1
|
Webber TA, Lorkiewicz S, Woods SP, Miller B, Soble JR. Does neuropsychological intraindividual variability index cognitive dysfunction, an invalid presentation, or both? Preliminary findings from a mixed clinical older adult veteran sample. J Clin Exp Neuropsychol 2024:1-22. [PMID: 39120111 DOI: 10.1080/13803395.2024.2388096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024]
Abstract
INTRODUCTION Intraindividual variability across a battery of neuropsychological tests (IIV-dispersion) can reflect normal variation in scores or arise from cognitive impairment. An alternate interpretation is IIV-dispersion reflects reduced engagement/invalid test data, although extant research addressing this interpretation is significantly limited. METHOD We used a sample of 97 older adult (mean age: 69.92), predominantly White (57%) or Black/African American (34%), and predominantly cis-gender male (87%) veterans. Examinees completed a comprehensive neuropsychological battery, including measures of reduced engagement/invalid test data (a symptom validity test [SVT], multiple performance validity tests [PVTs]), as part of a clinical evaluation. IIV-dispersion was indexed using the coefficient of variance (CoV). We tested 1) the relationships of raw scores and "failures" on SVT/PVTs with IIV-dispersion, 2) the relationship between IIV-dispersion and validity/neurocognitive disorder status, and 3) whether IIV-dispersion discriminated the validity/neurocognitive disorder groups using receiver operating characteristic (ROC) curves. RESULTS IIV-dispersion was significantly and independently associated with a selection of PVTs, with small to very large effect sizes. Participants with invalid profiles and cognitively impaired participants with valid profiles exhibited medium to large (d = .55-1.09) elevations in IIV-dispersion compared to cognitively unimpaired participants with valid profiles. A non-significant but small to medium (d = .35-.60) elevation in IIV-dispersion was observed for participants with invalid profiles compared to those with a neurocognitive disorder. IIV-dispersion was largely accurate at differentiating participants without a neurocognitive disorder from invalid participants and those with a neurocognitive disorder (areas under the Curve [AUCs]=.69-.83), while accuracy was low for differentiating invalid participants from those with a neurocognitive disorder (AUCs=.58-.65). CONCLUSIONS These preliminary data suggest IIV-dispersion may be sensitive to both neurocognitive disorders and compromised engagement. Clinicians and researchers should exercise due diligence and consider test validity (e.g. PVTs, behavioral signs of engagement) as an alternate explanation prior to interpretation of intraindividual variability as an indicator of cognitive impairment.
Collapse
Affiliation(s)
- Troy A Webber
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Sara Lorkiewicz
- Mental Health Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | | | - Brian Miller
- Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Neurology Care Line, Michael E. DeBakey VA Medical Center, Houston, TX, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| |
Collapse
|
2
|
Li H, Li S, Sun L, Song X. Factor-augmented transformation models for interval-censored failure time data. Biometrics 2024; 80:ujae078. [PMID: 39177025 DOI: 10.1093/biomtc/ujae078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/21/2024] [Accepted: 08/02/2024] [Indexed: 08/24/2024]
Abstract
Interval-censored failure time data frequently arise in various scientific studies where each subject experiences periodical examinations for the occurrence of the failure event of interest, and the failure time is only known to lie in a specific time interval. In addition, collected data may include multiple observed variables with a certain degree of correlation, leading to severe multicollinearity issues. This work proposes a factor-augmented transformation model to analyze interval-censored failure time data while reducing model dimensionality and avoiding multicollinearity elicited by multiple correlated covariates. We provide a joint modeling framework by comprising a factor analysis model to group multiple observed variables into a few latent factors and a class of semiparametric transformation models with the augmented factors to examine their and other covariate effects on the failure event. Furthermore, we propose a nonparametric maximum likelihood estimation approach and develop a computationally stable and reliable expectation-maximization algorithm for its implementation. We establish the asymptotic properties of the proposed estimators and conduct simulation studies to assess the empirical performance of the proposed method. An application to the Alzheimer's Disease Neuroimaging Initiative (ADNI) study is provided. An R package ICTransCFA is also available for practitioners. Data used in preparation of this article were obtained from the ADNI database.
Collapse
Affiliation(s)
- Hongxi Li
- School of Economics and Statistics, Guangzhou University, Guangzhou, 510006, China
| | - Shuwei Li
- School of Economics and Statistics, Guangzhou University, Guangzhou, 510006, China
| | - Liuquan Sun
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, and School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, 100190, China
| | - Xinyuan Song
- Department of Statistics, Chinese University of Hong Kong, Hong Kong, 999077, China
| |
Collapse
|
3
|
Vuoksimaa E, Saari TT, Aaltonen A, Aaltonen S, Herukka SK, Iso-Markku P, Kokkola T, Kyttälä A, Kärkkäinen S, Liedes H, Ollikainen M, Palviainen T, Ruotsalainen I, Toivola A, Urjansson M, Vasankari T, Vähä-Ypyä H, Forsberg MM, Hiltunen M, Jalanko A, Kälviäinen R, Kuopio T, Lähteenmäki J, Nyberg P, Männikkö M, Serpi R, Siltanen S, Palotie A, Kaprio J, Runz H, Julkunen V. TWINGEN: protocol for an observational clinical biobank recall and biomarker cohort study to identify Finnish individuals with high risk of Alzheimer's disease. BMJ Open 2024; 14:e081947. [PMID: 38866570 PMCID: PMC11177688 DOI: 10.1136/bmjopen-2023-081947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 05/09/2024] [Indexed: 06/14/2024] Open
Abstract
INTRODUCTION A better understanding of the earliest stages of Alzheimer's disease (AD) could expedite the development or administration of treatments. Large population biobanks hold the promise to identify individuals at an elevated risk of AD and related dementias based on health registry information. Here, we establish the protocol for an observational clinical recall and biomarker study called TWINGEN with the aim to identify individuals at high risk of AD by assessing cognition, health and AD-related biomarkers. Suitable candidates were identified and invited to participate in the new study among THL Biobank donors according to TWINGEN study criteria. METHODS AND ANALYSIS A multi-centre study (n=800) to obtain blood-based biomarkers, telephone-administered and web-based memory and cognitive parameters, questionnaire information on lifestyle, health and psychological factors, and accelerometer data for measures of physical activity, sedentary behaviour and sleep. A subcohort is being asked to participate in an in-person neuropsychological assessment (n=200) and wear an Oura ring (n=50). All participants in the TWINGEN study have genome-wide genotyping data and up to 48 years of follow-up data from the population-based older Finnish Twin Cohort (FTC) study of the University of Helsinki. The data collected in TWINGEN will be returned to THL Biobank from where it can later be requested for other biobank studies such as FinnGen that supported TWINGEN. ETHICS AND DISSEMINATION This recall study consists of FTC/THL Biobank/FinnGen participants whose data were acquired in accordance with the Finnish Biobank Act. The recruitment protocols followed the biobank protocols approved by Finnish Medicines Agency. The TWINGEN study plan was approved by the Ethics Committee of Hospital District of Helsinki and Uusimaa (number 16831/2022). THL Biobank approved the research plan with the permission no: THLBB2022_83.
Collapse
Affiliation(s)
- Eero Vuoksimaa
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Toni T Saari
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Aino Aaltonen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Sanna-Kaisa Herukka
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Paula Iso-Markku
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Tarja Kokkola
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aija Kyttälä
- THL Biobank, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sari Kärkkäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Liedes
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd, Oulu, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Ilona Ruotsalainen
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd, Espoo, Finland
| | - Auli Toivola
- THL Biobank, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mia Urjansson
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Pirkanmaa, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Pirkanmaa, Finland
| | - Markus M Forsberg
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland Ltd, Kuopio, Finland
| | - Mikko Hiltunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anu Jalanko
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Reetta Kälviäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Teijo Kuopio
- Central Finland Biobank, Wellbeing Services County of Central Finland and University of Jyväskylä, Jyväskylä, Finland
| | | | - Pia Nyberg
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
- Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Minna Männikkö
- Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raisa Serpi
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services County of North Ostrobothnia, Oulu, Finland
| | - Sanna Siltanen
- Finnish Clinical Biobank Tampere, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Heiko Runz
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Translational Sciences, Biogen Inc, Cambridge, Massachusetts, USA
| | - Valtteri Julkunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|
4
|
García-Gutiérrez F, Alegret M, Marquié M, Muñoz N, Ortega G, Cano A, De Rojas I, García-González P, Olivé C, Puerta R, García-Sanchez A, Capdevila-Bayo M, Montrreal L, Pytel V, Rosende-Roca M, Zaldua C, Gabirondo P, Tárraga L, Ruiz A, Boada M, Valero S. Unveiling the sound of the cognitive status: Machine Learning-based speech analysis in the Alzheimer's disease spectrum. Alzheimers Res Ther 2024; 16:26. [PMID: 38308366 PMCID: PMC10835990 DOI: 10.1186/s13195-024-01394-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND Advancement in screening tools accessible to the general population for the early detection of Alzheimer's disease (AD) and prediction of its progression is essential for achieving timely therapeutic interventions and conducting decentralized clinical trials. This study delves into the application of Machine Learning (ML) techniques by leveraging paralinguistic features extracted directly from a brief spontaneous speech (SS) protocol. We aimed to explore the capability of ML techniques to discriminate between different degrees of cognitive impairment based on SS. Furthermore, for the first time, this study investigates the relationship between paralinguistic features from SS and cognitive function within the AD spectrum. METHODS Physical-acoustic features were extracted from voice recordings of patients evaluated in a memory unit who underwent a SS protocol. We implemented several ML models evaluated via cross-validation to identify individuals without cognitive impairment (subjective cognitive decline, SCD), with mild cognitive impairment (MCI), and with dementia due to AD (ADD). In addition, we established models capable of predicting cognitive domain performance based on a comprehensive neuropsychological battery from Fundació Ace (NBACE) using SS-derived information. RESULTS The results of this study showed that, based on a paralinguistic analysis of sound, it is possible to identify individuals with ADD (F1 = 0.92) and MCI (F1 = 0.84). Furthermore, our models, based on physical acoustic information, exhibited correlations greater than 0.5 for predicting the cognitive domains of attention, memory, executive functions, language, and visuospatial ability. CONCLUSIONS In this study, we show the potential of a brief and cost-effective SS protocol in distinguishing between different degrees of cognitive impairment and forecasting performance in cognitive domains commonly affected within the AD spectrum. Our results demonstrate a high correspondence with protocols traditionally used to assess cognitive function. Overall, it opens up novel prospects for developing screening tools and remote disease monitoring.
Collapse
Affiliation(s)
| | - Montserrat Alegret
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Marquié
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Nathalia Muñoz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Gemma Ortega
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Amanda Cano
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Itziar De Rojas
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo García-González
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Clàudia Olivé
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Raquel Puerta
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Ainhoa García-Sanchez
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - María Capdevila-Bayo
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Laura Montrreal
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Vanesa Pytel
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Maitee Rosende-Roca
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
| | | | | | - Lluís Tárraga
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Agustín Ruiz
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Mercè Boada
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain
| | - Sergi Valero
- Ace Alzheimer Center Barcelona, Universitat Internacional de Catalunya, Barcelona, Spain.
- Networking Research Center on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain.
| |
Collapse
|
5
|
Lee AJ, Stark JH, Hayes SM. Baseline Frontoparietal Gray Matter Volume Predicts Executive Function Performance in Aging and Mild Cognitive Impairment at 24-Month Follow-Up. J Alzheimers Dis 2024; 100:357-374. [PMID: 38875035 DOI: 10.3233/jad-231468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Background Executive dysfunction in mild cognitive impairment (MCI) has been associated with gray matter atrophy. Prior studies have yielded limited insight into associations between gray matter volume and executive function in early and late amnestic MCI (aMCI). Objective To examine the relative importance of predictors of executive function at 24 months and relationships between baseline regional gray matter volume and executive function performance at 24-month follow-up in non-demented older adults. Methods 147 participants from the Alzheimer's Disease Neuroimaging Initiative (mean age = 70.6 years) completed brain magnetic resonance imaging and neuropsychological testing and were classified as cognitively normal (n = 49), early aMCI (n = 60), or late aMCI (n = 38). Analyses explored the importance of demographic, APOEɛ4, biomarker (p-tau/Aβ42, t-tau/Aβ42), and gray matter regions-of-interest (ROI) variables to 24-month executive function, whether ROIs predicted executive function, and whether relationships varied by baseline diagnostic status. Results Across all participants, baseline anterior cingulate cortex and superior parietal lobule volumes were the strongest predictors of 24-month executive function performance. In early aMCI, anterior cingulate cortex volume was the strongest predictor and demonstrated a significant interaction such that lower volume related to worse 24-month executive function in early aMCI. Educational attainment and inferior frontal gyrus volume were the strongest predictors of 24-month executive function performance for cognitively normal and late aMCI groups, respectively. Conclusions Baseline frontoparietal gray matter regions were significant predictors of executive function performance in the context of aMCI and may identify those at risk of Alzheimer's disease. Anterior cingulate cortex volume may predict executive function performance in early aMCI.
Collapse
Affiliation(s)
- Ann J Lee
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Jessica H Stark
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Scott M Hayes
- Department of Psychology, The Ohio State University, Columbus, OH, USA
- Chronic Brain Injury Initiative, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
6
|
Nemali A, Vockert N, Berron D, Maas A, Bernal J, Yakupov R, Peters O, Gref D, Cosma N, Preis L, Priller J, Spruth E, Altenstein S, Lohse A, Fliessbach K, Kimmich O, Vogt I, Wiltfang J, Hansen N, Bartels C, Schott BH, Maier F, Meiberth D, Glanz W, Incesoy E, Butryn M, Buerger K, Janowitz D, Pernecky R, Rauchmann B, Burow L, Teipel S, Kilimann I, Göerß D, Dyrba M, Laske C, Munk M, Sanzenbacher C, Müller S, Spottke A, Roy N, Heneka M, Brosseron F, Roeske S, Dobisch L, Ramirez A, Ewers M, Dechent P, Scheffler K, Kleineidam L, Wolfsgruber S, Wagner M, Jessen F, Duzel E, Ziegler G. Gaussian Process-based prediction of memory performance and biomarker status in ageing and Alzheimer's disease-A systematic model evaluation. Med Image Anal 2023; 90:102913. [PMID: 37660483 DOI: 10.1016/j.media.2023.102913] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/28/2023] [Accepted: 07/25/2023] [Indexed: 09/05/2023]
Abstract
Neuroimaging markers based on Magnetic Resonance Imaging (MRI) combined with various other measures (such as genetic covariates, biomarkers, vascular risk factors, neuropsychological tests etc.) might provide useful predictions of clinical outcomes during the progression towards Alzheimer's disease (AD). The use of multiple features in predictive frameworks for clinical outcomes has become increasingly prevalent in AD research. However, many studies do not focus on systematically and accurately evaluating combinations of multiple input features. Hence, the aim of the present work is to explore and assess optimal combinations of various features for MR-based prediction of (1) cognitive status and (2) biomarker positivity with a multi-kernel learning Gaussian process framework. The explored features and parameters included (A) combinations of brain tissues, modulation, smoothing, and image resolution; (B) incorporating demographics & clinical covariates; (C) the impact of the size of the training data set; (D) the influence of dimensionality reduction and the choice of kernel types. The approach was tested in a large German cohort including 959 subjects from the multicentric longitudinal study of cognitive impairment and dementia (DELCODE). Our evaluation suggests the best prediction of memory performance was obtained for a combination of neuroimaging markers, demographics, genetic information (ApoE4) and CSF biomarkers explaining 57% of outcome variance in out-of-sample predictions. The highest performance for Aβ42/40 status classification was achieved for a combination of demographics, ApoE4, and a memory score while usage of structural MRI further improved the classification of individual patient's pTau status.
