyperintensity
- EPI, echo planar imaging
- ETCO2, end-tidal carbon dioxide
- FAS, (verbal) fluency assessment scale
- FLAIR, fluid attenuation inversion recovery
- FWE, family-wise error
- HAM-D, Hamilton depression rating scale
- IPD, idiopathic Parkinson's disease
- Idiopathic Parkinson's disease
- L-dopa, levodopa
- LARS, Lille apathy rating scale
- LEDD, levodopa equivalent daily dose
- MCI, mild cognitive impairment
- MRI, magnetic resonance imaging
- MoCA
- MoCA, Montreal cognitive assessment
- NPI, neuropsychiatric inventory
- NVU, Neurovascular unit
- O2−, oxygen
- PET, positron emission tomography
- PIGD, Postural instability and gait disorder
- PL, parietal lobe
- PVH, periventricular hyperintensity
- ROI, region of interest
- SPECT, single positron emission computed tomography
- SPM, statistical parametric mapping
- STAR, signal targeting with alternating radiofrequency
- TD, tremor dominant
- TE, echo time
- TI, inversion time
- TL, temporal lobe
- TMT-B, trail making test B
- TR, repetition time
- UKPDS BB, United Kingdom Parkinson's Disease Society Brain Bank
- UPDRS, Unified Parkinson's disease Rating Scale
- WAIS-R, Wechsler adult intelligence scale-revised
- WML, white matter lesion
- fMRI, functional magnetic resonance imaging
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Affiliation(s)
- Sarah Al-Bachari
- Department of Neurology, Royal Preston Hospital, Preston, UK ; Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Laura M Parkes
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Rishma Vidyasagar
- Centre for Imaging Science, Institute of Population Health, University of Manchester, UK
| | - Martha F Hanby
- Department of Neurology, Royal Preston Hospital, Preston, UK
| | - Vivek Tharaken
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Iracema Leroi
- Institute of Brain, Behaviour and Mental Health, University of Manchester, UK
| | - Hedley C A Emsley
- Department of Neurology, Royal Preston Hospital, Preston, UK ; School of Medicine, University of Manchester, UK
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Raji CA, Tarzwell R, Pavel D, Schneider H, Uszler M, Thornton J, van Lierop M, Cohen P, Amen DG, Henderson T. Clinical utility of SPECT neuroimaging in the diagnosis and treatment of traumatic brain injury: a systematic review. PLoS One 2014; 9:e91088. [PMID: 24646878 PMCID: PMC3960124 DOI: 10.1371/journal.pone.0091088] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 02/10/2014] [Indexed: 12/14/2022] Open
Abstract
Purpose This systematic review evaluated the clinical utility of single photon emission computed tomography (SPECT) in traumatic brain injury (TBI). Methods After defining a PICO Statement (Population, Intervention, Comparison and Outcome Statement), PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria were applied to identify 1600 articles. After screening, 374 articles were eligible for review. Inclusion for review was focus on SPECT in the setting of mild, moderate, or severe TBI with cerebral lobar specificity of SPECT findings. Other inclusion criteria were comparison modalities in the same subjects and articles in English. Foreign language articles, SPECT studies that did not include comparison modalities, and case reports were not included for review. Results We identified 19 longitudinal and 52 cross-sectional studies meeting inclusion criteria. Three longitudinal studies examined diagnostic predictive value. The first showed positive predictive value increases from initial SPECT scan shortly after trauma to one year follow up scans, from 59% to 95%. Subsequent work replicated these results in a larger cohort. Longitudinal and cross sectional studies demonstrated SPECT lesion localization not detected by CT or MRI. The most commonly abnormal regions revealed by SPECT in cross-sectional studies were frontal (94%) and temporal (77%) lobes. SPECT was found to outperform both CT and MRI in both acute and chronic imaging of TBI, particularly mild TBI. It was also found to have a near 100% negative predictive value. Conclusions This review demonstrates Level IIA evidence (at least one non-randomized controlled trial) for the value of SPECT in TBI. Given its advantages over CT and MRI in the detection of mild TBI in numerous studies of adequate quality, and given its excellent negative predictive value, it may be an important second test in settings where CT or MRI are negative after a closed head injury with post-injury neurological or psychiatric symptoms.
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Affiliation(s)
- Cyrus A. Raji
- UCLA Medical Center, Los Angeles, California, United States of America
| | - Robert Tarzwell
- University of British Columbia School of Medicine, Vancouver, British Columbia, Canada
| | - Dan Pavel
- PathFinder Brain SPECT, Deerfield, Illinois, United States of America
| | | | - Michael Uszler
- St. Johns Health Center, Santa Monica, California, United States of America
| | - John Thornton
- Rossiter-Thornton Associates, Toronto, Ontario, Canada
| | | | - Phil Cohen
- Lions Gate Hospital, Vancouver, British Columbia, Canada
| | - Daniel G. Amen
- Amen Clinics, Inc., Newport Beach, California, United States of America
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Vlček K, Laczó J. Neural correlates of spatial navigation changes in mild cognitive impairment and Alzheimer's disease. Front Behav Neurosci 2014; 8:89. [PMID: 24672452 PMCID: PMC3955968 DOI: 10.3389/fnbeh.2014.00089] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Accepted: 03/01/2014] [Indexed: 11/13/2022] Open
Abstract
Although the memory impairment is a hallmark of Alzheimer's disease (AD), AD has also been characterized by spatial disorientation, which is present from its early stages. Spatial disorientation in AD manifests itself in getting lost in familiar and unfamiliar places and have been characterized more specifically using spatial navigation tests in both real space and virtual environments as an impairment in multiple spatial abilities, including allocentric and egocentric navigation strategies, visuo-spatial perception, or selection of relevant information for successful navigation. Patients suffering mild cognitive impairment (MCI), who are at a high risk of development of dementia, show impairment in a subset of these abilities, mainly connected with allocentric and egocentric processing. While spatial disorientation in typical AD patients probably reflects neurodegenerative changes in medial and posterior temporal, parietal, and frontal lobes, and retrosplenial cortex, the impairment of spatial navigation in MCI seem to be connected mainly with the medial temporal and also parietal brain changes. In this review, we will summarize the signs of brain disease in most MCI and AD patients showing in various tasks of spatial memory and navigation.