Collapse
Affiliation(s)
- A Nemali
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
| | - N Vockert
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - D Berron
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - A Maas
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - J Bernal
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - R Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - O Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Department of Psychiatry, Hindenburgdamm 30, 12203, Berlin, Germany
| | - D Gref
- Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Department of Psychiatry, Hindenburgdamm 30, 12203, Berlin, Germany
| | - N Cosma
- Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Department of Psychiatry, Hindenburgdamm 30, 12203, Berlin, Germany
| | - L Preis
- Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Department of Psychiatry, Hindenburgdamm 30, 12203, Berlin, Germany
| | - J Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, 10117 Berlin, Germany; School of Medicine, Technical University of Munich; Department of Psychiatry and Psychotherapy, Munich, Germany; University of Edinburgh and UK DRI, Edinburgh, UK
| | - E Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, 10117 Berlin, Germany
| | - S Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, 10117 Berlin, Germany
| | - A Lohse
- Department of Psychiatry and Psychotherapy, Charité, Charitéplatz 1, 10117 Berlin, Germany
| | - K Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Venusberg-Campus 1, 53127 Bonn, Germany
| | - O Kimmich
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - I Vogt
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - J Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany; Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - N Hansen
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - C Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - B H Schott
- Leibniz Institute for Neurobiology, Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Von-Siebold-Str. 5, 37075 Goettingen, Germany
| | - F Maier
- Department of Psychiatry, University of Cologne, Medical Faculty, Kerpener Strasse 62, 50924 Cologne, Germany
| | - D Meiberth
- Department of Psychiatry, University of Cologne, Medical Faculty, Kerpener Strasse 62, 50924 Cologne, Germany
| | - W Glanz
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Germany
| | - E Incesoy
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - M Butryn
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - K Buerger
- German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen-Strasse 17, 81377 Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377 Munich, Germany
| | - D Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377 Munich, Germany
| | - R Pernecky
- German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen-Strasse 17, 81377 Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) Munich, Munich, Germany; Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, UK
| | - B Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - L Burow
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - S Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - I Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - D Göerß
- Department of Psychosomatic Medicine, Rostock University Medical Center, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - M Dyrba
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - C Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - M Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - C Sanzenbacher
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - S Müller
- Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - A Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Department of Neurology, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - N Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - M Heneka
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Department of Psychiatry and Psychotherapy, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - F Brosseron
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - S Roeske
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - L Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - A Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Department of Neurology, University of Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Strasse 26, 50931 Köln, Germany; Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - M Ewers
- German Center for Neurodegenerative Diseases (DZNE, Munich), Feodor-Lynen-Strasse 17, 81377 Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Strasse 17, 81377 Munich, Germany
| | - P Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Germany
| | - K Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, 72076 Tübingen, Germany
| | - L Kleineidam
- University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Venusberg-Campus 1, 53127 Bonn, Germany
| | - S Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Venusberg-Campus 1, 53127 Bonn, Germany
| | - M Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; University of Bonn Medical Center, Department of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Venusberg-Campus 1, 53127 Bonn, Germany
| | - F Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Venusberg-Campus 1, 53127 Bonn, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Kerpener Strasse 62, 50924 Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Joseph-Stelzmann-Strasse 26, 50931 Köln, Germany
| | - E Duzel
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - G Ziegler
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| |
Collapse
|
7
|
Vuoksimaa E, Saari TT, Aaltonen A, Aaltonen S, Herukka SK, Iso-Markku P, Kokkola T, Kyttälä A, Kärkkäinen S, Liedes H, Ollikainen M, Palviainen T, Ruotsalainen I, Toivola A, Urjansson M, Vasankari T, Vähä-Ypyä H, Forsberg MM, Hiltunen M, Jalanko A, Kälviäinen R, Kuopio T, Lähteenmäki J, Nyberg P, Männikkö M, Serpi R, Siltanen S, Palotie A, Kaprio J, Runz H, Julkunen V. TWINGEN - protocol for an observational clinical biobank recall and biomarker study to identify individuals with high risk of Alzheimer's disease. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.03.23298018. [PMID: 37965200 PMCID: PMC10635260 DOI: 10.1101/2023.11.03.23298018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Introduction A better understanding of the earliest stages of Alzheimer's disease (AD) could expedite the development or administration of treatments. Large population biobanks hold the promise to identify individuals at an elevated risk of AD and related dementias based on health registry information. Here, we establish the protocol for an observational clinical recall and biomarker study called TWINGEN with the aim to identify individuals at high risk of AD by assessing cognition, health and AD-related biomarkers. Suitable candidates were identified and invited to participate in the new study among Finnish biobank donors according to TWINGEN study criteria. Methods and analysis A multi-center study (n=800) to obtain blood-based biomarkers, telephone-administered and web-based memory and cognitive parameters, questionnaire information on lifestyle, health and psychological factors, and accelerometer data for measures of physical activity, sedentary behavior and sleep. A sub-cohort are being asked to participate in an in-person neuropsychological assessment (n=200) and wear an Oura ring (n=50). All participants in the TWINGEN study have genome-wide genotyping data and up to 48 years of follow-up data from the population-based older Finnish Twin Cohort (FTC) study of the University of Helsinki. TWINGEN data will be transferred to Finnish Institute of Health and Welfare (THL) biobank and we aim to further to transfer it to the FinnGen study where it will be combined with health registry data for prediction of AD. Ethics and dissemination This recall study consists of FTC/THL/FinnGen participants whose data were acquired in accordance with the Finnish Biobank Act. The recruitment protocols followed the biobank protocols approved by Finnish Medicines Agency. The TWINGEN study plan was approved by the Ethics Committee of Hospital District of Helsinki and Uusimaa (number 16831/2022). THL Biobank approved the research plan with the permission no: THLBB2022_83.
Collapse
Affiliation(s)
- Eero Vuoksimaa
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Toni T Saari
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Aino Aaltonen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Sanna-Kaisa Herukka
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Paula Iso-Markku
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tarja Kokkola
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Aija Kyttälä
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Sari Kärkkäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Hilkka Liedes
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd., Oulu, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Ilona Ruotsalainen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- VTT Technical Research Centre of Finland Ltd., Espoo, Finland
| | - Auli Toivola
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Mia Urjansson
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Markus M Forsberg
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- VTT Technical Research Centre of Finland Ltd., Kuopio, Finland
| | - Mikko Hiltunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anu Jalanko
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Reetta Kälviäinen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Teijo Kuopio
- Central Finland Biobank, Central Finland Health Care District, Jyväskylä, Finland
| | | | - Pia Nyberg
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services county of North Ostrobothnia, Oulu, Finland
- Translational Medicine Research Unit, University of Oulu, Oulu, Finland
| | - Minna Männikkö
- Arctic Biobank, Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Raisa Serpi
- Biobank Borealis of Northern Finland, Oulu University Hospital, Wellbeing Services county of North Ostrobothnia, Oulu, Finland
| | - Sanna Siltanen
- Finnish Clinical Biobank Tampere, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- The Stanley Center for Psychiatric Research and Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Heiko Runz
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Translational Sciences, Biogen, Cambridge, MA, USA
| | - Valtteri Julkunen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Neurocenter, Kuopio University Hospital, Kuopio, Finland
| |
Collapse
|
8
|
Lefort-Besnard J, Naveau M, Delcroix N, Decker LM, Cignetti F. Grey matter volume and CSF biomarkers predict neuropsychological subtypes of MCI. Neurobiol Aging 2023; 131:196-208. [PMID: 37689017 DOI: 10.1016/j.neurobiolaging.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 09/11/2023]
Abstract
There is increasing evidence of different subtypes of individuals with mild cognitive impairment (MCI). An important line of research is whether neuropsychologically-defined subtypes have distinct patterns of neurodegeneration and cerebrospinal fluid (CSF) biomarker composition. In our study, we demonstrated that MCI participants of the ADNI database (N = 640) can be discriminated into 3 coherent neuropsychological subgroups. Our clustering approach revealed amnestic MCI, mixed MCI, and cluster-derived normal subgroups. Furthermore, classification modeling revealed that specific predictive features can be used to differentiate amnestic and mixed MCI from cognitively normal (CN) controls: CSF Aβ142 concentration for the former and CSF Aβ1-42 concentration, tau concentration as well as grey matter atrophy (especially in the temporal and occipital lobes) for the latter. In contrast, participants from the cluster-derived normal subgroup exhibited an identical profile to CN controls in terms of cognitive performance, brain structure, and CSF biomarker levels. Our comprehensive data analytics strategy provides further evidence that multimodal neuropsychological subtyping is both clinically and neurobiologically meaningful.
Collapse
Affiliation(s)
| | - Mikael Naveau
- Normandie Univ, UNICAEN, CNRS, CEA, INSERM, GIP Cyceron, Caen, France
| | - Nicolas Delcroix
- Normandie Univ, UNICAEN, CNRS, CEA, INSERM, GIP Cyceron, Caen, France
| | - Leslie Marion Decker
- Normandie Univ, UNICAEN, INSERM, COMETE, Caen, France; Normandie Univ, UNICAEN, CIREVE, Caen, France.
| | - Fabien Cignetti
- Univ. Grenoble Alpes, CNRS, VetAgro Sup, Grenoble INP, TIMC, Grenoble, France.
| |
Collapse
|
9
|
Pommy J, Conant L, Butts AM, Nencka A, Wang Y, Franczak M, Glass-Umfleet L. A graph theoretic approach to neurodegeneration: five data-driven neuropsychological subtypes in mild cognitive impairment. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:903-922. [PMID: 36648118 DOI: 10.1080/13825585.2022.2163973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 12/26/2022] [Indexed: 01/18/2023]
Abstract
Mild cognitive Impairment (MCI) is notoriously heterogenous in terms of clinical presentation, neuroimaging correlates, and subsequent progression. Predicting who will progress to dementia, which type of dementia, and over what timeframe is challenging. Previous work has attempted to identify MCI subtypes using neuropsychological measures in an effort to address this challenge; however, there is no consensus on approach, which may account for some of the variability. Using a hierarchical community detection approach, we examined cognitive subtypes within an MCI sample (from the Alzheimer's Disease Neuroimaging Initiative [ADNI] study). We then examined whether these subtypes were related to biomarkers (e.g., cortical volumes, fluorodeoxyglucose (FDG)-positron emission tomography (PET) hypometabolism) or clinical progression. We identified five communities (i.e., cognitive subtypes) within the MCI sample: 1) predominantly memory impairment, 2) predominantly language impairment, 3) cognitively normal, 4) multidomain, with notable executive dysfunction, 5) multidomain, with notable processing speed impairment. Community membership was significantly associated with 1) cortical volume in the hippocampus, entorhinal cortex, and fusiform cortex; 2) FDG PET hypometabolism in the posterior cingulate, angular gyrus, and inferior/middle temporal gyrus; and 3) conversion to dementia at follow up. Overall, community detection as an approach appears a viable method for identifying unique cognitive subtypes in a neurodegenerative sample that were linked to several meaningful biomarkers and modestly with progression at one year follow up.
Collapse
Affiliation(s)
- Jessica Pommy
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - L Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - A M Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - A Nencka
- Department of Radiology, Medical College of Wisconsin, Milwaukee, United States
| | - Y Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, United States
| | - M Franczak
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| | - L Glass-Umfleet
- Department of Neurology, Medical College of Wisconsin, Milwaukee, United States
| |
Collapse
|
10
|
De Marco M, Bocchetta M, Venneri A. Item-Level Scores on the Boston Naming Test as an Independent Predictor of Perirhinal Volume in Individuals with Mild Cognitive Impairment. Brain Sci 2023; 13:806. [PMID: 37239278 PMCID: PMC10216160 DOI: 10.3390/brainsci13050806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 04/17/2023] [Accepted: 05/10/2023] [Indexed: 05/28/2023] Open
Abstract
We explored the methodological value of an item-level scoring procedure applied to the Boston Naming Test (BNT), and the extent to which this scoring approach predicts grey matter (GM) variability in regions that sustain semantic memory. Twenty-seven BNT items administered as part of the Alzheimer's Disease Neuroimaging Initiative were scored according to their "sensorimotor interaction" (SMI) value. Quantitative scores (i.e., the count of correctly named items) and qualitative scores (i.e., the average of SMI scores for correctly named items) were used as independent predictors of neuroanatomical GM maps in two sub-cohorts of 197 healthy adults and 350 mild cognitive impairment (MCI) participants. Quantitative scores predicted clusters of temporal and mediotemporal GM in both sub-cohorts. After accounting for quantitative scores, the qualitative scores predicted mediotemporal GM clusters in the MCI sub-cohort; clusters extended to the anterior parahippocampal gyrus and encompassed the perirhinal cortex. This was confirmed by a significant yet modest association between qualitative scores and region-of-interest-informed perirhinal volumes extracted post hoc. Item-level scoring of BNT performance provides complementary information to standard quantitative scores. The concurrent use of quantitative and qualitative scores may help profile lexical-semantic access more precisely, and might help detect changes in semantic memory that are typical of early-stage Alzheimer's disease.
Collapse
Affiliation(s)
- Matteo De Marco
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK; (M.D.M.); (M.B.)
| | - Martina Bocchetta
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK; (M.D.M.); (M.B.)
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London WC1E 6BT, UK
| | - Annalena Venneri
- Centre for Cognitive and Clinical Neuroscience, Division of Psychology, Department of Life Sciences, College of Health, Medicine and Life Sciences, Brunel University London, London UB8 3PH, UK; (M.D.M.); (M.B.)
- Department of Medicine and Surgery, University of Parma, 43125 Parma, Italy
| | | |
Collapse
|
11
|
Hampton OL, Mukherjee S, Properzi MJ, Schultz AP, Crane PK, Gibbons LE, Hohman TJ, Maruff P, Lim YY, Amariglio RE, Papp KV, Johnson KA, Rentz DM, Sperling RA, Buckley RF. Harmonizing the preclinical Alzheimer cognitive composite for multicohort studies. Neuropsychology 2023; 37:436-449. [PMID: 35862098 PMCID: PMC9859944 DOI: 10.1037/neu0000833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Studies are increasingly examining research questions across multiple cohorts using data from the preclinical Alzheimer cognitive composite (PACC). Our objective was to use modern psychometric approaches to develop a harmonized PACC. METHOD We used longitudinal data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), Harvard Aging Brain Study (HABS), and Australian Imaging, Biomarker and Lifestyle Study of Ageing (AIBL) cohorts (n = 2,712). We further demonstrated our method with the Anti-Amyloid Treatment of Asymptomatic Alzheimer's Disease (A4) Study prerandomized data (n = 4,492). For the harmonization method, we used confirmatory factor analysis (CFA) on the final visit of the longitudinal cohorts to determine parameters to generate latent PACC (lPACC) scores. Overlapping tests across studies were set as "anchors" that tied cohorts together, while parameters from unique tests were freely estimated. We performed validation analyses to assess the performance of lPACC versus the common standardized PACC (zPACC). RESULTS Baseline (BL) scores for the zPACC were centered on zero, by definition. The harmonized lPACC did not define a common mean of zero and demonstrated differences in baseline ability levels across the cohorts. Baseline lPACC slightly outperformed zPACC in the prediction of progression to dementia. Longitudinal change in the lPACC was more constrained and less variable relative to the zPACC. In combined-cohort analyses, longitudinal lPACC slightly outperformed longitudinal zPACC in its association with baseline β-amyloid status. CONCLUSIONS This study proposes procedures for harmonizing the PACC that make fewer strong assumptions than the zPACC, facilitating robust multicohort analyses. This implementation of item response theory lends itself to adapting across future cohorts with similar composites. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Collapse
Affiliation(s)
- Olivia L. Hampton
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Shubhabrata Mukherjee
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Michael J. Properzi
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Aaron P. Schultz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Paul K. Crane
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Laura E. Gibbons
- Department of Medicine, Division of General Internal Medicine, University of Washington
| | - Timothy J. Hohman
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, United States
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Yen Ying Lim
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Rebecca E. Amariglio
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Kathryn V. Papp
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Keith A. Johnson
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
| | - Dorene M. Rentz
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Reisa A. Sperling
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
| | - Rachel F. Buckley
- Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, United States
- Department of Neurology, Brigham and Women’s Hospital, Center for Alzheimer Research and Treatment, Boston, Massachusetts, United States
- Melbourne School of Psychological Science, University of Melbourne
| |
Collapse
|
12
|
Umminger LF, Rojczyk P, Seitz-Holland J, Sollmann N, Kaufmann E, Kinzel P, Zhang F, Kochsiek J, Langhein M, Kim CL, Wiegand TLT, Kilts JD, Naylor JC, Grant GA, Rathi Y, Coleman MJ, Bouix S, Tripodis Y, Pasternak O, George MS, McAllister TW, Zafonte R, Stein MB, O'Donnell LJ, Marx CE, Shenton ME, Koerte IK. White Matter Microstructure Is Associated with Serum Neuroactive Steroids and Psychological Functioning. J Neurotrauma 2023; 40:649-664. [PMID: 36324218 PMCID: PMC10061338 DOI: 10.1089/neu.2022.0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Military service members are at increased risk for mental health issues, and comorbidity with mild traumatic brain injury (mTBI) is common. Largely overlapping symptoms between conditions suggest a shared pathophysiology. The present work investigates the associations among white matter microstructure, psychological functioning, and serum neuroactive steroids that are part of the stress-response system. Diffusion-weighted brain imaging was acquired from 163 participants (with and without military affiliation) and free-water-corrected fractional anisotropy (FAT) was extracted. Associations between serum neurosteroid levels of allopregnanolone (ALLO) and pregnenolone (PREGNE), psychological functioning, and whole-brain white matter microstructure were assessed using regression models. Moderation models tested the effect of mTBI and comorbid post-traumatic stress disorder (PTSD) and mTBI on these associations. ALLO is associated with whole-brain white matter FAT (β = 0.24, t = 3.05, p = 0.006). This association is significantly modulated by PTSD+mTBI comorbidity (β = 0.00, t = 2.50, p = 0.027), although an mTBI diagnosis alone did not significantly impact this association (p = 0.088). There was no significant association between PREGNE and FAT (p = 0.380). Importantly, lower FAT is associated with poor psychological functioning (β = -0.19, t = -2.35, p = 0.020). This study provides novel insight into a potential common pathophysiological mechanism of neurosteroid dysregulation underlying the high risk for mental health issues in military service members. Further, comorbidity of PTSD and mTBI may bring the compensatory effects of the brain's stress response to their limit. Future research is needed to investigate whether neurosteroid regulation may be a promising tool for restoring brain health and improving psychological functioning.
Collapse
Affiliation(s)
- Lisa F. Umminger
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Philine Rojczyk
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Johanna Seitz-Holland
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Nico Sollmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Elisabeth Kaufmann
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Neurology, Epilepsy Center, Ludwig-Maximilians-Universität, Munich, Germany
| | - Philipp Kinzel
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Fan Zhang
- Laboratory of Mathematics in Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Janna Kochsiek
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Mina Langhein
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Cara L. Kim
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Tim L. T. Wiegand
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
| | - Jason D. Kilts
- VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NorthCarolina, USA
- Department of Psychiatry and Behavior Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jennifer C. Naylor
- VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NorthCarolina, USA
- Department of Psychiatry and Behavior Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Gerald A. Grant
- Department of Neurosurgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Yogesh Rathi
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael J. Coleman
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
- Boston University Alzheimer's Disease and CTE Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Ofer Pasternak
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark S. George
- Psychiatry Department, Medical University of South Carolina, Charleston, South Carolina, USA
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Thomas W. McAllister
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts, USA
- Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Murray B. Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- School of Public Health, University of California San Diego, La Jolla, California, USA
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Lauren J. O'Donnell
- Laboratory of Mathematics in Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Christine E. Marx
- VA Mid-Atlantic Mental Illness Research and Clinical Center (MIRECC) and Durham VA Medical Center, Durham, NorthCarolina, USA
- Department of Psychiatry and Behavior Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Martha E. Shenton
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Inga K. Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatic and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Graduate School of Systemic Neuroscience, Ludwig-Maximilians-Universität, Munich, Germany
| |
Collapse
|
13
|
Yin C, Imms P, Cheng M, Amgalan A, Chowdhury NF, Massett RJ, Chaudhari NN, Chen X, Thompson PM, Bogdan P, Irimia A. Anatomically interpretable deep learning of brain age captures domain-specific cognitive impairment. Proc Natl Acad Sci U S A 2023; 120:e2214634120. [PMID: 36595679 PMCID: PMC9926270 DOI: 10.1073/pnas.2214634120] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/10/2022] [Indexed: 01/05/2023] Open
Abstract
The gap between chronological age (CA) and biological brain age, as estimated from magnetic resonance images (MRIs), reflects how individual patterns of neuroanatomic aging deviate from their typical trajectories. MRI-derived brain age (BA) estimates are often obtained using deep learning models that may perform relatively poorly on new data or that lack neuroanatomic interpretability. This study introduces a convolutional neural network (CNN) to estimate BA after training on the MRIs of 4,681 cognitively normal (CN) participants and testing on 1,170 CN participants from an independent sample. BA estimation errors are notably lower than those of previous studies. At both individual and cohort levels, the CNN provides detailed anatomic maps of brain aging patterns that reveal sex dimorphisms and neurocognitive trajectories in adults with mild cognitive impairment (MCI, N = 351) and Alzheimer's disease (AD, N = 359). In individuals with MCI (54% of whom were diagnosed with dementia within 10.9 y from MRI acquisition), BA is significantly better than CA in capturing dementia symptom severity, functional disability, and executive function. Profiles of sex dimorphism and lateralization in brain aging also map onto patterns of neuroanatomic change that reflect cognitive decline. Significant associations between BA and neurocognitive measures suggest that the proposed framework can map, systematically, the relationship between aging-related neuroanatomy changes in CN individuals and in participants with MCI or AD. Early identification of such neuroanatomy changes can help to screen individuals according to their AD risk.
Collapse
Affiliation(s)
- Chenzhong Yin
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
| | - Phoebe Imms
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
| | - Mingxi Cheng
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
| | - Anar Amgalan
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
| | - Nahian F. Chowdhury
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
| | - Roy J. Massett
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
| | - Nikhil N. Chaudhari
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
| | - Xinghe Chen
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
| | - Paul M. Thompson
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, CA90033
- Department of Quantitative & Computational Biology, Dana & David Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA90089
- Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
- Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
- Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
- Department of Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA90033
| | - Paul Bogdan
- Ming Hsieh Department of Electrical and Computer Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
| | - Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA90089
- Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA90089
- Department of Quantitative & Computational Biology, Dana & David Dornsife College of Arts & Sciences, University of Southern California, Los Angeles, CA90089
| | | |
Collapse
|
14
|
Kulimbet M, Glushkova N, Snitz B, Tsoy R, Adambekov S, Talbott E, Mereke A, Wu M, Zhumagaliuly A, Karaca F, Chang Y, Turuspekova S, Sekikawa A, Davletov K. Neuropsychological Assessment of Community-Dwelling Older Adults in Almaty, Kazakhstan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16189. [PMID: 36498262 PMCID: PMC9737569 DOI: 10.3390/ijerph192316189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/25/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Cognitive impairment in older adults is a major public concern for Kazakhstan's aging population. We aimed to (1) administer a neuropsychological test battery (NTB) in domains relevant to aging-associated cognitive impairment in a sample of adults aged 60+ without dementia in Almaty, Kazakhstan; (2) investigate the associations between demographic factors and test performance; and (3) provide information on the distribution of NTB scores as preliminary local normative data relevant for this population. A cross-sectional evaluation of 276 participants aged 60+ in Almaty, Kazakhstan, was conducted using cognitive instruments including tests of memory, attention, language, executive functions, visuospatial abilities, and processing speed. Multiple linear regression analyses were used to examine the association of demographic factors with neuropsychological test performance. The results from the regression analysis showed that those who are younger, have more years of education, are women, and are of Russian ethnicity had significantly better performance. The current study illustrated (1) the feasibility of administering the NTB to older adults in the general population in Kazakhstan; (2) the preliminary local normative neuropsychological measures; and (3) their independent associations with age, education, gender, and ethnicity. The findings are a platform for future research on dementia and cognitive impairment in older adults in Kazakhstan.
Collapse
Affiliation(s)
- Mukhtar Kulimbet
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
- Health Research Center, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
- Health Research Center, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Beth Snitz
- Department of Neurology, University of Pittsburgh, Pittsburgh, PA 15237, USA
| | - Radmila Tsoy
- Department of Nervous Diseases, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Shalkar Adambekov
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Evelyn Talbott
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Alibek Mereke
- Department of Epidemiology, Biostatistics and Evidence-Based Medicine, Al-Farabi Kazakh National University, Almaty 050040, Kazakhstan
| | - Minjie Wu
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Abzal Zhumagaliuly
- Public Health Department, Asfendiyarov Kazakh National Medical University, Almaty 050040, Kazakhstan
| | - Ferhat Karaca
- Department of Civil and Environmental Engineering, The Environment & Resource Efficiency Cluster, School of Engineering and Digital Sciences, Nazarbayev University, Nur-Sultan 010000, Kazakhstan
| | - Yuefang Chang
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Saule Turuspekova
- Department of Nervous Diseases, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Akira Sekikawa
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Kairat Davletov
- Health Research Center, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| |
Collapse
|
15
|
Molnár V, Lakner Z, Molnár A, Tárnoki DL, Tárnoki ÁD, Kunos L, Tamás L. The Predictive Role of Subcutaneous Adipose Tissue in the Pathogenesis of Obstructive Sleep Apnoea. Life (Basel) 2022; 12:life12101504. [PMID: 36294937 PMCID: PMC9605212 DOI: 10.3390/life12101504] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/20/2022] [Accepted: 09/23/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Although several methods are used to diagnose obstructive sleep apnoea (OSA), the disorder is still underdiagnosed, leading to public healthcare problems. The main aim of the present study was to analyse the role of artificial intelligence in OSA diagnostics and obstruction localisation and, moreover, the role of subcutaneous adipose tissue in OSA pathophysiology. The significance of the present investigation is that using US in OSA diagnostics and obstruction location, an additional opportunity besides standard procedures (i.e., drug-induced sleep endoscopy or polygraphy) is presented, which is vital due to the high number of undiagnosed cases. Applying the algorithm, including artificial intelligence, the presence of obstructions and its localisation, can be determined with high precision. This can be essential in therapy planning or preoperative patient preparation. Abstract Introduction: Our aim was to investigate the applicability of artificial intelligence in predicting obstructive sleep apnoea (OSA) and upper airway obstruction using ultrasound (US) measurements of subcutaneous adipose tissues (SAT) in the regions of the neck, chest and abdomen. Methods: One hundred patients were divided into mild (32), moderately severe-severe (32) OSA and non-OSA (36), according to the results of the polysomnography. These patients were examined using anthropometric measurements and US of SAT and drug-induced sleep endoscopy. Results: Using SAT US and anthropometric parameters, oropharyngeal obstruction could be predicted in 64% and tongue-based obstruction in 72%. In predicting oropharyngeal obstruction, BMI, abdominal and hip circumferences, submental SAT and SAT above the second intercostal space on the left were identified as essential parameters. Furthermore, tongue-based obstruction was predicted mainly by height, SAT measured 2 cm above the umbilicus and submental SAT. The OSA prediction was successful in 97% using the parameters mentioned above. Moreover, other parameters, such as US-based SAT, with SAT measured 2 cm above the umbilicus and both-sided SAT above the second intercostal spaces as the most important ones. Discussion: Based on our results, several categories of OSA can be predicted using artificial intelligence with high precision by using SAT and anthropometric parameters.