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Affiliation(s)
- Kamil Vlček
- Department of Neurophysiology of Memory, Institute of Physiology, Academy of Sciences of the Czech Republic , Prague , Czech Republic ; International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic
| | - Jan Laczó
- International Clinical Research Center, St. Anne's University Hospital Brno , Brno , Czech Republic ; Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital , Prague , Czech Republic
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24
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Damian M, Hausner L, Jekel K, Richter M, Froelich L, Almkvist O, Boada M, Bullock R, De Deyn PP, Frisoni GB, Hampel H, Jones RW, Kehoe P, Lenoir H, Minthon L, Olde Rikkert MGM, Rodriguez G, Scheltens P, Soininen H, Spiru L, Touchon J, Tsolaki M, Vellas B, Verhey FRJ, Winblad B, Wahlund LO, Wilcock G, Visser PJ. Single-domain amnestic mild cognitive impairment identified by cluster analysis predicts Alzheimer's disease in the european prospective DESCRIPA study. Dement Geriatr Cogn Disord 2014; 36:1-19. [PMID: 23651945 DOI: 10.1159/000348354] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS To identify prodromal Alzheimer's disease (AD) subjects using a data-driven approach to determine cognitive profiles in mild cognitive impairment (MCI). METHODS A total of 881 MCI subjects were recruited from 20 memory clinics and followed for up to 5 years. Outcome measures included cognitive variables, conversion to AD, and biomarkers (e.g. CSF, and MRI markers). Two hierarchical cluster analyses (HCA) were performed to identify clusters of subjects with distinct cognitive profiles. The first HCA included all subjects with complete cognitive data, whereas the second one selected subjects with very mild MCI (MMSE ≥28). ANOVAs and ANCOVAs were computed to examine whether the clusters differed with regard to conversion to AD, and to AD-specific biomarkers. RESULTS The HCAs identified 4-cluster solutions that best reflected the sample structure. One cluster (aMCIsingle) had a significantly higher conversion rate (19%), compared to subjective cognitive impairment (SCI, p < 0.0001), and non-amnestic MCI (naMCI, p = 0.012). This cluster was the only one showing a significantly different biomarker profile (Aβ42, t-tau, APOE ε4, and medial temporal atrophy), compared to SCI or naMCI. CONCLUSION In subjects with mild MCI, the single-domain amnestic MCI profile was associated with the highest risk of conversion, even if memory impairment did not necessarily cross specific cut-off points. A cognitive profile characterized by isolated memory deficits may be sufficient to warrant applying prevention strategies in MCI, whether or not memory performance lies below specific z-scores. This is supported by our preliminary biomarker analyses. However, further analyses with bigger samples are needed to corroborate these findings.
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Affiliation(s)
- Marinella Damian
- Department of Geriatric Psychiatry, Clinic of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany.
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Chincarini A, Bosco P, Gemme G, Esposito M, Rei L, Squarcia S, Bellotti R, Minthon L, Frisoni G, Scheltens P, Frölich L, Soininen H, Visser PJ, Nobili F. Automatic temporal lobe atrophy assessment in prodromal AD: Data from the DESCRIPA study. Alzheimers Dement 2013; 10:456-467. [PMID: 24035058 DOI: 10.1016/j.jalz.2013.05.1774] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 05/10/2013] [Accepted: 05/23/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND In the framework of the clinical validation of research tools, this investigation presents a validation study of an automatic medial temporal lobe atrophy measure that is applied to a naturalistic population sampled from memory clinic patients across Europe. METHODS The procedure was developed on 1.5-T magnetic resonance images from the Alzheimer's Disease Neuroimaging Initiative database, and it was validated on an independent data set coming from the DESCRIPA study. All images underwent an automatic processing procedure to assess tissue atrophy that was targeted at the hippocampal region. For each subject, the procedure returns a classification index. Once provided with the clinical assessment at baseline and follow-up, subjects were grouped into cohorts to assess classification performance. Each cohort was divided into converters (co) and nonconverters (nc) depending on the clinical outcome at follow-up visit. RESULTS We found the area under the receiver operating characteristic curve (AUC) was 0.81 for all co versus nc subjects, and AUC was 0.90 for subjective memory complaint (SMCnc) versus all co subjects. Furthermore, when training on mild cognitive impairment (MCI-nc/MCI-co), the classification performance generally exceeds that found when training on controls versus Alzheimer's disease (CTRL/AD). CONCLUSIONS Automatic magnetic resonance imaging analysis may assist clinical classification of subjects in a memory clinic setting even when images are not specifically acquired for automatic analysis.
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Affiliation(s)
- Andrea Chincarini
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy.
| | - Paolo Bosco
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Gianluca Gemme
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy
| | - Mario Esposito
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Luca Rei
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Sandro Squarcia
- Istituto Nazionale di Fisica Nucleare, Sezione di Genova, Genova, Italy; Dipartimento di Fisica, Università degli Studi di Genova, Genova, Italy
| | - Roberto Bellotti
- Dipartimento Interateneo di Fisica "M. Merlin" and TIRES, Università degli Studi di Bari, Bari, Italy; Istituto Nazionale di Fisica Nucleare, Sezione di Bari, Bari, Italy
| | - Lennart Minthon
- Clinical Memory Research Unit, Department of Clinical Sciences, Malmö Lund University, Malmo, Sweden
| | - Giovanni Frisoni
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands
| | - Lutz Frölich
- Department of Geriatric Psychiatry, Zentralinstitut für Seelische Gesundheit, University of Heidelberg, Mannheim, Germany
| | - Hilkka Soininen
- Department of Neurology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Pieter-Jelle Visser
- Alzheimer Centre, Department of Neurology, VU University Medical Centre, Amsterdam, The Netherlands; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Flavio Nobili
- Neurofisiologia Clinica, Dipartimento di Neuroscienze, Oftalmologia e Genetica, Azienda Ospedale-Università S. Martino, Genova, Italy
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Soucy JP, Bartha R, Bocti C, Borrie M, Burhan AM, Laforce R, Rosa-Neto P. Clinical applications of neuroimaging in patients with Alzheimer's disease: a review from the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia 2012. Alzheimers Res Ther 2013; 5:S3. [PMID: 24565260 PMCID: PMC3980588 DOI: 10.1186/alzrt199] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In May 2012, the Fourth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia brought together in Montreal experts from around Canada to update Canadian recommendations for the diagnosis and management of patients with neurodegenerative conditions associated with deterioration of cognition. Multiple topics were discussed. The present paper is a highly condensed version of those recommendations that were produced to support discussions in the field of neuroimaging for clinical diagnosis of those conditions.
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Affiliation(s)
- Jean-Paul Soucy
- PET Unit, McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, 3801 University Street, Montreal, Quebec, Canada H3A 2B4
| | - Robert Bartha
- Robarts Research Institute, Western University, London, Ontario, Canada
| | - Christian Bocti
- Service de Neurologie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Michael Borrie
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
| | - Amer M Burhan
- Department of Medicine, Division of Geriatric Medicine, Western University, London, Ontario, Canada
| | - Robert Laforce
- Clinique Interdisciplinaire de Mémoire, Département des Sciences Neurologiques, CHU de Québec, Université Lava, Quebec, Quebec, Canada
| | - Pedro Rosa-Neto
- Translational Neuroinmaging Laboratory, McGill Centre for Studies in Aging, Douglas Research Institute, McGill University, Montreal, Quebec, Canada
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Garcia-Ptacek S, Eriksdotter M, Jelic V, Porta-Etessam J, Kåreholt I, Manzano Palomo S. Subjective cognitive impairment: Towards early identification of Alzheimer disease. Neurologia 2013; 31:562-71. [PMID: 23601758 DOI: 10.1016/j.nrl.2013.02.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Revised: 02/13/2013] [Accepted: 02/17/2013] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Neurodegeneration in Alzheimer disease (AD) begins decades before dementia and patients with mild cognitive impairment (MCI) already demonstrate significant lesion loads. Lack of information about the early pathophysiology in AD complicates the search for therapeutic strategies.Subjective cognitive impairment is the description given to subjects who have memory-related complaints without pathological results on neuropsychological tests. There is no consensus regarding this heterogeneous syndrome, but at least some of these patients may represent the earliest stage in AD. METHOD We reviewed available literature in order to summarise current knowledge on subjective cognitive impairment. RESULTS Although they may not present detectable signs of disease, SCI patients as a group score lower on neuropsychological tests than the general population does, and they also have a higher incidence of future cognitive decline. Depression and psychiatric co-morbidity play a role but cannot account for all cognitive complaints. Magnetic resonance imaging studies in these patients reveal a pattern of hippocampal atrophy similar to that of amnestic mild cognitive impairment and functional MRI shows increased activation during cognitive tasks which might indicate compensation for loss of function. Prevalence of an AD-like pattern of beta-amyloid (Aβ42) and tau proteins in cerebrospinal fluid is higher in SCI patients than in the general population. CONCLUSIONS Memory complaints are relevant symptoms and may predict AD. Interpatient variability and methodological differences between clinical studies make it difficult to assign a definition to this syndrome. In the future, having a standard definition and longitudinal studies with sufficient follow-up times and an emphasis on quantifiable variables may clarify aspects of early AD.
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Affiliation(s)
- S Garcia-Ptacek
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Estocolmo, Suecia.