Collapse
Affiliation(s)
- Viktória Molnár
- Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, 1083 Budapest, Hungary
- Correspondence: ; Tel.: +36-20-663-2402
| | - Zoltán Lakner
- Szent István Campus, Hungarian University of Agriculture and Life Sciences, 2100 Gödöllő, Hungary
| | - András Molnár
- Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, 1083 Budapest, Hungary
| | | | | | - László Kunos
- Department of Pulmonology, Pulmonology Hospital of Törökbálint, 2045 Törökbálint, Hungary
| | - László Tamás
- Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, 1083 Budapest, Hungary
- Department of Voice, Speech and Swallowing Therapy, Faculty of Health Sciences, Semmelweis University, 1083 Budapest, Hungary
| |
Collapse
|
16
|
Chang M, Brainerd CJ. Predicting conversion from mild cognitive impairment to Alzheimer's disease with multimodal latent factors. J Clin Exp Neuropsychol 2022; 44:316-335. [PMID: 36036715 DOI: 10.1080/13803395.2022.2115015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
INTRODUCTION We studied the ability of latent factor scores to predict conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) and investigated whether multimodal factor scores improve predictive power, relative to single-modal factor scores. METHOD We conducted exploratory factor analyses (EFAs) and confirmatory factor analyses (CFAs) of the baseline data of MCI subjects in the Alzheimer's Disease Neuroimaging Initiative (ADNI) to generate factor scores for three data modalities: neuropsychological (NP), magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF). Factor scores from single or multiple modalities were entered in logistic regression models to predict MCI to AD conversion for 160 ADNI subjects over a 2-year interval. RESULTS NP factors attained an area under the curve (AUC) of .80, with a sensitivity of .66 and a specificity of .77. MRI factors reached a comparable level of performance (AUC = .80, sensitivity = .66, specificity = .78), whereas CSF factors produced weaker prediction (AUC = .70, sensitivity = .56, specificity = .79). Combining NP factors with MRI or CSF factors produced better prediction than either MRI or CSF factors alone. Similarly, adding MRI factors to NP or CSF factors produced improvements in prediction relative to NP or CSF factors alone. However, adding CSF factors to either NP or MRI factors produced no improvement in prediction. CONCLUSIONS Latent factor scores provided good accuracy for predicting MCI to AD conversion. Adding NP or MRI factors to factors from other modalities enhanced predictive power but adding CSF factors did not.
Collapse
Affiliation(s)
- Minyu Chang
- Department of Psychology and Human Neuroscience Institute, Cornell University, Ithaca, New York, USA
| | - C J Brainerd
- Department of Psychology and Human Neuroscience Institute, Cornell University, Ithaca, New York, USA
| |
Collapse
|
17
|
Nichols EL, Cadar D, Lee J, Jones RN, Gross AL. Linear linking for related traits (LLRT): A novel method for the harmonization of cognitive domains with no or few common items. Methods 2022; 204:179-188. [PMID: 34843977 PMCID: PMC9133269 DOI: 10.1016/j.ymeth.2021.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 11/18/2022] Open
Abstract
Harmonization means to make data comparable. Recent efforts to generate comparable data on cognitive performance of older adults from many different countries around the world have presented challenges for direct comparison. Neuropsychological instruments vary in many respects, including language, administration techniques and cultural differences, which all present important obstacles to assumptions regarding the presence of linking items. Item response theory (IRT) methods have been previously used to harmonize cross-national data on cognition, but these methods rely on linking items to establish the shared metric. We introduce an alternative approach for linking cognitive performance across two (or more) groups when the fielded assessments contain no items that can be reasonably considered linking items: Linear Linking for Related Traits (LLRT). We demonstrate this methodological approach in a sample from a single United States study split by educational attainment, and in two sets of cross-national comparisons (United States to England, and United States to India). All data were collected as part of the Harmonized Cognitive Assessment Protocol (HCAP) and are publicly available. Our method relies upon strong assumptions, and we offer suggestions for how the method can be extended to relax those assumptions in future work.
Collapse
Affiliation(s)
- Emma L Nichols
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD 21205, United States.
| | - Dorina Cadar
- Institute of Epidemiology & Health, University College London, Grower Street, London WC1E 6BT, England.
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, 635 Downey Way, VPD 405, Los Angeles, CA 90089, United States; RAND Corporation, 1776 Main St. Santa Monica, CA 90401, United States.
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Department of Neurology, Warren Alpert Medical School, Brown University Box G-BH, 700 Butler Drive, Providence, RI 02906, United States.
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, W6508, Baltimore, MD 21205, United States.
| |
Collapse
|
18
|
Yang KC, Hsieh WC, Chou YH. Cognitive factor structure and measurement invariance between healthy controls and patients with major depressive disorder. J Psychiatr Res 2022; 151:598-605. [PMID: 35636038 DOI: 10.1016/j.jpsychires.2022.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 05/03/2022] [Accepted: 05/20/2022] [Indexed: 02/01/2023]
Abstract
Cognitive impairments are crucial in functional outcomes of major depressive disorder (MDD). The effectiveness of currently available treatment methods for cognitive deficits is suboptimal. A cognitive test battery is often applied to evaluate cognition with multiple interrelated and difficult-to-interpret outcomes. Generating cognitive factor scores after the confirmation of a common cognitive structure and measurement invariance between healthy controls (HCs) and patients may aid in understanding cognition further. This methodology has been applied for several neuropsychiatric disorders, but not for MDD. Therefore, we conducted a series of exploratory factor analyses (EFA), confirmatory factor analyses (CFA), and multiple groups CFA (MGCFA) for a cognitive test battery in HCs and patients with MDD. The initial EFA of 106 HCs yielded a three-factor model-comprising attention, memory, and executive function. The CFA confirmed the initial model in other 94 HCs with revisions, which reasonably fit the cognitive data of 54 patients with MDD. MGCFA supported the measurement invariance of the determined model between HCs and patients with MDD. The associations of cognitive factor scores with age or education and the effect sizes of group differences in cognitive factor scores externally validated the determined model. In conclusion, this is the first study to demonstrate the measurement invariance of a cognitive model between HCs and patients with MDD using MGCFA. The measurement invariance substantiated valid group comparisons of factor scores and their relationships with other markers. The current results may be applicable for the development of improved treatment strategies for cognitive impairments in MDD.
Collapse
Affiliation(s)
- Kai-Chun Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Chih Hsieh
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Hwa Chou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Center for Quality Management, Taipei Veterans General Hospital, Taipei, Taiwan.
| |
Collapse
|
19
|
Rodriguez-Porcel F, Wyman-Chick KA, Abdelnour Ruiz C, Toledo JB, Ferreira D, Urwyler P, Weil RS, Kane J, Pilotto A, Rongve A, Boeve B, Taylor JP, McKeith I, Aarsland D, Lewis SJG. Clinical outcome measures in dementia with Lewy bodies trials: critique and recommendations. Transl Neurodegener 2022; 11:24. [PMID: 35491418 PMCID: PMC9059356 DOI: 10.1186/s40035-022-00299-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/31/2022] [Indexed: 12/28/2022] Open
Abstract
The selection of appropriate outcome measures is fundamental to the design of any successful clinical trial. Although dementia with Lewy bodies (DLB) is one of the most common neurodegenerative conditions, assessment of therapeutic benefit in clinical trials often relies on tools developed for other conditions, such as Alzheimer's or Parkinson's disease. These may not be sufficiently valid or sensitive to treatment changes in DLB, decreasing their utility. In this review, we discuss the limitations and strengths of selected available tools used to measure DLB-associated outcomes in clinical trials and highlight the potential roles for more specific objective measures. We emphasize that the existing outcome measures require validation in the DLB population and that DLB-specific outcomes need to be developed. Finally, we highlight how the selection of outcome measures may vary between symptomatic and disease-modifying therapy trials.
Collapse
Affiliation(s)
- Federico Rodriguez-Porcel
- Department of Neurology, Medical University of South Carolina, 208b Rutledge Av., Charleston, SC, 29403, USA.
| | - Kathryn A. Wyman-Chick
- grid.280625.b0000 0004 0461 4886Department of Neurology, Center for Memory and Aging, HealthPartners, Saint Paul, MN USA
| | - Carla Abdelnour Ruiz
- grid.7080.f0000 0001 2296 0625Autonomous University of Barcelona, Barcelona, Spain
| | - Jon B. Toledo
- grid.15276.370000 0004 1936 8091Fixel Institute for Neurological Diseases, University of Florida, Gainesville, FL USA
| | - Daniel Ferreira
- grid.4714.60000 0004 1937 0626Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Center for Alzheimer’s Research, Karolinska Institutet, Stockholm, Sweden ,grid.66875.3a0000 0004 0459 167XDepartment of Radiology, Mayo Clinic, Rochester, MN USA
| | - Prabitha Urwyler
- grid.5734.50000 0001 0726 5157ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Rimona S. Weil
- grid.83440.3b0000000121901201Dementia Research Centre, University College London, London, UK
| | - Joseph Kane
- grid.4777.30000 0004 0374 7521Centre for Public Health, Queen’s University, Belfast, UK
| | - Andrea Pilotto
- grid.7637.50000000417571846Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Arvid Rongve
- grid.413782.bDepartment of Research and Innovation, Helse Fonna, Haugesund Hospital, Haugesund, Norway ,grid.7914.b0000 0004 1936 7443Institute of Clinical Medicine (K1), The University of Bergen, Bergen, Norway
| | - Bradley Boeve
- grid.66875.3a0000 0004 0459 167XDepartment of Neurology, Center for Sleep Medicine, Mayo Clinic, Rochester, MN USA
| | - John-Paul Taylor
- grid.1006.70000 0001 0462 7212Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Ian McKeith
- grid.1006.70000 0001 0462 7212Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Dag Aarsland
- grid.13097.3c0000 0001 2322 6764Department of Old Age Psychiatry Institute of Psychiatry Psychology and Neuroscience, King’s College London, London, UK
| | - Simon J. G. Lewis
- grid.1013.30000 0004 1936 834XForeFront Parkinson’s Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, 100 Mallett Street, Camperdown, NSW 2050 Australia
| | | |
Collapse
|
20
|
Casanova R, Hsu FC, Barnard RT, Anderson AM, Talluri R, Whitlow CT, Hughes TM, Griswold M, Hayden KM, Gottesman RF, Wagenknecht LE. Comparing data-driven and hypothesis-driven MRI-based predictors of cognitive impairment in individuals from the Atherosclerosis Risk in Communities (ARIC) study. Alzheimers Dement 2022; 18:561-571. [PMID: 34310039 PMCID: PMC8789939 DOI: 10.1002/alz.12427] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/15/2021] [Accepted: 06/15/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION A data-driven index of dementia risk based on magnetic resonance imaging (MRI), the Alzheimer's Disease Pattern Similarity (AD-PS) score, was estimated for participants in the Atherosclerosis Risk in Communities (ARIC) study. METHODS AD-PS scores were generated for 839 cognitively non-impaired individuals with a mean follow-up of 4.86 years. The scores and a hypothesis-driven volumetric measure based on several brain regions susceptible to AD were compared as predictors of incident cognitive impairment in different settings. RESULTS Logistic regression analyses suggest the data-driven AD-PS scores to be more predictive of incident cognitive impairment than its counterpart. Both biomarkers were more predictive of incident cognitive impairment in participants who were White, female, and apolipoprotein E gene (APOE) ε4 carriers. Random forest analyses including predictors from different domains ranked the AD-PS scores as the most relevant MRI predictor of cognitive impairment. CONCLUSIONS Overall, the AD-PS scores were the stronger MRI-derived predictors of incident cognitive impairment in cognitively non-impaired individuals.
Collapse
Affiliation(s)
- Ramon Casanova
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem
| | - Ryan T. Barnard
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem
| | - Andrea M. Anderson
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem
| | - Rajesh Talluri
- University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Timothy M. Hughes
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Kathleen M. Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem
| | | | - Lynne E. Wagenknecht
- Divison of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | |
Collapse
|
21
|
Kang K, Song X. Consistent estimation of a joint model for multivariate longitudinal and survival data with latent variables. J MULTIVARIATE ANAL 2022. [DOI: 10.1016/j.jmva.2021.104827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
22
|
Arsiwala LT, Guo X, Ramulu PY, Sharrett AR, Mihailovic A, Swenor BK, Mosley T, Dong Y, Abraham AG. Associations of Visual Function With Cognitive Performance in Community-Based Older Adults: The Eye Determinants of Cognition Study. J Gerontol A Biol Sci Med Sci 2021; 77:2133-2140. [PMID: 35089306 DOI: 10.1093/gerona/glab349] [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: 06/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Given the detrimental impacts of visual and cognitive impairment separately, in older adults, understanding their coexistence could inform strategies against age-related cognitive changes. METHODS Participants from Washington County (White) and Jackson (Black) sites of the Atherosclerosis Risk in Communities Study were recruited who differed on racial, regional, urbanicity, and community-based factors. Presenting distance visual acuity (DVA; representing vision loss due to disease or lack of eye-care), corrected DVA (representing optimal correction for refractive loss of vision), and contrast sensitivity were measured. Factor scores for global cognition, memory, executive function, and language domains were calculated for 3 visits. We quantified the associations of vision measures with change in cognitive scores, stratified by community/race, using generalized estimating equations. RESULTS In 982 participants, mean (standard deviation [SD]) baseline age was 74 (4) years, with 37% males and 45% Jackson/Black participants. As hypothesized, after accounting for potential confounders, in the better-eye, worse presenting DVA was associated with greater 10-year decline rate in global cognition, memory, and executive function in Washington County/White participants (eg, global cognition: -0.08 SD [95% confidence interval: -0.12, -0.04]). Worse corrected DVA was associated with greater 10-year decline rate in executive function in Washington County/White participants (-0.10 SD [-0.15, -0.04]). Better contrast sensitivity was associated with lower 10-year decline rate in global cognition and executive function in Washington County/White participants (eg, global cognition: 0.10 SD [0.06,0.14]). None of these associations were confirmed in Jackson/Black participants. CONCLUSIONS Our study supports a functional link between some vision measures and cognition in older adults, but in only 1 of the 2 communities studied.
Collapse
Affiliation(s)
- Lubaina T Arsiwala
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Xinxing Guo
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Pradeep Y Ramulu
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Aleksandra Mihailovic
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas Mosley
- Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA.,Division of Neurology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - YaNan Dong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Alison G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.,Department of Epidemiology, School of Public Health, University of Colorado, Denver, Colorado, USA.,Department of Ophthalmology, School of Medicine, University of Colorado, Denver, Colorado, USA
| |
Collapse
|
23
|
El-Gamal FEZA, Elmogy M, Mahmoud A, Shalaby A, Switala AE, Ghazal M, Soliman H, Atwan A, Alghamdi NS, Barnes GN, El-Baz A. A Personalized Computer-Aided Diagnosis System for Mild Cognitive Impairment (MCI) Using Structural MRI (sMRI). SENSORS (BASEL, SWITZERLAND) 2021; 21:5416. [PMID: 34450858 PMCID: PMC8400990 DOI: 10.3390/s21165416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/28/2021] [Accepted: 08/03/2021] [Indexed: 12/31/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder that targets the central nervous system (CNS). Statistics show that more than five million people in America face this disease. Several factors hinder diagnosis at an early stage, in particular, the divergence of 10-15 years between the onset of the underlying neuropathological changes and patients becoming symptomatic. This study surveyed patients with mild cognitive impairment (MCI), who were at risk of conversion to AD, with a local/regional-based computer-aided diagnosis system. The described system allowed for visualization of the disorder's effect on cerebral cortical regions individually. The CAD system consists of four steps: (1) preprocess the scans and extract the cortex, (2) reconstruct the cortex and extract shape-based features, (3) fuse the extracted features, and (4) perform two levels of diagnosis: cortical region-based followed by global. The experimental results showed an encouraging performance of the proposed system when compared with related work, with a maximum accuracy of 86.30%, specificity 88.33%, and sensitivity 84.88%. Behavioral and cognitive correlations identified brain regions involved in language, executive function/cognition, and memory in MCI subjects, which regions are also involved in the neuropathology of AD.