| | - M Eriksdotter
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Estocolmo, Suecia; Department of Geriatric Medicine, Karolinska University Hospital, Karolinska Institutet/Stockholm University, Estocolomo, Suecia
| | - V Jelic
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Estocolmo, Suecia; Department of Geriatric Medicine, Karolinska University Hospital, Karolinska Institutet/Stockholm University, Estocolomo, Suecia
| | - J Porta-Etessam
- Servicio de Neurología, Hospital Clínico San Carlos, Madrid, España
| | - I Kåreholt
- Aging Research Center, Karolinska Institutet and Stockholm University, Estocolmo, Suecia; Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Suecia
| | - S Manzano Palomo
- Servicio de Neurología, Hospital Infanta Cristina, Parla, Madrid, España
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Venero C, Díaz-Mardomingo C, Pereda-Pérez I, García-Herranz S, Utrera L, Valencia A, Peraita H. Increased morning salivary cortisol levels in older adults with nonamnestic and multidomain mild cognitive impairment. Psychoneuroendocrinology 2013; 38:488-98. [PMID: 22857785 DOI: 10.1016/j.psyneuen.2012.07.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 07/10/2012] [Accepted: 07/10/2012] [Indexed: 01/24/2023]
Abstract
Exposure to elevated glucocorticoid levels has a detrimental impact on cognitive function. In the present study, elderly individuals were classified according to their cognitive status to (i) cognitively healthy; (ii) amnestic; (iii) nonamnestic; or (iv) multidomain, with an extensive cognitive profiling. Salivary cortisol samples were taken at awakening, evening and night. We report that, compared to cognitively normal control individuals, subjects with nonamnestic or multidomain mild cognitive impairment profiles show increased salivary cortisol levels, immediately after awakening, but not in the evening or at night. Importantly, individuals with amnestic mild cognitive impairment did not show this increase in salivary cortisol levels. We also found that higher morning cortisol levels were associated with a lower global cognitive state, as well as poorer score in executive function and visuoconstructive praxes, verbal fluency, and a worse free immediate recall of items from a word list. These findings open new avenues to the use of salivary cortisol levels as a possible biomarker for nonamnestic and multidomain mild cognitive impairment in elderly subjects.
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Affiliation(s)
- César Venero
- Department of Psychobiology, Universidad Nacional de Educación a Distancia, Madrid, Spain.
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Missonnier P, Herrmann FR, Richiardi J, Rodriguez C, Deiber MP, Gold G, Giannakopoulos P. Attention-Related Potentials Allow for a Highly Accurate Discrimination of Mild Cognitive Impairment Subtypes. NEURODEGENER DIS 2013; 12:59-70. [DOI: 10.1159/000338815] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 04/16/2012] [Indexed: 11/19/2022] Open
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The diagnosis and evaluation of dementia and mild cognitive impairment with emphasis on SPECT perfusion neuroimaging. CNS Spectr 2012; 17:176-206. [PMID: 22929226 DOI: 10.1017/s1092852912000636] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As the world population ages, the incidence of dementing illnesses will dramatically increase. The number of people afflicted with dementia is expected to quadruple in the next 50 years. Since the neuropathology of the dementias precedes clinical symptoms often by several years, earlier detection and intervention could be key steps to mitigating the progression and burden of these diseases. This review will explore methods of evaluating, differentiating, and diagnosing the multiple forms of dementia. Particular emphasis will be placed on the diagnosis of mild cognitive impairment-the precursor to dementia. Anatomical imaging; cerebrospinal fluid markers; functional neuroimaging, such as positron emission tomography and single photon emission tomography; and molecular imaging, such as amyloid marker imaging, will be assessed in terms of sensitivity and specificity. Cost will also be a consideration, as the growing population afflicted with dementia represents an increasingly large financial encumbrance to the healthcare systems of every nation. In the face of expensive new markers and limited availability of cyclotrons, single photon emission computer tomography (SPECT) provides relatively high sensitivity and specificity at a comparatively low overall cost.
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Stomrud E, Forsberg A, Hägerström D, Ryding E, Blennow K, Zetterberg H, Minthon L, Hansson O, Londos E. CSF biomarkers correlate with cerebral blood flow on SPECT in healthy elderly. Dement Geriatr Cogn Disord 2012; 33:156-63. [PMID: 22722670 DOI: 10.1159/000338185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The preclinical patterns of biological markers for Alzheimer's disease (AD) in vivo need further exploration. The aim of this study was therefore to investigate CSF biomarkers, regional cerebral blood flow (rCBF) and cognitive performance in cognitively healthy older individuals. METHOD Within a 2-week period, 32 cognitively healthy older individuals underwent CSF analysis, rCBF measurement and cognitive testing. The CSF was analysed for β-amyloid(1-42) (Aβ42), total tau protein (T-tau) and hyperphosphorylated tau protein (P-tau). The rCBF results were analysed with statistical parametric mapping to investigate rCBF covariance with the other measurements. RESULTS High CSF P-tau and T-tau levels correlated with decreased rCBF in the right superior posterior medial frontal lobe whereas high CSF P-tau levels also correlated with increased rCBF in the left fronto-temporal border zone area. No significant covariance was seen between rCBF and CSF Aβ42. Neither CSF P-tau and T-tau levels nor rCBF in the current right frontal and left posterior locations were associated with cognitive performance. CONCLUSIONS Our findings suggest a possible correlation between tau pathology and blood flow abnormalities in individuals without any overt cognitive symptoms. An association with AD development is possible but other explanatory mechanisms cannot be excluded.
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Affiliation(s)
- Erik Stomrud
- Clinical Memory Research Unit, Department of Clinical Sciences Malmo, Lund University, Malmo, Sweden.
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Alegret M, Cuberas-Borrós G, Vinyes-Junqué G, Espinosa A, Valero S, Hernández I, Roca I, Ruíz A, Rosende-Roca M, Mauleón A, Becker JT, Castell-Conesa J, Tárraga L, Boada M. A two-year follow-up of cognitive deficits and brain perfusion in mild cognitive impairment and mild Alzheimer's disease. J Alzheimers Dis 2012; 30:109-20. [PMID: 22406443 DOI: 10.3233/jad-2012-111850] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The 15-Objects Test (15-OT) provides useful gradation of visuoperceptual impairment from normal aging through Alzheimer's disease (AD) and correlates with temporo-parietal perfusion. The objectives of this study were to analyze progression of 15-OT performance in mild cognitive impairment (MCI) and AD, and its correlates with cognition and single photon emission computerized tomography (SPECT), as well as to examine neuropsychological and SPECT differences between the MCI patients who developed AD and those who did not. From the initial 126 participants (42/group), 38 AD, 39 MCI, and 38 elderly controls (EC) were reassessed (SPECT: 35 AD, 33 MCI, 35 EC) after two years. The progression of cognitive and SPECT scores during this period was compared between groups, and baseline data between converters and non-converters. The 15-OT was the only measure of progression that differed between the three groups; worsening scores on 15-OT were associated with worsening in verbal and visual retention, and decreased perfusion on left postsubicular area. In the MCI patients, cerebral perfusion fell over the two years in medial-posterior cingulate and fronto-temporo-parietal regions; AD showed extensive changes involving almost all cerebral regions. No SPECT changes were detected in controls. At baseline, the MCI patients who developed AD differed from non-converters in verbal recognition memory, but not in SPECT perfusion. In conclusion, SPECT and 15-OT appear to provide a potential measure to differentiate between normal aging, MCI, and AD. Worsening on 15-OT was related to decreased perfusion in postsubicular area; but further longitudinal studies are needed to determine the contribution of 15-OT as a predictor of AD from MCI.
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Affiliation(s)
- Montserrat Alegret
- Memory Clinic of Fundació ACE, Institut Català de Neurociències Aplicades, C/Marquès de Sentmenat 35-37, Barcelona, Spain.
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Yoon HJ, Park KW, Jeong YJ, Kang DY. Correlation between neuropsychological tests and hypoperfusion in MCI patients: anatomical labeling using xjView and Talairach Daemon Software. Ann Nucl Med 2012; 26:656-64. [DOI: 10.1007/s12149-012-0625-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 06/18/2012] [Indexed: 10/28/2022]
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Significant correlation between cerebral hypoperfusion and neuropsychological assessment scores of patients with mild cognitive impairment. Nucl Med Commun 2012; 33:848-58. [PMID: 22692580 DOI: 10.1097/mnm.0b013e32835587f8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The regions of significant correlation between cerebral hypoperfusion and neuropsychological assessment scores were evaluated using (99m)Tc-HMPAO SPECT in patients with mild cognitive impairment (MCI) on the basis of its three subtypes, namely, single-domain amnestic MCI (aMCI-s), multiple-domain amnestic MCI (aMCI-m), and nonamnestic MCI (naMCI), following which comparisons were made among the three subtypes of MCI. METHODS Regions of hypoperfusion were determined by comparing the three groups with the normal group. Neuropsychological assessment included tests to evaluate attention, language and related functions, visuospatial function, memory, frontal-executive function, and mini-mental state examination and depression scores. Regions of cerebral hypoperfusion were identified by comparing the three groups of MCI patients with the normal group (P<0.05, uncorrected). One-way analysis of variance was used to examine differences across groups, and post-hoc a-priori pairwise comparisons were used for between-group analyses. The regions of significant correlation, related to the neuropsychological assessment scores, were identified by simple regression of SPM8 within the masking image of the area of cerebral hypoperfusion (P<0.05, uncorrected). RESULTS The regions of cerebral hypoperfusion were identified by comparing members of the normal group with patients with aMCI-s, aMCI-m, and naMCI. The patients with aMCI-m showed significant correlation with all neuropsychological assessment scores, but the patients with aMCI-s correlated with four neuropsychological assessment scores of attention. The patients with naMCI revealed no significantly correlated regions (P<0.05, uncorrected). The regions that correlated with neuropsychological assessment scores in patients with aMCI-s were very small compared with those in patients with aMCI-m. The correlated regions in patients with aMCI-m were restricted to the left cerebrum and cerebellum. Brain areas showed significant correlation between neuropsychological assessment scores and hypoperfusion, which was evaluated by simple regression with the threshold being P less than 0.05, uncorrected. Rey complex figure test 20 min delayed, Korean-color word stroop test word reading, and Korean mini-mental state examination scores correlated more strongly with cerebral hypoperfusion compared with other assessment scores. CONCLUSION The specific pattern of significant correlation of cerebral hypoperfusion with neuropsychological assessment scores was classified into three subtypes (aMCI-s, aMCI-m, and naMCI) according to the patients' deficits in their cognitive domains.
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Inoue K, Meguro K, Akanuma K, Meguro M, Yamaguchi S, Fukuda H. Impaired memory and executive function associated with decreased medial temporal and prefrontal blood flow in Clinical Dementia Rating 0.5 status: the Osaki-Tajiri project. Psychogeriatrics 2012; 12:27-33. [PMID: 22416826 DOI: 10.1111/j.1479-8301.2011.00384.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The Clinical Dementia Rating (CDR) is an assessment of dementia severity based on observations of activities of daily living, and a CDR of 0.5 (CDR 0.5) represents questionable dementia. A combination of the Cognitive Abilities Screening Instrument (CASI) and the Trail Making Test (TMT) scores discriminated CDR 0.5 subjects from healthy participants with a high degree of accuracy. We investigated the neurological background of CDR 0.5 subjects by correlating CASI and TMT scores with regional cerebral blood flow (rCBF) as measured by single photon emission computed tomography (SPECT). METHODS From a community-based cohort, 22 CDR 0.5 participants were recruited. CASI and TMT scores, rCBF measure using [(123) I]-N-isopropyl-p-iodoamphetamine and SPECT were obtained. We evaluated the relationships between the CASI domain scores, between TMT scores and rCBF in a regions-of-interest-based analysis, and voxel-based analysis using Statistical Parametric Mapping 5 software. RESULTS We found that lower rCBF in the left medial temporal cortex correlated with a decreased CASI domain recent memory score both in the regions-of-interest and statistical parametric mapping analysis. In both the regions-of-interest and statistical parametric mapping analysis, the rCBF in the left prefrontal cortex correlated with CASI domain remote memory and mental manipulation and concentration. CONCLUSIONS Our results indicate that some CDR 0.5 subjects have functional impairments in the medial temporal lobe as well as in the prefrontal cortex, as reflected in the cognitive decline measured by CASI and TMT.