Collapse
Affiliation(s)
- Fatma El-Zahraa A. El-Gamal
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (F.E.-Z.A.E.-G.); (A.M.); (A.S.); (A.E.S.); (A.E.-B.)
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt; (M.E.); (H.S.); (A.A.)
| | - Mohammed Elmogy
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt; (M.E.); (H.S.); (A.A.)
| | - Ali Mahmoud
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (F.E.-Z.A.E.-G.); (A.M.); (A.S.); (A.E.S.); (A.E.-B.)
| | - Ahmed Shalaby
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (F.E.-Z.A.E.-G.); (A.M.); (A.S.); (A.E.S.); (A.E.-B.)
| | - Andrew E. Switala
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (F.E.-Z.A.E.-G.); (A.M.); (A.S.); (A.E.S.); (A.E.-B.)
| | - Mohammed Ghazal
- Department of Electrical and Computer Engineering, Abu Dhabi University, Abu Dhabi 59911, United Arab Emirates;
| | - Hassan Soliman
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt; (M.E.); (H.S.); (A.A.)
| | - Ahmed Atwan
- Information Technology Department, Faculty of Computers and Information, Mansoura University, Mansoura 35516, Egypt; (M.E.); (H.S.); (A.A.)
| | - Norah Saleh Alghamdi
- College of Computer and Information Science, Princess Nourah Bint Abdulrahman University, Riyadh 11564, Saudi Arabia
| | - Gregory Neal Barnes
- Department of Neurology, University of Louisville, Louisville, KY 40292, USA;
| | - Ayman El-Baz
- Bioengineering Department, University of Louisville, Louisville, KY 40292, USA; (F.E.-Z.A.E.-G.); (A.M.); (A.S.); (A.E.S.); (A.E.-B.)
| |
Collapse
|
24
|
Wright LM, De Marco M, Venneri A. A Graph Theory Approach to Clarifying Aging and Disease Related Changes in Cognitive Networks. Front Aging Neurosci 2021; 13:676618. [PMID: 34322008 PMCID: PMC8311855 DOI: 10.3389/fnagi.2021.676618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/04/2021] [Indexed: 01/12/2023] Open
Abstract
In accordance with the physiological networks that underlie it, human cognition is characterized by both the segregation and interdependence of a number of cognitive domains. Cognition itself, therefore, can be conceptualized as a network of functions. A network approach to cognition has previously revealed topological differences in cognitive profiles between healthy and disease populations. The present study, therefore, used graph theory to determine variation in cognitive profiles across healthy aging and cognitive impairment. A comprehensive neuropsychological test battery was administered to 415 participants. This included three groups of healthy adults aged 18-39 (n = 75), 40-64 (n = 75), and 65 and over (n = 70) and three patient groups with either amnestic (n = 75) or non-amnestic (n = 60) mild cognitive impairment or Alzheimer's type dementia (n = 60). For each group, cognitive networks were created reflective of test-to-test covariance, in which nodes represented cognitive tests and edges reflected statistical inter-nodal significance (p < 0.05). Network metrics were derived using the Brain Connectivity Toolbox. Network-wide clustering, local efficiency and global efficiency of nodes showed linear differences across the stages of aging, being significantly higher among older adults when compared with younger groups. Among patients, these metrics were significantly higher again when compared with healthy older controls. Conversely, average betweenness centralities were highest in middle-aged participants and lower among older adults and patients. In particular, compared with controls, patients demonstrated a distinct lack of centrality in the domains of semantic processing and abstract reasoning. Network composition in the amnestic mild cognitive impairment group was similar to the network of Alzheimer's dementia patients. Using graph theoretical methods, this study demonstrates that the composition of cognitive networks may be measurably altered by the aging process and differentially impacted by pathological cognitive impairment. Network alterations characteristic of Alzheimer's disease in particular may occur early and be distinct from alterations associated with differing types of cognitive impairment. A shift in centrality between domains may be particularly relevant in identifying cognitive profiles indicative of underlying disease. Such techniques may contribute to the future development of more sophisticated diagnostic tools for neurodegenerative disease.
Collapse
Affiliation(s)
- Laura M Wright
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Matteo De Marco
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom.,Department of Life Sciences, Brunel University London, London, United Kingdom
| |
Collapse
|
25
|
Kwak S, Kim H, Kim H, Youm Y, Chey J. Distributed functional connectivity predicts neuropsychological test performance among older adults. Hum Brain Mapp 2021; 42:3305-3325. [PMID: 33960591 PMCID: PMC8193511 DOI: 10.1002/hbm.25436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 01/30/2023] Open
Abstract
Neuropsychological test is an essential tool in assessing cognitive and functional changes associated with late-life neurocognitive disorders. Despite the utility of the neuropsychological test, the brain-wide neural basis of the test performance remains unclear. Using the predictive modeling approach, we aimed to identify the optimal combination of functional connectivities that predicts neuropsychological test scores of novel individuals. Resting-state functional connectivity and neuropsychological tests included in the OASIS-3 dataset (n = 428) were used to train the predictive models, and the identified models were iteratively applied to the holdout internal test set (n = 216) and external test set (KSHAP, n = 151). We found that the connectivity-based predicted score tracked the actual behavioral test scores (r = 0.08-0.44). The predictive models utilizing most of the connectivity features showed better accuracy than those composed of focal connectivity features, suggesting that its neural basis is largely distributed across multiple brain systems. The discriminant and clinical validity of the predictive models were further assessed. Our results suggest that late-life neuropsychological test performance can be formally characterized with distributed connectome-based predictive models, and further translational evidence is needed when developing theoretically valid and clinically incremental predictive models.
Collapse
Affiliation(s)
- Seyul Kwak
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
| | - Hairin Kim
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
| | - Hoyoung Kim
- Department of PsychologyChonbuk National UniversityJeonjuRepublic of Korea
| | - Yoosik Youm
- Department of SociologyYonsei UniversitySeoulRepublic of Korea
| | - Jeanyung Chey
- Department of PsychologySeoul National UniversitySeoulRepublic of Korea
| |
Collapse
|
26
|
Amaefule CO, Dyrba M, Wolfsgruber S, Polcher A, Schneider A, Fliessbach K, Spottke A, Meiberth D, Preis L, Peters O, Incesoy EI, Spruth EJ, Priller J, Altenstein S, Bartels C, Wiltfang J, Janowitz D, Bürger K, Laske C, Munk M, Rudolph J, Glanz W, Dobisch L, Haynes JD, Dechent P, Ertl-Wagner B, Scheffler K, Kilimann I, Düzel E, Metzger CD, Wagner M, Jessen F, Teipel SJ. Association between composite scores of domain-specific cognitive functions and regional patterns of atrophy and functional connectivity in the Alzheimer's disease spectrum. Neuroimage Clin 2020; 29:102533. [PMID: 33360018 PMCID: PMC7770965 DOI: 10.1016/j.nicl.2020.102533] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 11/24/2020] [Accepted: 12/12/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cognitive decline has been found to be associated with gray matter atrophy and disruption of functional neural networks in Alzheimer's disease (AD) in structural and functional imaging (fMRI) studies. Most previous studies have used single test scores of cognitive performance among monocentric cohorts. However, cognitive domain composite scores could be more reliable than single test scores due to the reduction of measurement error. Adopting a multicentric resting state fMRI (rs-fMRI) and cognitive domain approach, we provide a comprehensive description of the structural and functional correlates of the key cognitive domains of AD. METHOD We analyzed MRI, rs-fMRI and cognitive domain score data of 490 participants from an interim baseline release of the multicenter DELCODE study cohort, including 54 people with AD, 86 with Mild Cognitive Impairment (MCI), 175 with Subjective Cognitive Decline (SCD), and 175 Healthy Controls (HC) in the AD-spectrum. Resulting cognitive domain composite scores (executive, visuo-spatial, memory, working memory and language) from the DELCODE neuropsychological battery (DELCODE-NP), were previously derived using confirmatory factor analysis. Statistical analyses examined the differences between diagnostic groups, and the association of composite scores with regional atrophy and network-specific functional connectivity among the patient subgroup of SCD, MCI and AD. RESULT Cognitive performance, atrophy patterns and functional connectivity significantly differed between diagnostic groups in the AD-spectrum. Regional gray matter atrophy was positively associated with visuospatial and other cognitive impairments among the patient subgroup in the AD-spectrum. Except for the visual network, patterns of network-specific resting-state functional connectivity were positively associated with distinct cognitive impairments among the patient subgroup in the AD-spectrum. CONCLUSION Consistent associations between cognitive domain scores and both regional atrophy and network-specific functional connectivity (except for the visual network), support the utility of a multicentric and cognitive domain approach towards explicating the relationship between imaging markers and cognition in the AD-spectrum.
Collapse
Affiliation(s)
| | - Martin Dyrba
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany
| | - Steffen Wolfsgruber
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | | | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Dix Meiberth
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Cologne, Germany
| | - Lukas Preis
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Oliver Peters
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Enise I Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Eike J Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Slawek Altenstein
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Goettingen, Germany
| | - Jens Wiltfang
- German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen (UMG), Goettingen, Germany; Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Daniel Janowitz
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Katharina Bürger
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tuebingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Matthias Munk
- Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
| | - Janna Rudolph
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - John D Haynes
- Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin, Berlin, Germany
| | - Peter Dechent
- MR-Research in Neurology and Psychiatry, Georg-August-University Goettingen, Germany
| | - Birgit Ertl-Wagner
- Institute for Clinical Radiology, Ludwig Maximilians University, Munich, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tuebingen, Tuebingen, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
| | - Coraline D Metzger
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital, Bonn, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Psychiatry, University of Cologne, Cologne, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Stefan J Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| |
Collapse
|
27
|
Jiang S, Xie Y, Colditz GA. Functional ensemble survival tree: Dynamic prediction of Alzheimer’s disease progression accommodating multiple time‐varying covariates. J R Stat Soc Ser C Appl Stat 2020. [DOI: 10.1111/rssc.12449] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Shu Jiang
- Division of Public Health Sciences Washington University School of Medicine in St. Louis St. Louis USA
| | - Yijun Xie
- Department of Statistics and Actuarial Sciences University of Waterloo Waterloo Canada
| | - Graham A. Colditz
- Division of Public Health Sciences Washington University School of Medicine in St. Louis St. Louis USA
| |
Collapse
|
28
|
Cremona S, Jobard G, Zago L, Mellet E. Word Meaning Contributes to Free Recall Performance in Supraspan Verbal List-Learning Tests. Front Psychol 2020; 11:2043. [PMID: 32922343 PMCID: PMC7457129 DOI: 10.3389/fpsyg.2020.02043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 07/23/2020] [Indexed: 11/13/2022] Open
|
29
|
Gross AL, Khobragade PY, Meijer E, Saxton JA. Measurement and Structure of Cognition in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia. J Am Geriatr Soc 2020; 68 Suppl 3:S11-S19. [PMID: 32815599 PMCID: PMC7513554 DOI: 10.1111/jgs.16738] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/24/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To test whether a relatively complex model of human cognitive abilities based on Cattell-Horn-Carroll (CHC) theory, developed mainly in English-speaking samples, adequately describes correlations among tests in the Longitudinal Aging Study in India-Diagnostic Assessment of Dementia (LASI-DAD), and to develop accurate measures of cognition for older individuals in India. DESIGN LASI-DAD participants were recruited from participants aged 60 years and older from 14 states in the core LASI survey, with a stratified sampling design. SETTING Participants were interviewed at home or in a participating hospital, according to their preferences. PARTICIPANTS Community-residing older adults aged 60 years and older (N = 3,224). MEASUREMENTS A variety of cognitive tests were administered during two pretests and chosen for their appropriateness for measuring cognition in older adults in India and suitability for calibration with the core LASI survey and the Harmonized Cognitive Assessment Protocol. RESULTS We evaluated the factor structure of the test battery and its conformity with a classical CHC factor model that incorporated measurement models for general cognition, five broad domains (orientation, executive functioning, language/fluency, memory, and visuospatial), and five narrow domains (reasoning, attention/speed, immediate memory, delayed memory, and recognition memory) of cognitive performance. Model fit was adequate (root mean square error of approximation = 0.051; comparative fit index = 0.916; standardized root mean squared residual = 0.060). CONCLUSION We demonstrated configural factorial invariance of a cognitive battery in the Indian LASI-DAD using CHC theory. Broad domain factors may be used in future research to rank individuals with respect to cognitive performance and classify cognitive impairment. J Am Geriatr Soc 68:S11-S19, 2020.
Collapse
Affiliation(s)
- Alden L. Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Pranali Y. Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, California
| | - Erik Meijer
- Center for Economic and Social Research, University of Southern California, Los Angeles, California
| | - Judith A. Saxton
- Center for Economic and Social Research, University of Southern California, Los Angeles, California
| |
Collapse
|
30
|
Wolfsgruber S, Kleineidam L, Guski J, Polcher A, Frommann I, Roeske S, Spruth EJ, Franke C, Priller J, Kilimann I, Teipel S, Buerger K, Janowitz D, Laske C, Buchmann M, Peters O, Menne F, Fuentes Casan M, Wiltfang J, Bartels C, Düzel E, Metzger C, Glanz W, Thelen M, Spottke A, Ramirez A, Kofler B, Fließbach K, Schneider A, Heneka MT, Brosseron F, Meiberth D, Jessen F, Wagner M. Minor neuropsychological deficits in patients with subjective cognitive decline. Neurology 2020; 95:e1134-e1143. [PMID: 32636322 DOI: 10.1212/wnl.0000000000010142] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 03/03/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To determine the nature and extent of minor neuropsychological deficits in patients with subjective cognitive decline (SCD) and their association with CSF biomarkers of Alzheimer disease (AD). METHOD We analyzed data from n = 449 cognitively normal participants (n = 209 healthy controls, n = 240 patients with SCD) from an interim data release of the German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study (DELCODE). An extensive neuropsychological test battery was applied at baseline for which we established a latent, 5 cognitive domain factor structure comprising learning and memory, executive functions, language abilities, working memory, and visuospatial functions. We compared groups in terms of global and domain-specific performance and correlated performance with different CSF markers of AD pathology. RESULTS We observed worse performance (Cohen d = ≈0.25-0.5, adjusted for age, sex differences with analysis of covariance) in global performance, memory, executive functions, and language abilities for the SCD group compared to healthy controls. In addition, worse performance in these domains was moderately (r = ≈0.3) associated with lower CSF β-amyloid42/40 and CSF β-amyloid42/phosphorylated tau181 in the whole sample and specifically in the SCD subgroup. CONCLUSIONS Within the spectrum of clinically unimpaired (i.e., before mild cognitive impairment) cognitive performance, SCD is associated with minor deficits in memory, executive function, and language abilities. The association of these subtle cognitive deficits with AD CSF biomarkers speaks to their validity and potential use for the early detection of underlying preclinical AD.