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Affiliation(s)
- Kentaro Inoue
- Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, Sendai, Miyagi, Japan
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Wang B, Guo Q, Zhao Q, Hong Z. Memory deficits for non-amnestic mild cognitive impairment. J Neuropsychol 2012; 6:232-41. [DOI: 10.1111/j.1748-6653.2011.02024.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Jacobs HI, Van Boxtel MP, Jolles J, Verhey FR, Uylings HB. Parietal cortex matters in Alzheimer's disease: An overview of structural, functional and metabolic findings. Neurosci Biobehav Rev 2012; 36:297-309. [DOI: 10.1016/j.neubiorev.2011.06.009] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 06/15/2011] [Accepted: 06/21/2011] [Indexed: 01/18/2023]
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Staffen W, Ladurner G, Höller Y, Bergmann J, Aichhorn M, Golaszewski S, Kronbichler M. Brain activation disturbance for target detection in patients with mild cognitive impairment: an fMRI study. Neurobiol Aging 2011; 33:1002.e1-16. [PMID: 21993055 DOI: 10.1016/j.neurobiolaging.2011.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 08/30/2011] [Accepted: 09/02/2011] [Indexed: 10/16/2022]
Abstract
Functional brain imaging in mild cognitive impairment (MCI) reveals differences in activation of task-relevant brain areas between patients and age-matched healthy controls. However, some studies reported hyperactivation and others hypoactivation in MCI compared with controls. The inconsistencies may be explained by compensatory mechanisms due to high complexity of the applied tasks. The oddball task is a simple paradigm that is known to activate a widespread network in the brain, involving attentional and monitoring mechanisms. In the present study, we examined amnestic or amnestic multidomain MCI patients (n = 12) and healthy controls (n = 13) in an auditory oddball task. Participants had to respond to infrequent targets and inhibit response to infrequent novel-nontarget stimuli. Lower stimulus related activation was found in MCI patients compared with healthy controls in parts of the middle temporal gyrus, the temporal pole, regions along the superior temporal sulcus, in the left cuneus, the left supramarginal gyrus, the anterior cingulated cortex and in the left inferior and middle frontal gyrus. Activation for oddball stimuli is assumed to reflect an automatic reflexive engagement of many brain regions in response to potentially important changes in the environment as well as cognitive control to monitor responses. The mechanisms of attention and cognitive control may be severely impaired in MCI and thus, underlie the cognitive deficits of this clinical group.
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Affiliation(s)
- Wolfgang Staffen
- Department of Neurology, Christian-Doppler-Clinic, Paracelsus Private Medical University, Salzburg, Austria.
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Abstract
Over the past five to ten years, neuroimaging capability for neurodegenerative diseases has made remarkable progress. However, debate remains as to the true clinical utility of these advanced and costly investigations. Not only is the place of these tests in diagnostic algorithms unclear, but the access to them varies both within and between countries. We sought to gather informed opinion from recognized leaders in the field who can combine both an academic and a clinical perspective on the use of neuroimaging in their own countries. Opinion is presented from Scotland, Argentina, the Czech Republic, France, the USA and Australia. The emerging consensus was one of ongoing caution. While in most countries there was a sense that the use of more advanced imaging techniques was growing, their hour has not yet cometh. However, these techniques, rather than falling from the Ivory Tower, should descend slowly step by step onto fertile and receptive clinics from where better clinical guidelines will emerge.
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Edman A, Edenbrandt L, Fredén-Lindqvist J, Nilsson M, Wallin A. Asymmetric cerebral blood flow in patients with mild cognitive impairment: possible relationship to further cognitive deterioration. Dement Geriatr Cogn Dis Extra 2011; 1:228-36. [PMID: 22163247 PMCID: PMC3199881 DOI: 10.1159/000329447] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Aim To explore patterns of cerebral blood flow in patients with mild cognitive impairment (MCI), who (1) eventually deteriorate into overt dementia, with no particular focus on the type of dementia, or (2) do not appear to further deteriorate in their cognitive functions. Methods Thirty-seven MCI patients, with or without vascular pathology, were studied prospectively. The patients underwent 99mTc-HMPAO SPECT analysis at baseline. Possible clinical conversion into dementia within a 2-year period was assessed. Results Nineteen patients had progressive MCI (PMCI), while 18 patients were considered clinically stable (SMCI). PMCI patients had more often abnormally low cerebral blood flow in at least one of the frontal, temporal, parietal or occipital lobes compared to SMCI patients (12/19 vs. 5/18; p = 0.049). At least one of the temporal regions was found to be abnormal in 9 PMCI patients in contrast to only 1 SMCI patient (p = 0.008). More specifically, blood flow in the medial portion of the left temporal region was abnormal in 8 PMCI patients, a pattern seen in 1 SMCI patient only (p = 0.019). Conclusion The results suggest that blood flow reductions particularly in the left medial temporal region indicate an elevated risk of further cognitive decline in MCI patients.