Collapse
Affiliation(s)
- Steffen Wolfsgruber
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany.
| | - Luca Kleineidam
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Jannis Guski
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Alexandra Polcher
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Ingo Frommann
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Sandra Roeske
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Eike Jakob Spruth
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Christiana Franke
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Josef Priller
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Ingo Kilimann
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Stefan Teipel
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Katharina Buerger
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Daniel Janowitz
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Christoph Laske
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Martina Buchmann
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Oliver Peters
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Felix Menne
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Manuel Fuentes Casan
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Jens Wiltfang
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Claudia Bartels
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Emrah Düzel
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Coraline Metzger
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Wenzel Glanz
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Manuela Thelen
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Annika Spottke
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Alfredo Ramirez
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Barbara Kofler
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Klaus Fließbach
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Anja Schneider
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Michael T Heneka
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Frederic Brosseron
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Dix Meiberth
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Frank Jessen
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | - Michael Wagner
- From the German Center for Neurodegenerative Diseases (S.W., L.K., J.G., A.P., I.F., S.R., M.T., A. Spottke, A.R., B.K., K.F., A. Schneider, M.H., F.B., D.M., F.J., M.W.); Department of Neurodegenerative Diseases and Geriatric Psychiatry (S.W., L.K., J.G., A.P., I.F., A.R., B.K., K.F., A. Schneider, M.T.H., F.B., M.W.), University of Bonn; German Center for Neurodegenerative Diseases (E.J.S., J.P., O.P., F.M., M.F.C.); Department of Psychiatry and Psychotherapy (E.J.S., C.F., J.P.), Charité-Universitätsmedizin Berlin; German Center for Neurodegenerative Diseases (I.K., S.T.); Department of Psychosomatic Medicine (I.K., S.T.), Rostock University Medical Center; German Center for Neurodegenerative Diseases (K.B.); Institute for Stroke and Dementia Research (K.B., D.J.), University Hospital, LMU Munich; German Center for Neurodegenerative Diseases (C.L., M.B.); Section for Dementia Research (C.L., M.B.), Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen; Charité-Universitätsmedizin Berlin (O.P., F.M., M.F.C.), corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin; (O.P., F.M., M.F.C.), Berlin Institute of Health, Institute of Psychiatry and Psychotherapy; German Center for Neurodegenerative Diseases (J.W., C.B.); Department of Psychiatry and Psychotherapy (J.W., C.B.), University Medical Center Goettingen, University of Goettingen; German Center for Neurodegenerative Diseases (E.D., C.M.); Institute of Cognitive Neurology and Dementia Research (E.D., C.M., W.G.) and Department of Psychiatry and Psychotherapy (C.M.), Otto-von-Guericke University, Magdeburg; Department of Neurology (A. Spottke), University Hospital Bonn; and Division of Neurogenetics and Molecular Psychiatry (A.R.) and Department of Psychiatry (M.T., D.M., F.J.), Medical Faculty University of Cologne, Germany
| | | |
Collapse
|
31
|
Vermeent S, Dotsch R, Schmand B, Klaming L, Miller JB, van Elswijk G. Evidence of Validity for a Newly Developed Digital Cognitive Test Battery. Front Psychol 2020; 11:770. [PMID: 32390918 PMCID: PMC7194127 DOI: 10.3389/fpsyg.2020.00770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 03/30/2020] [Indexed: 01/11/2023] Open
Abstract
Clinical practice still relies heavily on traditional paper-and-pencil testing to assess a patient’s cognitive functions. Digital technology has the potential to be an efficient and powerful alternative, but for many of the existing digital tests and test batteries the psychometric properties have not been properly established. We validated a newly developed digital test battery consisting of digitized versions of conventional neuropsychological tests. Two confirmatory factor analysis models were specified: a model based on traditional neuropsychological theory and expert consensus and one based on the Cattell-Horn-Carroll (CHC) taxonomy. For both models, the outcome measures of the digital tests loaded on the cognitive domains in the same way as established in the neuropsychological literature. Interestingly, no clear distinction could be made between the CHC model and traditional neuropsychological model in terms of model fit. Taken together, these findings provide preliminary evidence for the structural validity of the digital cognitive test battery.
Collapse
Affiliation(s)
- Stefan Vermeent
- Digital Cognitive Diagnostics, Philips Healthcare, Eindhoven, Netherlands
| | - Ron Dotsch
- Department of Brain, Behavior and Cognition, Philips Research, Eindhoven, Netherlands
| | - Ben Schmand
- Digital Cognitive Diagnostics, Philips Healthcare, Eindhoven, Netherlands
| | - Laura Klaming
- Department of Brain, Behavior and Cognition, Philips Research, Eindhoven, Netherlands
| | - Justin B Miller
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| | - Gijs van Elswijk
- Digital Cognitive Diagnostics, Philips Healthcare, Eindhoven, Netherlands
| |
Collapse
|
32
|
Agelink van Rentergem JA, de Vent NR, Schmand BA, Murre JMJ, Staaks JPC, Huizenga HM. The Factor Structure of Cognitive Functioning in Cognitively Healthy Participants: a Meta-Analysis and Meta-Analysis of Individual Participant Data. Neuropsychol Rev 2020; 30:51-96. [PMID: 32008158 PMCID: PMC7089912 DOI: 10.1007/s11065-019-09423-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 12/04/2019] [Indexed: 12/14/2022]
Abstract
Many neuropsychologists are of the opinion that the multitude of cognitive tests may be grouped into a much smaller number of cognitive domains. However, there is little consensus on how many domains exist, what these domains are, nor on which cognitive tests belong to which domain. This incertitude can be solved by factor analysis, provided that the analysis includes a broad range of cognitive tests that have been administered to a very large number of people. In this article, two such factor analyses were performed, each combining multiple studies. However, because it was not possible to obtain complete multivariate data on more than the most common test variables in the field, not all possible domains were examined here. The first analysis was a factor meta-analysis of correlation matrices combining data of 60,398 healthy participants from 52 studies. Several models from the literature were fitted, of which a version based on the Cattell-Horn-Carroll (CHC) model was found to describe the correlations better than the others. The second analysis was a factor analysis of the Advanced Neuropsychological Diagnostics Infrastructure (ANDI) database, combining scores of 11,881 participants from 54 Dutch and Belgian studies not included in the first meta-analysis. Again, the model fit was better for the CHC model than for other models. Therefore, we conclude that the CHC model best characterizes both cognitive domains and which test belongs to each domain. Therefore, although originally developed in the intelligence literature, the CHC model deserves more attention in neuropsychology.
Collapse
Affiliation(s)
- Joost A. Agelink van Rentergem
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS Amsterdam, The Netherlands
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nathalie R. de Vent
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS Amsterdam, The Netherlands
| | - Ben A. Schmand
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS Amsterdam, The Netherlands
- Department of Medical Psychology, Academic Medical Center, Amsterdam, The Netherlands
- Amsterdam Brain and Cognition Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap M. J. Murre
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS Amsterdam, The Netherlands
| | - Janneke P. C. Staaks
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - ANDI Consortium
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Hilde M. Huizenga
- Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018WS Amsterdam, The Netherlands
- Amsterdam Brain and Cognition Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
- Research priority area Yield, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
33
|
Garcia-Alvarez L, Gomar JJ, Sousa A, Garcia-Portilla MP, Goldberg TE. Breadth and depth of working memory and executive function compromises in mild cognitive impairment and their relationships to frontal lobe morphometry and functional competence. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2019; 11:170-179. [PMID: 30911598 PMCID: PMC6416209 DOI: 10.1016/j.dadm.2018.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The extent of working memory (WM) and executive function (EF) impairment in mild cognitive impairment (MCI) is not well-characterized. METHODS We compared 48 patients with MCI, 124 noncognitively impaired elderly healthy controls, and 57 patients with Alzheimer's disease (AD) on multiple WM/EF measures, frontal lobe integrity indexes, and functioning. RESULTS Patients with MCI demonstrated worse performance on nearly all WM/EF tests. This profile of impairment was refined in a factor analysis that identified three primary WM/EF constructs: WM storage; speed and controlled visual search; and manipulation of information and problem solving. EF impairments were associated with reductions in prefrontal cortical thickness. WM/EF accounted for over 50% of the variance in functional competence. DISCUSSION In MCI, WM/EF impairments are far from rare, based on specific compromises to frontal cortex circuitry, and are associated with loss of everyday functioning. WM/EF impairments, even at this potentially prodromal stage of AD, have clinically deleterious consequences.
Collapse
Affiliation(s)
- Leticia Garcia-Alvarez
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
- Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias (Finba), Oviedo, Spain
| | - Jesus J. Gomar
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
- The Litwin-Zucker Alzheimer's Research Center, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- FIDMAG Hermanas Hospitalarias Research Foundation, SantBoi de Llobregat, Spain
| | - Amber Sousa
- The Litwin-Zucker Alzheimer's Research Center, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - Maria P. Garcia-Portilla
- Department of Psychiatry, University of Oviedo, Oviedo, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain
- Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias (Finba), Oviedo, Spain
| | - Terry E. Goldberg
- Division of Geriatric Psychiatry, Psychiatry, Columbia University Medical Center, NY, USA
| |
Collapse
|
34
|
Taddé BO, Jacqmin-Gadda H, Dartigues JF, Commenges D, Proust-Lima C. Dynamic modeling of multivariate dimensions and their temporal relationships using latent processes: Application to Alzheimer's disease. Biometrics 2019; 76:886-899. [PMID: 31647111 DOI: 10.1111/biom.13168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/20/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
Alzheimer's disease gradually affects several components including the cerebral dimension with brain atrophies, the cognitive dimension with a decline in various functions, and the functional dimension with impairment in the daily living activities. Understanding how such dimensions interconnect is crucial for Alzheimer's disease research. However, it requires to simultaneously capture the dynamic and multidimensional aspects and to explore temporal relationships between dimensions. We propose an original dynamic structural model that accounts for all these features. The model defines dimensions as latent processes and combines a multivariate linear mixed model and a system of difference equations to model trajectories and temporal relationships between latent processes in finely discrete time. Dimensions are simultaneously related to their observed (possibly multivariate) markers through nonlinear equations of observation. Parameters are estimated in the maximum likelihood framework enjoying a closed form for the likelihood. We demonstrate in a simulation study that this dynamic model in discrete time benefits the same causal interpretation of temporal relationships as models defined in continuous time as long as the discretization step remains small. The model is then applied to the data of the Alzheimer's Disease Neuroimaging Initiative. Three longitudinal dimensions (cerebral anatomy, cognitive ability, and functional autonomy) measured by six markers are analyzed, and their temporal structure is contrasted between different clinical stages of Alzheimer's disease.
Collapse
Affiliation(s)
- Bachirou O Taddé
- INSERM, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, ISPED, Bordeaux, France
| | - Hélène Jacqmin-Gadda
- INSERM, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, ISPED, Bordeaux, France
| | - Jean-François Dartigues
- INSERM, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, ISPED, Bordeaux, France
| | - Daniel Commenges
- INSERM, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, ISPED, Bordeaux, France
| | - Cécile Proust-Lima
- INSERM, Bordeaux Population Health Research Center, UMR1219, University of Bordeaux, ISPED, Bordeaux, France
| |
Collapse
|
35
|
Mirza SS, Saeed U, Knight J, Ramirez J, Stuss DT, Keith J, Nestor SM, Yu D, Swardfager W, Rogaeva E, St George Hyslop P, Black SE, Masellis M. APOE ε4, white matter hyperintensities, and cognition in Alzheimer and Lewy body dementia. Neurology 2019; 93:e1807-e1819. [PMID: 31575706 PMCID: PMC6946485 DOI: 10.1212/wnl.0000000000008377] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 06/13/2019] [Indexed: 01/07/2023] Open
Abstract
Objective To determine if APOE ε4 influences the association between white matter hyperintensities (WMH) and cognitive impairment in Alzheimer disease (AD) and dementia with Lewy bodies (DLB). Methods A total of 289 patients (AD = 239; DLB = 50) underwent volumetric MRI, neuropsychological testing, and APOE ε4 genotyping. Total WMH volumes were quantified. Neuropsychological test scores were included in a confirmatory factor analysis to identify cognitive domains encompassing attention/executive functions, learning/memory, and language, and factor scores for each domain were calculated per participant. After testing interactions between WMH and APOE ε4 in the full sample, we tested associations of WMH with factor scores using linear regression models in APOE ε4 carriers (n = 167) and noncarriers (n = 122). We hypothesized that greater WMH volume would relate to worse cognition more strongly in APOE ε4 carriers. Findings were replicated in 198 patients with AD from the Alzheimer's Disease Neuroimaging Initiative (ADNI-I), and estimates from both samples were meta-analyzed. Results A significant interaction was observed between WMH and APOE ε4 for language, but not for memory or executive functions. Separate analyses in APOE ε4 carriers and noncarriers showed that greater WMH volume was associated with worse attention/executive functions, learning/memory, and language in APOE ε4 carriers only. In ADNI-I, greater WMH burden was associated with worse attention/executive functions and language in APOE ε4 carriers only. No significant associations were observed in noncarriers. Meta-analyses showed that greater WMH volume was associated with worse performance on all cognitive domains in APOE ε4 carriers only. Conclusion APOE ε4 may influence the association between WMH and cognitive performance in AD and DLB.