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Affiliation(s)
- Ake Edman
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Malmö, Sweden
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Dalrymple-Alford JC, Livingston L, MacAskill MR, Graham C, Melzer TR, Porter RJ, Watts R, Anderson TJ. Characterizing mild cognitive impairment in Parkinson's disease. Mov Disord 2011; 26:629-36. [DOI: 10.1002/mds.23592] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Revised: 10/26/2010] [Accepted: 11/22/2010] [Indexed: 11/11/2022] Open
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Alegret M, Vinyes-Junqué G, Boada M, Martínez-Lage P, Cuberas G, Espinosa A, Roca I, Hernández I, Valero S, Rosende-Roca M, Mauleón A, Becker And JT, Tárraga L. Brain perfusion correlates of visuoperceptual deficits in mild cognitive impairment and mild Alzheimer's disease. J Alzheimers Dis 2010; 21:557-67. [PMID: 20555146 DOI: 10.3233/jad-2010-091069] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Visuoperceptual processing is impaired early in the clinical course of Alzheimer's disease (AD). The 15-Objects Test (15-OT) detects such subtle performance deficits in mild cognitive impairment (MCI) and mild AD. Reduced brain perfusion in the temporal, parietal, and prefrontal regions have been found in early AD and MCI patients. The objectives of this study were to confirm the role of the 15-OT in the diagnosis of MCI and AD and to investigate the brain perfusion correlates of visuoperceptual dysfunction (15-OT) in subjects with MCI, AD, and normal aging. Forty-two AD, 42 MCI, and 42 healthy elderly control subjects underwent a brain Single Photon Emission Tomography (SPECT) and separately completed the 15-OT. An analysis of variance compared 15-OT scores between groups. SPM5 was used to analyse the SPECT data. 15-OT performance was impaired in the MCI and AD patients. In terms of the SPECT scans, AD patients showed reduced perfusion in temporal-parietal regions, while the MCI subjects had decreased perfusion in the middle and posterior cingulate. When MCI and AD groups were compared, a significant brain perfusion reduction was found in temporo-parietal regions. In the whole sample, 15-OT performance was significantly correlated with the clinical dementia rating scores, and with the perfusion in the bilateral posterior cingulate and the right temporal pole, with no significant correlation in each separate group. Our findings suggest that the 15-OT performance provides a useful gradation of impairment from normal aging to AD, and it seems to be related to perfusion in the bilateral posterior cingulate and the right temporal pole.
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Affiliation(s)
- Montserrat Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.
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Cao X, Guo Q, Zhao Q, Jin L, Fu J, Hong Z. The neuropsychological characteristics and regional cerebral blood flow of vascular cognitive impairment-no dementia. Int J Geriatr Psychiatry 2010; 25:1168-76. [PMID: 20054836 DOI: 10.1002/gps.2458] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the neuropsychological characteristics of VCI-ND and to analyze the relationship between deficit pattern and regional cerebral blood flow (rCBF) in various VCI-ND subtypes defined by cognitive features. METHODS 69 subjects diagnosed with VCI-ND were recruited, then further classified into four subtypes: amnestic VCI-ND with single memory impairment (subtype I, n = 19), amnestic VCI-ND with multi-domain impairment (subtype II, n = 27), non-amnestic VCI-ND with single domain impairment (subtype III, n = 16), and non-amnestic VCI-ND with multi-domain impairment (subtype IV, n = 7) according to their cognitive profile. Xenon-CT scan was administered to 31 VCI-ND patients (11 of subtype I, 12 of subtype II and 8 of subtype III) and 10 normal controls (NC) to evaluate rCBF. RESULTS The rate of different cognitive domains impairment in VCI-ND group ranged from 17 to 66%, lowest in clock drawing test and highest in time of modified version of trails making test A and maze tracing compared with NC, significant reduced rCBF was found in bilateral temporal lobe and thalamus, left periventricular white matter and caudate of subtype I, and in left temporal lobe and lenticular nucleus, bilateral periventricular white matter, white matter adjacent to left posterior horn of lateral ventricular and right caudate of subtype III, while significant reduced rCBF of subtype II was found in left subfrontal white matter, bilateral subtemporoparietal white matter, right lenticular nucleus, and in both regions of subtype I and III. CONCLUSIONS The manifestation of rCBF in VCI-ND subtypes was consistent with performance of neuropsychological assessment.
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Affiliation(s)
- Xinyi Cao
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Fudan University, Shanghai, China
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Bai F, Watson DR, Zhang Z. Hippocampal dysfunction in amnestic-type mild cognitive impairment: implications for predicting Alzheimer’s risk. FUTURE NEUROLOGY 2009. [DOI: 10.2217/fnl.09.36] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Functional MRI is an attractive method for studying cognitive task-related and resting-state patterns of brain activation and connectivity. Since hippocampal dysfunction has been widely reported in patients with amnestic-type mild cognitive impairment (MCI) with Alzheimer’s risk, a number of studies have focused on this region of the brain; these studies are reviewed here. Three principle findings are highlighted: first, impaired hippocampal function relates to disturbances in episodic memory encoding and retrieval in MCI, but possibly in different ways; second, there is evidence of a nonlinear relationship between memory function and hippocampal activity as one progresses through the stages of MCI to Alzheimer’s disease; and third, hippocampal function is intimately related to default mode network mechanisms. Future work should be directed toward extending our understanding of the relationships between hippocampal function in MCI and pathological and cognitive disturbance. This may be a valuable neuroimaging marker in the objective of early detection of the disease processes that presage the development of Alzheimer’s disease.