Collapse
Affiliation(s)
- Saira Saeed Mirza
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK.
| | - Usman Saeed
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Jo Knight
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Joel Ramirez
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Donald T Stuss
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Julia Keith
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Sean M Nestor
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Di Yu
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Walter Swardfager
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Ekaterina Rogaeva
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Peter St George Hyslop
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Sandra E Black
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | - Mario Masellis
- From the Division of Neurology, Department of Medicine (S.S.M., D.T.S., S.E.B., M.M.), Hurvitz Brain Sciences Research Program (S.S.M., J.R., D.T.S., D.Y., W.S., S.E.B., M.M.) and LC Campbell Cognitive Neurology Research Unit (U.S., J.R., S.M.N., D.Y., W.S., S.E.B., M.M.), Sunnybrook Research Institute, Institute of Medical Science (U.S., S.E.B., M.M.), Rehabilitation Sciences Institute (D.T.S., S.E.B.), and Department of Psychiatry (S.M.N.), Faculty of Medicine, Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (J.R., D.Y., W.S., S.E.B.) and Department of Anatomic Pathology (J.K.), Sunnybrook Health Sciences Centre, Department of Psychology, Faculty of Arts and Science (D.T.S.), Department of Pharmacology & Toxicity (D.Y., W.S.), Tanz Centre for Research in Neurodegenerative Diseases (E.R., P.S.G.H.), and Institute of Biomaterials and Biomedical Engineering (S.E.B.), University of Toronto, Canada; Data Science Institute and Medical School (J.K.), Lancaster University, Lancaster; and Cambridge Institute for Medical Research (P.S.G.H.), Department of Clinical Neuroscience, University of Cambridge, UK
| | | |
Collapse
|
36
|
Gil G, Magaldi RM, Busse AL, Ribeiro ES, Brucki SMD, Yassuda MS, Jacob-Filho W, Apolinario D. Development of a word accentuation test for predicting cognitive performance in Portuguese-speaking populations. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:560-567. [PMID: 31508682 DOI: 10.1590/0004-282x20190089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/24/2019] [Indexed: 06/10/2023]
Abstract
The Word Accentuation Test (WAT) has been used to predict premorbid intelligence and cognitive performance in Spanish-speaking populations. It requires participants to read a list of words without the accent marks that indicate the stressed syllable. Label="OBJECTIVE">As Portuguese pronunciation is also strongly based on accent marks, our aim was to develop a Brazilian version of the WAT. METHODS An initial pool of 60 items was constructed and a final version of 40 items (named WAT-Br) was derived by item response theory. A sample of 206 older adults underwent the WAT-Br and a standardized neuropsychological battery. Independent ratings were performed by two observers in 58 random participants. RESULTS The items showed moderate to high discrimination (α between 0.93 and 25.04) and spanned a wide range of difficulty (β between -2.07 and 1.40). The WAT-Br was shown to have an excellent internal consistency (Kuder-Richardson Formula 20 = 0.95) and inter-rater reliability (intraclass correlation coefficient = 0.92). It accounted for 61% of the variance in global cognitive performance. CONCLUSION A version of the WAT for Portuguese-speaking populations was developed and proved to be a valuable tool for estimating cognitive performance.
Collapse
Affiliation(s)
- Gislaine Gil
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
| | - Regina Miksian Magaldi
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
| | - Alexandre Leopold Busse
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
| | - Elyse Soares Ribeiro
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
- Hospital das Clínicas, Divisão de Psicologia, São Paulo SP, Brasil
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brasil
| | - Mônica Sanches Yassuda
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, Grupo de Neurologia Cognitiva e Comportamental, São Paulo SP, Brasil
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, São Paulo SP, Brasil
| | - Wilson Jacob-Filho
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
| | - Daniel Apolinario
- Universidade de São Paulo, Faculdade de Medicina, Departamento de Clínica Médica, Disciplina de Geriatria, São Paulo SP Brasil
| |
Collapse
|
37
|
Avila JF, Rentería MA, Witkiewitz K, Verney SP, Vonk JMJ, Manly JJ. Measurement invariance of neuropsychological measures of cognitive aging across race/ethnicity by sex/gender groups. Neuropsychology 2019; 34:3-14. [PMID: 31464473 DOI: 10.1037/neu0000584] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVE The purpose of this study was to evaluate the measurement invariance of a neuropsychological battery across race/ethnicity by sex/gender subgroups over repeated measurements. METHOD Participants were 6,057 non-Hispanic White (NHW), Black, and Hispanic men and women in the Washington/Hamilton Heights Inwood Columbia Aging Project (WHICAP) who were administered neuropsychological tests of memory, language, and visuospatial abilities at 18 to 24-month intervals for up to 25 years. Invariance analyses were conducted on the three-factor model across sex/gender, racial/ethnic, and sex/gender by racial/ethnic subgroups, as well as across five assessment timepoints. RESULTS The three-factor model demonstrated full measurement invariance across sex/gender groups and over repeated measurements. However, partial measurement invariance (invariant factor structure and factor loadings but nonequivalent observed score intercepts) for the language domain was exhibited across racial/ethnic and sex/gender by racial/ethnic subgroups. CONCLUSION Establishing measurement invariance is essential for valid interpretation of group differences in cognitive test performance. Findings from the current study highlight the need for continued examination of sex/gender by racial/ethnic differences in measurement properties of assessment tools, as well as expanded research on sex/gender variability across other understudied racial/ethnic groups. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
Collapse
Affiliation(s)
| | - Miguel Arce Rentería
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain
| | | | | | - Jet M J Vonk
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain
| | - Jennifer J Manly
- Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain
| |
Collapse
|
38
|
Pires L, Moura O, Guerrini C, Buekenhout I, Simões MR, Leitão J. Confirmatory Factor Analysis of Neurocognitive Measures in Healthy Young Adults: The Relation of Executive Functions with Other Neurocognitive Functions. Arch Clin Neuropsychol 2019; 34:350-365. [PMID: 29688248 DOI: 10.1093/arclin/acy040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 03/12/2018] [Accepted: 04/03/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The present study aimed to investigate the factor structure of a set of neurocognitive tests theoretically assessing executive functions (EF), verbal abilities (VA), and processing speed (PS). This study extended previous research by analyzing if each test is better explained by the specific factor to which it theoretically belongs or by a more general neurocognitive factor; and also by analyzing the relations between the neurocognitive factors. METHODS Using confirmatory factor analysis (CFA) we examined the factor structure of nine neurocognitive tests (EF: Working Memory, Tower, Divided Attention, Stroop, and Verbal Fluency tests; VA: Word List and Confrontation Naming tests; PS: Coding and Telephone Search tests) in a nonclinical sample (N = 90; 18-33 years old, 76 women). We tested five factor models of neurocognitive functioning: a one-factor model; two models with two-correlated factors; and two models with three-correlated factors. RESULTS A three-correlated-factor model, with EF, VA, and PS factors, was the most suitable for our neuropsychological data. The Verbal Fluency test was better explained by the VA factor rather than by the EF factor. The EF factor was correlated with the PS factor, but not with the VA factor. CONCLUSIONS Most of the neurocognitive measures used in the present study loaded in the expected factors (with the exception of the Verbal Fluency that was apparently more related to VA). EF and PS represent related but separable functions. Our results highlight the need for a careful interpretation of test scores since performance on one test usually requires multiple functions.
Collapse
Affiliation(s)
- Luís Pires
- CINEICC - Neuropsychology Research and Cognitive and Behavioural Intervention Center, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Memory, Language and Executive Functions Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Centre for Health and Clinical Neuroscience, Psychology, School of Life Sciences, University of Hull, UK
| | - Octávio Moura
- CINEICC - Neuropsychology Research and Cognitive and Behavioural Intervention Center, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Psychological Assessment Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Chiara Guerrini
- Centre for Health and Clinical Neuroscience, Psychology, School of Life Sciences, University of Hull, UK
| | - Imke Buekenhout
- CINEICC - Neuropsychology Research and Cognitive and Behavioural Intervention Center, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Memory, Language and Executive Functions Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Mário R Simões
- CINEICC - Neuropsychology Research and Cognitive and Behavioural Intervention Center, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Psychological Assessment Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - José Leitão
- CINEICC - Neuropsychology Research and Cognitive and Behavioural Intervention Center, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.,Memory, Language and Executive Functions Lab, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
39
|
Bregman N, Kavé G, Shiner T, Biran I. Dissociation in awareness of memory and language decline in Alzheimer's disease. Int J Geriatr Psychiatry 2019; 34:548-554. [PMID: 30548691 DOI: 10.1002/gps.5049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 12/09/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The aim of this study was to examine awareness of decline in memory and in language in individuals with Alzheimer's disease (AD), by comparing participant and informant ratings, as well as these ratings and actual test performance. METHODS We analyzed data from 149 individuals with AD enrolled in the Alzheimer's Disease Neuroimaging Initiative (ADNI) who filled the Everyday Cognition questionnaire and performed memory and language tasks. RESULTS Participants provided significantly lower assessments of decline than did informants for both memory and language. There was a negative association between informant ratings and memory test scores but no association between participant ratings and memory test scores. Both participant and informant ratings correlated negatively with performance on the language tests. Informant, but not participant, ratings contributed to the prediction of one memory variable beyond demographic factors. Participant ratings contributed to the prediction of language scores beyond demographic factors more than did informant ratings. CONCLUSIONS The findings reflect better awareness of decline in language than of decline in memory in individuals with AD.
Collapse
Affiliation(s)
- Noa Bregman
- Center for Memory and Attention Disorders, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gitit Kavé
- Center for Memory and Attention Disorders, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Department of Education and Psychology, The Open University, Ra'anana, Israel
| | - Tamara Shiner
- Center for Memory and Attention Disorders, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Movement Disorders Unit, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Iftah Biran
- Center for Memory and Attention Disorders, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | |
Collapse
|
40
|
Gavett BE, Stypulkowski K, Johnson L, Hall J, O'Bryant SE. Factor structure and measurement invariance of a neuropsychological test battery designed for assessment of cognitive functioning in older Mexican Americans. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2018; 10:536-544. [PMID: 30364611 PMCID: PMC6197794 DOI: 10.1016/j.dadm.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The present study sought to investigate the measurement invariance of commonly used neuropsychological tests in an ethnically (Hispanic vs. non-Hispanic) and linguistically (Spanish vs. English) diverse sample. METHODS Participants were 736 middle-aged and older adults (M Age = 62.1, SD = 9.1) assessed at baseline. Measurement invariance testing was performed using multiple-group confirmatory factor analysis. RESULTS A five-factor model (memory, attention/executive functioning/processing speed, language, visuospatial, and motor) fit the data well (CFI = 0.979, RMSEA = 0.047) and the composite reliability of the factors ranged from .76 (visuospatial) to .97 (motor). The five-factor model was found to possess strict measurement invariance for ethnicity and language without a decrement in fit compared to a strong (scalar) invariance model (ΔCFI = .000, ΔRMSEA = .002). DISCUSSION These results indicate that a five-factor model is suitable for estimating cognitive functioning in Mexican Americans and non-Hispanic whites without bias by ethnicity or language.
Collapse
Affiliation(s)
- Brandon E. Gavett
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Katie Stypulkowski
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Leigh Johnson
- Center for Alzheimer's & Neurodegenerative Disease Research, Institute for Healthy Aging, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | - James Hall
- Center for Alzheimer's & Neurodegenerative Disease Research, Institute for Healthy Aging, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | - Sid E. O'Bryant
- Center for Alzheimer's & Neurodegenerative Disease Research, Institute for Healthy Aging, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| |
Collapse
|
41
|
Head D, Allison S, Lucena N, Hassenstab J, Morris JC. Latent structure of cognitive performance in the adult children study. J Clin Exp Neuropsychol 2017; 39:621-635. [PMID: 27868476 PMCID: PMC5438781 DOI: 10.1080/13803395.2016.1252725] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The Adult Children Study (ACS) at the Knight Alzheimer's Disease Research Center is a longitudinal investigation designed to identify and validate potential biomarkers of preclinical Alzheimer's disease (AD) in cognitively normal individuals with and without a family history of AD. The purpose of the current study was to validate the proposed latent structure of the ACS psychometric battery. METHOD Confirmatory factor analyses of baseline data in a sample of 229 (75 men) cognitively normal middle-aged to older adult individuals assessed a hypothesized 4-factor model of cognitive performance. Measurement invariance was investigated as a function of family history of AD and apolipoprotein E (APOE) status. RESULTS This study confirmed a priori hypotheses of 4 latent cognitive domains in a unique longitudinal sample of cognitively normal adults. In addition, there was evidence of a similar factor structure for family history and APOE status groups. CONCLUSION These robust indicators of a broad range of cognitive domains will be used in future investigations to track the influence of family history of AD on cognitive performance over time. In addition, associations with fluid, structural, and molecular biomarkers of preclinical AD will be further examined, both cross-sectionally and longitudinally in this sample.
Collapse
Affiliation(s)
- Denise Head
- Department of Psychology, Washington University in St. Louis
- Knight Alzheimer’s Disease Research Center, Washington University in St. Louis
- Department of Radiology, Washington University in St. Louis
| | | | | | - Jason Hassenstab
- Department of Psychology, Washington University in St. Louis
- Knight Alzheimer’s Disease Research Center, Washington University in St. Louis
- Department of Neurology, Washington University in St. Louis
| | - John C. Morris
- Knight Alzheimer’s Disease Research Center, Washington University in St. Louis
- Department of Neurology, Washington University in St. Louis
| |
Collapse
|
42
|
Haroz EE, Jordans M, de Jong J, Gross A, Bass J, Tol W. Measuring Hope Among Children Affected by Armed Conflict: Cross-Cultural Construct Validity of the Children's Hope Scale. Assessment 2017; 24:528-539. [PMID: 26508802 PMCID: PMC5835958 DOI: 10.1177/1073191115612924] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated the cross-cultural construct validity of hope, a factor associated with mental health protection and promotion, using the Children's Hope Scale (CHS). The sample ( n = 1,057; 48% girls) included baseline data from three cluster-randomized controlled trials with children affected by armed conflict ( n = 329 Burundi; n = 403 Indonesia; n = 325 Nepal). The confirmatory factor analysis in each country indicated good fit for the hypothesized two-factor model. Analysis by gender indicated that configural invariance was supported and that scalar invariance was demonstrated in Indonesia. However, metric and scalar invariance were not supported in Burundi and Nepal. In country comparisons, configural and metric invariance were met, but scalar invariance was not supported. Evidence from this study supports the use of the CHS within various sociocultural settings and across genders, but direct comparisons of CHS scores across groups should be done with caution. Rigorous evaluations of the measurement properties of mental health protective and promotive factors are necessary to inform both research and practice.
Collapse
Affiliation(s)
- Emily E. Haroz
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark Jordans
- HealthNet TPO, Amsterdam, Netherlands
- Kings College London, London, UK
| | | | - Alden Gross
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judith Bass
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Wietse Tol
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
43
|
Robust Identification of Alzheimer's Disease subtypes based on cortical atrophy patterns. Sci Rep 2017; 7:43270. [PMID: 28276464 PMCID: PMC5343676 DOI: 10.1038/srep43270] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/19/2017] [Indexed: 02/08/2023] Open
Abstract
Accumulating evidence suggests that Alzheimer's disease (AD) is heterogenous and can be classified into several subtypes. Here, we propose a robust subtyping method for AD based on cortical atrophy patterns and graph theory. We calculated similarities between subjects in their atrophy patterns throughout the whole brain, and clustered subjects with similar atrophy patterns using the Louvain method for modular organization extraction. We applied our method to AD patients recruited at Samsung Medical Center and externally validated our method by using the AD Neuroimaging Initiative (ADNI) dataset. Our method categorized very mild AD into three clinically distinct subtypes with high reproducibility (>90%); the parietal-predominant (P), medial temporal-predominant (MT), and diffuse (D) atrophy subtype. The P subtype showed the worst clinical presentation throughout the cognitive domains, while the MT and D subtypes exhibited relatively mild presentation. The MT subtype revealed more impaired language and executive function compared to the D subtype.
Collapse
|
44
|
A comparison of theoretical and statistically derived indices for predicting cognitive decline. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 6:171-181. [PMID: 28275699 PMCID: PMC5328960 DOI: 10.1016/j.dadm.2016.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Both theoretical and statistically derived approaches have been used in research settings for predicting cognitive decline. METHODS Fifty-eight cognitively normal (NC) and 71 mild cognitive impairment (MCI) subjects completed a comprehensive cognitive battery for up to 5 years of follow-up. Composite indices of cognitive function were derived using a classic theoretical approach and exploratory factor analysis (EFA). Cognitive variables comprising each factor were averaged to form the EFA composite indices. Logistic regression was used to investigate whether these cognitive composites can reliably predict cognitive outcomes. RESULTS Neither method predicted decline in NC. The theoretical memory, executive, attention, and language composites and the EFA-derived "attention/executive" and "verbal memory" composites were significant predictors of decline in MCI. The best models achieved an area under the curve of 0.94 in MCI. CONCLUSIONS The theoretical and the statistically derived cognitive composite approaches are useful in predicting decline in MCI but not in NC.
Collapse
|
45
|
Application of Latent Variable Methods to the Study of Cognitive Decline When Tests Change over Time. Epidemiology 2016; 26:878-87. [PMID: 26414855 DOI: 10.1097/ede.0000000000000379] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The way a construct is measured can differ across cohort study visits, complicating longitudinal comparisons. We demonstrated the use of factor analysis to link differing cognitive test batteries over visits to common metrics representing general cognitive performance, memory, executive functioning, and language. METHODS We used data from three visits (over 26 years) of the Atherosclerosis Risk in Communities Neurocognitive Study (N = 14,252). We allowed individual tests to contribute information differentially by race, an important factor to consider in cognitive aging. Using generalized estimating equations, we compared associations of diabetes with cognitive change using general and domain-specific factor scores versus averages of equally weighted standardized test scores. RESULTS Factor scores provided stronger associations with diabetes at the expense of greater variability around estimates (e.g., for general cognitive performance, -0.064 standard deviation units/year, standard error = 0.015, vs. -0.041 standard deviation units/year, standard error = 0.014), which is consistent with the notion that factor scores more explicitly address error in measuring assessed traits than averages of standardized tests. CONCLUSIONS Factor analysis facilitates use of all available data when measures change over time, and further, it allows objective evaluation and correction for differential item functioning.
Collapse
|
46
|
Rawlings AM, Bandeen-Roche K, Gross AL, Gottesman RF, Coker LH, Penman AD, Sharrett AR, Mosley TH. Factor structure of the ARIC-NCS Neuropsychological Battery: An evaluation of invariance across vascular factors and demographic characteristics. Psychol Assess 2016; 28:1674-1683. [PMID: 26963590 DOI: 10.1037/pas0000293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Neuropsychological test batteries are designed to assess cognition in detail by measuring cognitive performance in multiple domains. This study examines the factor structure of tests from the ARIC-NCS battery overall and across informative subgroups defined by demographic and vascular risk factors in a population of older adults. We analyzed neuropsychological test scores from 6,413 participants in the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) examined in 2011-2013. Confirmatory factor analysis (CFA) was used to assess the fit of an a priori hypothesized 3-domain model, and fit statistics were calculated and compared to 1- and 2-domain models. Additionally, we tested for stability (invariance) of factor structures among different subgroups defined by diabetes, hypertension, age, sex, race, and education. Mean age of participants was 76 years, 76% were White, and 60% were female. CFA on the a priori hypothesized 3-domain structure, including memory, sustained attention and processing speed, and language, fit the data better (comparative fit index [CFI] = 0.973, root mean square error of approximation [RMSEA] = 0.059) than the 2-domain (CFI = 0.960, RMSEA = 0.070) and 1-domain (CFI = 0.947, RMSEA = 0.080) models. Bayesian information criterion value was lowest, and quantile-quantile plots indicated better fit, for the 3-domain model. Additionally, multiple-group CFA supported a common structure across the tested demographic subgroups, and indicated strict invariance by diabetes and hypertension status. In this community-based population of older adults with varying levels of cognitive performance, the a priori hypothesized 3-domain structure fit the data well. The identified factors were configurally invariant by age, sex, race, and education, and strictly invariant by diabetes and hypertension status. (PsycINFO Database Record
Collapse
Affiliation(s)
- Andreea M Rawlings
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | | | - Laura H Coker
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine
| | - Alan D Penman
- Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center
| |
Collapse
|
47
|
Vivot A, Power MC, Glymour MM, Mayeda ER, Benitez A, Spiro A, Manly JJ, Proust-Lima C, Dufouil C, Gross AL. Jump, Hop, or Skip: Modeling Practice Effects in Studies of Determinants of Cognitive Change in Older Adults. Am J Epidemiol 2016; 183:302-14. [PMID: 26825924 DOI: 10.1093/aje/kwv212] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 08/10/2015] [Indexed: 12/31/2022] Open
Abstract
Improvements in cognitive test scores upon repeated assessment due to practice effects (PEs) are well documented, but there is no empirical evidence on whether alternative specifications of PEs result in different estimated associations between exposure and rate of cognitive change. If alternative PE specifications produce different estimates of association between an exposure and rate of cognitive change, this would be a challenge for nearly all longitudinal research on determinants of cognitive aging. Using data from 3 cohort studies-the Three-City Study-Dijon (Dijon, France, 1999-2010), the Normative Aging Study (Greater Boston, Massachusetts, 1993-2007), and the Washington Heights-Inwood Community Aging Project (New York, New York, 1999-2012)-for 2 exposures (diabetes and depression) and 3 cognitive outcomes, we compared results from longitudinal models using alternative PE specifications: no PEs; use of an indicator for the first cognitive visit; number of prior testing occasions; and square root of the number of prior testing occasions. Alternative specifications led to large differences in the estimated rates of cognitive change but minimal differences in estimated associations of exposure with cognitive level or change. Based on model fit, using an indicator for the first visit was often (but not always) the preferred model. PE specification can lead to substantial differences in estimated rates of cognitive change, but in these diverse examples and study samples it did not substantively affect estimated associations of risk factors with change.
Collapse
|
48
|
Clerici F, Ghiretti R, Di Pucchio A, Pomati S, Cucumo V, Marcone A, Vanacore N, Mariani C, Cappa SF. Construct validity of the Free and Cued Selective Reminding Test in older adults with memory complaints. J Neuropsychol 2015; 11:238-251. [DOI: 10.1111/jnp.12087] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 09/16/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Francesca Clerici
- Centre for Research and Treatment on Cognitive Dysfunctions; Institute of Clinical Neurology; Department of Clinical Sciences; ‘Luigi Sacco’ Hospital; University of Milan; Italy
| | - Roberta Ghiretti
- Centre for Research and Treatment on Cognitive Dysfunctions; Institute of Clinical Neurology; Department of Clinical Sciences; ‘Luigi Sacco’ Hospital; University of Milan; Italy
| | - Alessandra Di Pucchio
- National Centre for Epidemiology; Surveillance and Health Promotion; National Institute of Health; Rome Italy
| | - Simone Pomati
- Centre for Research and Treatment on Cognitive Dysfunctions; Institute of Clinical Neurology; Department of Clinical Sciences; ‘Luigi Sacco’ Hospital; University of Milan; Italy
| | - Valentina Cucumo
- Centre for Research and Treatment on Cognitive Dysfunctions; Institute of Clinical Neurology; Department of Clinical Sciences; ‘Luigi Sacco’ Hospital; University of Milan; Italy
| | | | - Nicola Vanacore
- National Centre for Epidemiology; Surveillance and Health Promotion; National Institute of Health; Rome Italy
| | - Claudio Mariani
- Centre for Research and Treatment on Cognitive Dysfunctions; Institute of Clinical Neurology; Department of Clinical Sciences; ‘Luigi Sacco’ Hospital; University of Milan; Italy
| | - Stefano Francesco Cappa
- Institute for Advanced Study IUSS; Pavia Italy
- Division of Neuroscience; San Raffaele Scientific Institute; Milan Italy
| |
Collapse
|
49
|
Tripodis Y, Zirogiannis N. Dynamic Factor Analysis for Multivariate Time Series: An Application to Cognitive Trajectories. INTERNATIONAL JOURNAL OF CLINICAL BIOSTATISTICS AND BIOMETRICS 2015; 1:001. [PMID: 26753177 PMCID: PMC4704801 DOI: 10.23937/2469-5831/1510001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We propose a dynamic factor model appropriate for large epidemiological studies and develop an estimation algorithm which can handle datasets with large number of subjects and short temporal information. The algorithm uses a two cycle iterative approach for parameter estimation in such a large dataset. Each iteration consists of two distinct cycles, both following an EM algorithm approach. This iterative process will continue until convergence is achieved. We utilized a dataset from the National Alzheimer Coordinating Center (NACC) to estimate underlying measures of cognition based on a battery of observed neuropsychological tests. We assess the goodness of fit and the precision of the dynamic factor model estimators and compare it with a non-dynamic version in which temporal information is not used. The dynamic factor model is superior to a non-dynamic version with respect to fit statistics shown in simulation experiments. Moreover, it has increased power to detect differences in the rate of decline for a given sample size.
Collapse
|
50
|
Weiner MW, Veitch DP, Aisen PS, Beckett LA, Cairns NJ, Cedarbaum J, Green RC, Harvey D, Jack CR, Jagust W, Luthman J, Morris JC, Petersen RC, Saykin AJ, Shaw L, Shen L, Schwarz A, Toga AW, Trojanowski JQ. 2014 Update of the Alzheimer's Disease Neuroimaging Initiative: A review of papers published since its inception. Alzheimers Dement 2015; 11:e1-120. [PMID: 26073027 PMCID: PMC5469297 DOI: 10.1016/j.jalz.2014.11.001] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/18/2013] [Indexed: 01/18/2023]
Abstract
The Alzheimer's Disease Neuroimaging Initiative (ADNI) is an ongoing, longitudinal, multicenter study designed to develop clinical, imaging, genetic, and biochemical biomarkers for the early detection and tracking of Alzheimer's disease (AD). The initial study, ADNI-1, enrolled 400 subjects with early mild cognitive impairment (MCI), 200 with early AD, and 200 cognitively normal elderly controls. ADNI-1 was extended by a 2-year Grand Opportunities grant in 2009 and by a competitive renewal, ADNI-2, which enrolled an additional 550 participants and will run until 2015. This article reviews all papers published since the inception of the initiative and summarizes the results to the end of 2013. The major accomplishments of ADNI have been as follows: (1) the development of standardized methods for clinical tests, magnetic resonance imaging (MRI), positron emission tomography (PET), and cerebrospinal fluid (CSF) biomarkers in a multicenter setting; (2) elucidation of the patterns and rates of change of imaging and CSF biomarker measurements in control subjects, MCI patients, and AD patients. CSF biomarkers are largely consistent with disease trajectories predicted by β-amyloid cascade (Hardy, J Alzheimer's Dis 2006;9(Suppl 3):151-3) and tau-mediated neurodegeneration hypotheses for AD, whereas brain atrophy and hypometabolism levels show predicted patterns but exhibit differing rates of change depending on region and disease severity; (3) the assessment of alternative methods of diagnostic categorization. Currently, the best classifiers select and combine optimum features from multiple modalities, including MRI, [(18)F]-fluorodeoxyglucose-PET, amyloid PET, CSF biomarkers, and clinical tests; (4) the development of blood biomarkers for AD as potentially noninvasive and low-cost alternatives to CSF biomarkers for AD diagnosis and the assessment of α-syn as an additional biomarker; (5) the development of methods for the early detection of AD. CSF biomarkers, β-amyloid 42 and tau, as well as amyloid PET may reflect the earliest steps in AD pathology in mildly symptomatic or even nonsymptomatic subjects and are leading candidates for the detection of AD in its preclinical stages; (6) the improvement of clinical trial efficiency through the identification of subjects most likely to undergo imminent future clinical decline and the use of more sensitive outcome measures to reduce sample sizes. Multimodal methods incorporating APOE status and longitudinal MRI proved most highly predictive of future decline. Refinements of clinical tests used as outcome measures such as clinical dementia rating-sum of boxes further reduced sample sizes; (7) the pioneering of genome-wide association studies that leverage quantitative imaging and biomarker phenotypes, including longitudinal data, to confirm recently identified loci, CR1, CLU, and PICALM and to identify novel AD risk loci; (8) worldwide impact through the establishment of ADNI-like programs in Japan, Australia, Argentina, Taiwan, China, Korea, Europe, and Italy; (9) understanding the biology and pathobiology of normal aging, MCI, and AD through integration of ADNI biomarker and clinical data to stimulate research that will resolve controversies about competing hypotheses on the etiopathogenesis of AD, thereby advancing efforts to find disease-modifying drugs for AD; and (10) the establishment of infrastructure to allow sharing of all raw and processed data without embargo to interested scientific investigators throughout the world.
Collapse
Affiliation(s)
- Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
| | - Dallas P Veitch
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Paul S Aisen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Laurel A Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Nigel J Cairns
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jesse Cedarbaum
- Neurology Early Clinical Development, Biogen Idec, Cambridge, MA, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - William Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Johan Luthman
- Neuroscience Clinical Development, Neuroscience & General Medicine Product Creation Unit, Eisai Inc., Philadelphia, PA, USA
| | - John C Morris
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | | | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Li Shen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Adam Schwarz
- Tailored Therapeutics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Arthur W Toga
- Laboratory of Neuroimaging, Institute of Neuroimaging and Informatics, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - John Q Trojanowski
- Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Udall Parkinson's Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|