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Affiliation(s)
- Feng Bai
- School of Clinical Medicine, Southeast University; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Ding Jia Qiao road No. 87, 210009, Nanjing, China
| | - David R Watson
- School of Medicine & Dentistry, Queen’s University Belfast, BT9 7BL, Belfast, UK
| | - Zhijun Zhang
- School of Clinical Medicine, Southeast University; Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Ding Jia Qiao road No. 87, 210009, Nanjing, China
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Visser PJ, Verhey F, Knol DL, Scheltens P, Wahlund LO, Freund-Levi Y, Tsolaki M, Minthon L, Wallin AK, Hampel H, Bürger K, Pirttila T, Soininen H, Rikkert MO, Verbeek MM, Spiru L, Blennow K. Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study. Lancet Neurol 2009; 8:619-27. [PMID: 19523877 DOI: 10.1016/s1474-4422(09)70139-5] [Citation(s) in RCA: 403] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) pathology is common in patients with amnestic mild cognitive impairment (aMCI) without dementia, but the prevalence of AD pathology in patients with subjective cognitive impairment (SCI) and non-amnestic mild cognitive impairment (naMCI) is unknown. AD is characterised by decreased CSF concentrations of Abeta(42) and increased concentrations of tau. We investigated the prevalence of a CSF AD profile in patients with SCI, naMCI, or aMCI and the association of this profile with cognitive outcome in each group. METHODS Patients with SCI, naMCI, aMCI, and neurologically healthy controls were recruited from 20 memory clinics across Europe, between January, 2003, and June, 2005, into this prospective cohort study. A CSF AD profile was defined as an abnormal ratio of Abeta(42):tau. Patients were assessed annually up to 3 years. Outcome measures were changes in memory, overall cognition, mini-mental state examination (MMSE) score, daily function, and progression to AD-type dementia. FINDINGS The CSF AD profile was more common in patients with SCI (31 of 60 [52%]), naMCI (25 of 37 [68%]), and aMCI (56 of 71 [79%]) than in healthy controls (28 of 89 [31%]). The profile was associated with cognitive decline in patients with naMCI (memory, MMSE, and daily function) and in patients with aMCI (MMSE and daily function). In patients with aMCI, a CSF AD profile was predictive of AD-type dementia (OR 26.8, 95% CI 1.6-456.4). INTERPRETATION AD is a common cause of SCI, naMCI, and aMCI and is associated with cognitive decline in patients with naMCI or aMCI. Patients with SCI might be in the early stages of AD, and cognitive decline might become apparent only after longer follow-up. FUNDING European Commission; Ana Aslan International Foundation.
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Affiliation(s)
- Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, University of Maastricht, 6200 MD Maastricht, Netherlands.
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Babiloni C, Visser PJ, Frisoni G, De Deyn PP, Bresciani L, Jelic V, Nagels G, Rodriguez G, Rossini PM, Vecchio F, Colombo D, Verhey F, Wahlund LO, Nobili F. Cortical sources of resting EEG rhythms in mild cognitive impairment and subjective memory complaint. Neurobiol Aging 2008; 31:1787-98. [PMID: 19027196 DOI: 10.1016/j.neurobiolaging.2008.09.020] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2007] [Revised: 09/12/2008] [Accepted: 09/30/2008] [Indexed: 10/21/2022]
Abstract
Are cortical electroencephalographic (EEG) rhythms altered in amnesic and non-amnesic mild cognitive impairment (MCI), subjective memory complaint (SMC), and healthy elderly (Nold) subjects? Eyes-closed resting EEG was recorded in 79 Nold, 53 SMC, 51 non-amnesic MCI, and 92 amnesic MCI subjects. EEG rhythms of interest were delta (2-4 Hz), theta (4-8 Hz), alpha 1 (8-10.5 Hz), alpha 2 (10.5-13 Hz), beta 1 (13-20 Hz), beta 2 (20-30 Hz) and gamma (30-40 Hz). Cortical EEG sources were estimated by standardized low resolution brain electromagnetic tomography (sLORETA). Results showed that (i) the frontal delta sources were greater in amplitude in the amnesic MCI and SMC subjects than in the Nold subjects (p<0.05-0.01); (ii) the parietal and occipital theta sources were lower in amplitude in the SMC subjects than in the Nold subjects (p<0.046); (iii) the occipital theta sources were greater in amplitude in the amnesic MCI subjects than in the SMC and non-amnesic MCI subjects (p<0.02-0.01); (iv) the parietal and occipital alpha 1 sources were greater in amplitude in the Nold subjects than in the SMC, non-amnesic MCI and amnesic MCI subjects (p<0.00001); (v) the central alpha 1 sources were lower in amplitude in the SMC subjects than in the non-amnesic MCI subjects (p<0.002); (vi) the occipital alpha 1 sources were greater in amplitude in the SMC subjects than in the amnesic MCI subjects (p<0.0003); (vii) the parietal and occipital alpha 2 sources were greater in amplitude in the Nold subjects than in the non-amnesic MCI subjects (p<0.041-0.0004); (viii) the occipital alpha 2 sources were greater in the SMC subjects than in the non-amnesic MCI subjects (p<0.02). These results suggest that amnesic MCI and SMC subjects present some of the typical alterations of brain neural synchronization as revealed by resting cortical EEG rhythms in Alzheimer's disease patients.
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